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r� �.. <br />APPLICATION FOR CONSTRUCTION <br />PERMIT <br />rlle Everpreen pyp�p�1 <br />��T�oF e <br />everett <br />BUILDING DEPARTMENT <br />259•8810 TO BE COMPLETED IN INK— PLEASE PRINT <br />�HEq �IAILFU�R[55 C�iY LP PMONE <br />�'a.n � S.� �SSo,f% �-��� �-�w� � ei2c� LG�� �/ .Z..�.Z- 3 y L <br />.,, e��q� i,v z�N rHone <br />PLUMBINGCUNiRPGiOR MFILAO�RE55 GRV ZIP PNDNE LIf,ENSE• <br />IYNEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑'rVOODS�OVE/PPPL INSERT ❑ BUILDING RELOCATION <br />LOT� BLOLR OF <br />PlUM81NG <br />WATER <br />DISP. <br />PREVENTERS <br />VS - RAINLEA <br />CE - BAR, ETI <br />� <br />OR ITEM <br />�� � � v� <br />iYPEOFGONSi � OCLUPANCYGR( <br />ALLOW�BLEIACTUAL 1/- � 1 n � <br />n� �� <br />SIZEOF9LDG. NOAFSTOPIES <br />216(0 �yF %` / <br />6L4'✓/ V/!/�R�J _/ <br />FIRFSPPINKlER5RE0UIRE� ❑VE$ �N� <br />F <br />� <br />� <br />5 >` <br />S <br />S � <br />� � SIOE SEiBAGR � � <br />� <br />VACANT SITE <br />i VES ❑ NO <br />NOAF OWELLING UNIt; <br />/ <br />BSMi. OCG LOADA' <br />Y 'y� <br />❑N <br />HE�GHT UMITALION <br />28 <br />I HERE6YCERTIFY'HAT I HAVC READ AND E%AMINEDTHISAPPLICATION AND <br />KNOW 7HE SAM E 70 BE 7r7UE AND CORRECT. ALL PROVISIONS OF LAWS AND <br />ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLETED WlTfi <br />WHE7MERSPECIFIEDHEREIN OR NOT. THEGRANTINGOFAPERMIT DOES NOT <br />PRESUME TO GIVE AUiHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PER� <br />FORMANCE UF CONSTRUCiION. THAT I AM AUiHORIZEO BY THE OWNER OF <br />TIilS PROPER7Y TO PERFORM TH E\NORK FOR W HICH APPLICATION IS MAOE <br />AND I COMPLY WITH THE STATE CONTRACTORS LAW 18.2,7 RCW NO <br />296.200 WAC. //� <br />SiGNAIUREUFCONiPACiOnqa UDIORILEDNGE41 �ni[ <br />APPUGa SQ1�Z�55 CE SCNOANOB SI SSNnME <br />MECHANICAL <br />NO. TVPE OF EOUIP: <br />A/C- A/HNDLG UNITS- M.F <br />FORCED AIR SYSTEMS - 8.T <br />UNITHEATERS-B.T.U. M <br />FAN <br />8 CHIMNEY <br />SUB <br />FEES <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />STATE BUILDING SURCHARGE <br />STATE ENEFGV SURCHARGE <br />PUBIIC WORKS <br />TOTAL <br />M EA <br />S fj ' _ <br />ffi <br />--r — <br />5 " � � <br />pEGEIPf NO. <br />5 <br />FEE <br />l� , i..-� i-- / <br />� <br />