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APPLICATION FOR CONSTRUCTION <br />PERMIT <br />rne e�s.v�aen <br />CITV OF <br />everett <br />BUILDING DEPARTMENT <br />259-8870 TO BE COMPLETED IN INK — PLEASE PRINT <br />OWNER IA411A00RC55 rnr zir• rnor�[ <br />/l��/�A-lU �sS����. �17oB_'�_l�[�c�—�--� ��-- p�'�6�---- `�2S'.� =337� <br />{� MAIL�GbRF55 CIiV ZIP PIION4 <br />�P�er(� <br />"___ _ _."__.______ —__ <br />�CGIIITEGTORDESIGN[R M�ILADO�E55 CIiY IIP PIIONE <br />S�c-r � — "-"__ __— _" _ __-_ — <br />GENEF4CONTR�CTOR M411.ADOR[55 G1Y ZIP� PIION[ LILCNSE• <br />�a. �Q_ �_{��<'����� <br />MECN�NIC�ICONiHAGiOR MAII �ODRESS GITY ZiP �MONE LICCNSE • <br />PLUMB�NOCANTF�GTOR MMI ADOR[55 --"� � GITY ZIP --� PIIONE lIC[NSE � <br />GUSS OF WORN ---� <br />❑ NEW ❑ ADDITION ❑ ALiERATION ❑ P@PAIF � <br />TEN�NIIMPNWEMENTORIMERIORRCMODE� VI� <br />CONPUCT VWICE OF WORK _ <br />DF.� NiBEWORrcAND50U�REfOOT�GEINVOIVE� �/ <br />'��� s"^s, C: Fi �— �)`'' <br />PRO OSED Uu � O: BUiIDM� / <br />W G1 <br />lEOeL DE9CHIPfION OF PROPERiV ISIIOWN BEIOW � H ATTICN FOUR CDPnIES� <br />�OTlf—= e�oCn�-L�– or _ r � �_ �S �___/ a / .._ /� /F' _'_" <br />/L��. <br />/� (� <br />��– .� I �_J' �� ,O %i�. (}'.- � \ � <br />DEIAOLITION ❑ WOODSIOVElFRPL WSERT ❑ dUI1.DING RELOCATION <br />GONTACiPCR50NFNOVHONENO <br />PROJELI�D�RE55 . --�–/ –...��– � �� � � � � � –�—_���� <br />. "� % �� � �� �U�/ . .✓�. <br />PLUMlIN6 <br />N� <br />WATER CLOSE <br />BATHTUB <br />SHOWEfi <br />OFITEM � FEE <br />_–.__– I– ___ .. _ I – _. <br />DRINKINGFOUNTAW ___ .___ —_ <br />FLOORDRAIN '__,_.-- '– __'_ –_ <br />BACKFLOW PREVENTERS __ <br />FOOFDRAINS–AAWLEAD[RS ,_, .. <br />SINKISERVICE=BAR,ETC�� __ . <br />RNE SPRINNlERS <br />5�0 <br />I HEPEBV CERTIFY T I1AT I IiAVE READ AND E%AMINED T1115 APPLICATION AND <br />KNO W?NE S�ME TO dE TfiUE AND CORPECT. ALL PROVISIONS OF LAWS AND <br />ORDINANCES GOVERNING THIS TYPE OF WOFK WILL BE COMPLETED WITH <br />WMET HEfi SP[GFlED HEPEIN OR NOT. TME GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTh10RITV lO VIOLATE OR CANCEL TME PROVISIONS OF <br />ANY O711E R STA1 E ON l OCAL LAW REGULA7ING GUNSiRUCT10N OR 1 HE PER� <br />iORMA1JCE. OF CONSTHUCTION THAT I AM AUTHORIZED BY THE OWNER OF <br />7HIS PROPERTV TO PERFORM THE WORK FOR WHICM APPLICATION IS MADE <br />AND I COAIPLV WITH THE STAiE CONTRACTORS LAW 1827 RCW AND <br />296 200 WAC � .7 �� 0 �.� <br />SGNRiURLO�GUfl1NRL1ur�I111R1111NRIZ6DPGENi �AIE f'� <br />X � /�'� �� <br />.r��rv�cirrulisiiss1�fCnscriou+ euswc"ss�Me–�-----_— <br />! <br />MECNANICRL <br />NO. TYPE OF EOUIPMENT <br />A/G -A/��NDI.GUNITS–HP. _ <br />FORCEDAIRSVS7EM5-9TU. MEA _ <br />�UNITIIEATERS�-BTU. M <br />CLOTHESDRYEHS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER IIcATEfl <br />WOOD STOVE <br />METAL FIRLPLACE b CHIMNEV <br />FIRBPLACEINSERT <br />. _ __ _ –__– _.–_ <br />HBAT PUh1P <br />. .. _ _._.. . __. _ . _._ _—__ <br />GAS PIPIIJG . . ..______. ..___' <br />E%HAUSTFAN ___.__ <br />----_ I_ _ ---1--1-=1-= <br />$1=-==1=-1=- <br />_-"� KYES 1.1 NO <br />� yY� <br />OGGUPANCYGRO�P NOOFDWEIIII <br />Q' � <br />NO OF STORIFS esut. occ iono <br />nr <br />I1 N <br />HEIG111lIMITPT <br />❑ YF.S ❑ NO <br />FEES <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTIIER <br />FEE <br />_ __ <br />su e rorni <br />PEPMIT <br />TOTALFEE <br />STATE BUILDING SUiiCHARGE <br />STATE ENERGV SURCHARGE <br />PU ILIC WORKS <br />TOTAI <br />FEE <br />