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APPLICi�ION FOR CONSTRI..:T10N <br /> PERMIT <br /> Ma E�erp�een <br /> CITY OF evrmtt <br /> everett e <br /> BUILDING DEPARTMENT <br /> 259•8810 TO BE COMPLETED IN INK- PLEASE PRINT <br /> pry MAILPOORE55 G�iV :iP PMONE <br /> � k_ �-�"h!— %-�--T-� i.,nniY,4,i7,� l �v�E7 7�?:3 7S�- �7�'.3 <br /> IEN�NT ti�A�L/�DflE55 CITY 21P PNONE <br /> RRf�11TECTONDE516N[R MAILADOPE55 CIIY ZIP FHONE <br /> i i,tiC�1�i �oaa z7�-�-- ��/3v tv�-k�T/- �'��u i aS� - �ga� <br /> GENEPA CO TP�CTOR MnILADDNE55 CiTY 21P GNONE LiGENS ��T <br /> � � �o��n_."t...��I..�i���i�i�r�_�n=�l !- (.i-::L�ET. 1���'j .� SJ - U7a-� �"fz�Y <br /> M 'M ICALCO ifl�GTON � MAIL�ODAE55 C�1V � ZIP PNONE LILENSE� <br /> Pl11MB�NGCONTR�LTOR MnIL�DDPE55 CiIY ZIP PMONE LiGENSE• <br /> CLlSS Oi WORK <br /> �NEW ❑ aODITION ❑ ALTERATION ❑ REPAIR ❑ DEMOUTION ❑ WOODSTOVE/FRPL INS[RT ❑ BUILDING RELOCATION <br /> TENANTIMPROVEMENTORINTEPIORREMODELONLY CONTACTPERSONRNpPHONLNO <br /> � fANTRI.GTPRICEOFWORK $� E�LI�. ��A.^� 2.jZ- �I� Y3 <br /> DEBGRIBE WORK�ND SOU�RE FOOTAGE MVOLVED <br /> r <br /> ,� � - �/ <br /> PNOPOSEDUSE eui�on+o IHEREBVCERTIFY?HATIHAVEREADANDExAMINEDTHISAFPLICATIONAND <br /> �e`�� 61�J�—C KNOWTHESAME70BETRUEANDCORRECLALIPROVISION50FLAWSAND <br /> IEWL�ESCRIPTIONOF PROPERTYISHUWN BELOW OPRTT�GM FOUN WPIE51 ORDINANCES GOVERNING THIS T'PE OF WORK WILL BE COMPLE7E0 WITH <br /> WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OFA PERMIT DOES NOT <br /> �1 � PRESUME TO GIVE HUTHORIT'TO VIOLA7E OR CANCEL THE PROVISIONS OF <br /> �ot `� B�ocK� OF ^ � ANYOTHERSTATEORLOCALLAWREGULA7INGCONSTRUCTIONORTHEPEF� <br /> FORMANCE OF CONSTRUCTION.THAT I AM AUTHORILED BY THE OWNER OF <br /> �� _- u THISPROPERNTOPERFORMTHEWORKFORWHICHAPPLICATIONISMADE <br /> AND I COMPLY WITH THE STATE CONTRACTORS LAW 1827 RCW AND <br /> 296200 WAC. <br /> SIGNAiIIREOFLONiRAGTOR PUfHOR12E�PGENT CATE <br /> x � .. �- 3 - �9 <br /> PPOJECT�DORESS T nPPLIGqNJip USME �GEN N .PNOBUSiNE55NnME <br /> �� ��� �{ <br /> PLUMBIN6 MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> ,3 WATERCLOSET(TOILEn � NC—A/HNDLGUNITS—H.P. <br /> J BATHTUB — PORCED AIR SYS7EMS—B.T.U. M EA '— <br /> LAVATORY�WASHBASIN� � UNITHEATERS—B.T.U. M <br /> SHOWER - � CLOTHES DRYERS <br /> KITCHEN SINKB DISP. � VENTILATION FAN � � <br /> / DISHWASHER l RANGE HOOD �� <br /> LAUNORYTRAY � WATER HEATER r J <br /> CLOTHES WASMER � WOOD STOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEY � <br /> DRINKIN6 FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTEiiS GAS PIPIN� <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC I <br /> SUBTOTAL 5 � SUBTOTAL �_ 5 ;.� <br /> PEfiMIT 5 '� PERMIT 5 <br /> TOTAL FEE 5 — TOTAL FEE 5 `'- <br /> FRONISETB�GN PE�RSEfBACK SIOESETBAGK PUNLNECI(NUMBEN FEE PECEIPTMO. <br /> �� � � � ' �� a� �3�- �o��- <br /> use�Zpp ne �ornaen V���LLLANTSITE FEES VALUATION FEE <br /> C"� `1 p�i5 ❑NO ��! <br /> {�� � BUILDING �s Z Z (J � C�(ti/ �% <br /> ttPEOfCANST. OCCUPANGYGROUP NOOFpWEL41NGUNrtS <br /> ALLOWABlEMG1UAL �� _ � / PLUMBING ) � <br /> SREOFBLDG NO.OiSTORIES �T. OCCLOAD MECHANICAL ; � <br /> � — � � <br /> N I � � <br /> Si3 �,i,A,�,� IIEiGHTLI,IlATION OTHER�� <br /> LU43 )ci�• �8 — . <br /> r;ne�5vair�K�,dSnwweeo ❑ves rvo STATE�WLDINGSURCHARGE ` �i) <br /> STA7E ENERGV SURCIIARGE <br /> APP4GRTIONACGBY FLANSRPPN.BY PUBLICWORKS � / <br /> � / ) � I <br /> � ��(� TOTAL _ ( [ <br />