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f�s Erorprssn <br />CITV OF <br />everett <br />BUILDING DEPARTMENT <br />259-8810 <br />� �ice <br />APPLIC.♦TION FOR CONSTRuCT10N <br />PERMIT <br />TO BE COMPLETED IN INK — PLEASE PRINT <br />���ifC�/ R'J/(/ �- 23'2 — <br />•RCHITEGTOPOESIGNEN M�RAODRESS CILY ZIP PNONE <br />Soan d <br />everett <br />e <br />' � LICENSE • <br />'oM,.'.r�/.�6,C,N <br />VLUMBINpCONTp�GTON MMIADORE55 CrtY 2iP PNONE UCENSE• <br />❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVFJFRPLINSERT ❑ BUILOIN�RELOCATIOV <br />CONTIUCT PRICE OF WORK <br />//�UV <br />LOT BLOGN �� OF <br />� 'S r � c/�IOL/JS /iz�� <br />y LD/�' � <br />F�� <br />arr f �cx �z - : <br />PLUMBINO <br />j' JuM�r iT <br />LAVATORY <br />SHOWER <br />KITCHEN 1 <br />DRRINS— <br />ccwvirF _ <br />- eooy <br />SUBTOTAL 5 <br />PERMIT $ <br />TO7'AL FEE S <br />�RONTSET�ACI( RE�RSF&1CK Si0E5ET8I�,n <br />� `� ' <br />USE20NE LOT�REA WCRNi51TE <br />R_ � � � - ` � ❑ YES ❑ NO <br />:� <br />IYVEOFCONST. OCCUPANCYGROUP NOOFOWELLII <br />�«�,.a«,.�t�.� .-3 I <br />SRE OF HO. Of STORIES BSMT. OCG LOAO <br />C `�t� �� °� �( <br />MEIGHT LIA11T�1 <br />FIRESPRINKLERSREOUIRED ❑YES lINU ' <br />APPLICRION �GG BY PUNS� -By <br />4� <br />�l �S/9 3 <br />I HEREBV CEIiTIFV THAT I HAVE READ AND E%AMINED THIS APPLICRTION AND <br />KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS ANO <br />ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLETED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OFA PERMIT DOES NOT <br />PRESUME TO GIVE AUTFiOR17V TO VIOLRTE OR CANCEL THE PROVISIONS OF <br />ANV OTHER STATE OR LOCAL LAW REG;'LATING CONSTFUCTION OR THE PER� <br />FORMANCE OF CONS7FUCTION. TMAT I AM AUTHORIZED BV THE OWNER OF <br />THIS PROPERTV TO PERfORM THE WORK FOR WHICH APPLICATION IS MADE <br />AND I COMPLY WITH 7HE STATE CONTRACiORS LAW 1827 RCW AND <br />286.200 WAC. <br />$IGNATU FGONTRACTOROPAUTHORREDAGENi UATE <br />X �� /�/i'G�.��-� �-a'f�z', <br />A/C — NHNDLG UNITS — H.P. <br />FORCED AIR SYS7EM5— B.T.U. <br />UNITHcA7ERS-9T.U. M <br />CLOTHESORYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIMNEV <br />HEAT <br />GASI <br />SUB TOTAL <br />PERMIT <br />TOTAI FEE <br />FEE/j ,^ <br />/O.dV <br />BUILDING <br />PLUMBIN3 <br />MECHANICAL <br />OTHER <br />STATE BUILDING SURCHARGE <br />STATEENERGYSURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />S <br />FEE <br />