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APPLIC..TION FOR CONSTRI.CTION <br />PERMIT <br />fhe Evergreen �we�e <br />CITY OF � <br />everett <br />BUILDING DEPARTMENT <br />259•8810 TO BE COMPLETED IN INK— PLEASE PRINT <br />OWNER M411.AU�RE55 Gil ZIP P�IONL <br />��- ��-�����;��5 cflo I _ �e'� rn�;,ay ��! :,e,�t{--�7Frao3 _ ��3 =�� <br />IEN�NT <br />- _.____"-_ _ .. <br />�OGIIITECfONDE5IGNER M�IL<pMi4S5 <br />GENER�IGONiPACLOR nuil.A����CSS <br />CIIY L11' PIIONL <br />_. _" _ — . _ _ . _ _. _. "'. <br />- (:IIV 11P PIIDNE IICF.NS[� <br />_—"_ __ <br />M CII�NIG�LCONLR�CfOR A1411 �f10F1:tl5 . . . CIIY * !II• . . PIIONL �-- ... _._. -- �IICENSE� i <br />�,,,1�I,1^ ,,�^AYu���My�s 3Fs1 p � �i �a -" �4_ �_�'. ��.���c,�S_ �._ VtiVI_��l43�0 � <br />1S3d�L-�- - Mn -Fn��' '----' nir zm r�ny([ �-uccr+se.— <br />PLIIMBI GLONiPACTOR � "O-'��/�' T�}(•/�(4�37KS <br />. . .... ____— _ IL_t__ V <br />CLASSOFWONK —___._.._. ._-_ __.. _'_ _ _..._"____—_ <br />❑ NEW ❑ ADOITION �A�TENATION ❑ BEPAIH _I� DEMOLI710N ❑ WOOUSIOVE/FHPLINSEHT_❑ Bl11LDINGNELOCATION __ <br />TEN�NTIMPROVEMEi1fORIMERiOBRf:1.100ElONLV------ — IIO�II+CiPEfi50NPN�P110NCN0 <br />GONTR�CTPF�GEOFWORK. _.___"_ _.___." . ___---______--_ —_-- — I <br />�or e�ocn__—_ oF <br />s c� � � c��� o►�� _a.v_-� --- <br />PROJECT�DDPE55 • � <br />PIUMBINO <br />NoT- <br />KITCHEN <br />�uowse�ei�crun� <br />FlRESPPINKIEPS <br />FIXTUNE OH <br />PREVENTERS <br />dC— GAINI EO <br />sue <br />❑ YE$ ❑ NO <br />FEE <br />_ $ .._-._-_ <br />$ -__- <br />S <br />SIO[ 5[IB�CN <br />WLANL 511[ <br />ll YCS 11 NO <br />lp NOOFDWELIINGUNI <br />esMr. occ io>o <br />❑Y <br />❑N <br />HEIGIITlIlA1TAT10N <br />�PPIICATIDNI.CGBY PI�NS�PPflOV — <br />_�'_�__ ._"_.__.—'__'_—_ <br />I I IE REBY CERI IFY THAT I I IAVE READ AND E%FMINED THIS APPLICATION AND <br />KNOW `� �E SAME TO BE 7PUE AND CORRECT. ALL PROVISIONS OF LAWS AND <br />ORDINANCES GOVERNING 71{IS TYPE OF WORK WILL BE COMPLEiED WITH <br />W11ET H ER SPECIFIED I�IEREIN OR NOT. THE GRnNTING OF A PERMIT �OES NOT <br />PRE511A1E TO GIVE Al1THORIN TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY Ol11LH S7A7 E UR IACAL LAW FEGUI.ATING CONSTRUCTION OR THE PER- <br />FORMANGE OF CONSTRUCTION. 7HAT I AM AUTHORIZED BV THE OWNER OF <br />u IIS PFiOPERI Y TO PEfiFOHM 111E WGRK FOR W HICH APPLICATION IS MADE <br />AN� I COMPI.Y Wlill 711E STATE CONTRACTORS LAW 7827 fiCW AND <br />29' 200 WAC <br />: :NMIII�I: 'ON Al:lulluNAl1111O II�G[ llAlE <br />o� � � A��� ,gl�l� <br />APPI <br />MECHANICAL <br />Nq, TYPEOFEOUIPMENT <br />A/C-- A/11ND�G UNITS- HP <br />' FORCEDAIRSYSTFMS�-BT.U�C <br />UNI711LATLRS-B7U M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />JJATER HEPTER <br />WOOD STOVE <br />ME7AL FIREPLACE 8 <br />FIREPLACEINSERT <br />HEAi PUMP <br />GAS PIPING <br />E%HAUSTFAN <br />ree <br />_ _ _'_ __ <br />_ ___._ _.___SUBTOTAL . _'_§. ____ <br />— -- - --' --� PEHA7IT S �C <br />_'_____ ._"_ .____. _'_—."______-___ <br />TO7Al FEE $ �J <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />STATE BUILDING SURCHANGE <br />STATE ENERGV SURCIIARGE <br />PUI3LIG WORKS <br />TOTAL <br />FEE <br />