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APPLICA.ION FOR CONSTRU�:TION <br />RERMIT <br />Me Everpreen <br />CITV OF cvrreU <br />everett e <br />BUILDING DEPARTMENT <br />259•eSto TO BE COMPLETED IN INK— PLEASE PRINT <br />OWHEP �// AIRILAOORE55 GIIY ZIP PHONE <br />�e �� cF �%OfMA T�maH y Sd �,�o��_�vg_[-✓e��rt G/9_98zo,� 3Ss Sk� <br />TEN�NT MAllA0URE55 f.liY IIP 1'110NE <br />S �- ,9- <br />•RCMITEGTORDESIGNEN MnILApORESS LIIY ZIP P�ION[ <br />�L�� 2✓^ <br />GENENeICONTRAGTOR MnR: RE55 CItY 21P PIIONE IICENSE• <br />O (� �'L Q � <br />MEGHANIG�LCONiR�CTOR MARADDRE55 CrtY 2iP P��ONE LICENSE• <br />�"�_ <br />%UMBINOGONTR�GTOR MAILAl10R[55 CILY ZIP PIIONE LICENSE• <br />❑ NEW �. ADDITION ❑ ALTERATION ❑ REPAIR ❑ OEMOLITION ❑ WOODSTOVE/FRPLINSERT ❑ BUILDINGRELOCATION <br />._ .............._._..._... _..... � <br />CONTR�CTPRIGEOFWORK ��rfn �_ <br />. /� <br />ioT.�/�� e�ocK_�_ or _�1. _le_t'a� �----- <br />E� < � �,-�_B—pa�a4�----- <br />IWCl.1l�UUXCii " <br />�6a S Sa,.�haQ l�v¢ �v <br />PLUMBINO <br />NO. TYPEOFFI%TUREORITEM <br />WATER CLOSEI� (TOILEn <br />BATHTI�B <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DiiAIN <br />nwr vnn�rvo - <br />S�NK ISERVICE - <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />FRONTSETB�CN RGRSET04C1( <br />❑SE20N�' IOT��' <br />'S <br />TYPEOF ST. OCLIIPANGYGPOUP <br />ALLOWABLE/�Cill� - 1 � <br />IV <br />SIZEOFBl00 NOOFSiORIES 95M <br />l038' S� � �cN <br />fi E SPRiNHI ERS REOUIPEU ❑ YES f�NO _ <br />�PPLIC�TIOq \C�C��C_ 9Y PL�NS �PPNnBV <br />- '� I /- _ <br />FEE <br />I HEREBY CERTIfY THAT I HAVE READ AND EaAMINE� iH15 APPLICATION AND <br />KNO W iHE SAME TO BE iFU E AND CORRECT. ALL PFOVISIONS OF LAWS AN D <br />ORDINANCES GOVEPNING THIS LVPE OF WORK WILL BE COMPLETED WITH <br />WHETHEFiSPECIFIED HEREIN OR NOT. THEGRANTINGOFAPERMITDOESNOT <br />PRESUME TO GIVE AUTlIORIN TO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANY OTHER STATE OH I.00AL LAW REGl1LATING CONSTRUCTION OR THE PER• <br />PORMANCE OF CONSTRUCTION. fHAT I AM AUTNORIIEO BY 7HE OWNER OF <br />iH15 PROP[RTV TO PGRFORM THE WOHK FOR WHICH APPLICATION IS MADE <br />AN� I COMPLY WIIII TIIE STAT[ CONTRACTORS LAW 1827 RCW AND <br />296200 W4C. <br />$IGNAtUOFOFCONIR�CIU1111NAUI1IJBILED�G[NL I]41E <br />MECHRNICAL <br />UNIT HEPTERS- BS.U. <br />CLOTMES DRYERS <br />VENTI' ATION FAN <br />RANGE11000 <br />�-- WATERHEATER <br />WOOD STOVE <br />_ GAS PIPING <br />- EXIIAUST FAN <br />S <br />$ _-_—'_'- <br />$ _ —.__ _ _ <br />$i0[$[tOaCN PU <br />��� — l <br />( <br />V�LANi §li� <br />❑ YE$ j( NO <br />�I <br />� <br />i <br />M <br />$UB TOTAL <br />PERfAIT <br />TOTAL FEE <br />IN'NjOMBEN c FEE � <br />��� O,L� '. � <br />BUILOING <br />PLUMBING <br />MECHANICAL <br />OTHER �� <br />STATE ILDING SURCIIARGE <br />STATE tNERGY SURCMARIiE <br />PUBLIC WORKS <br />TOTAL <br />M EA <br />VALUATION <br />F7 <br />� <br />� <br />