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r� ,.�.,, <br />APPLICATION FOR CONSTR..CTION <br />PERMIT <br />Iha Everpreen <br />CITY OF evcrett <br />everett e <br />BUILDING DEPARTMENT <br />259-B810 TO BE COMPLET'�D IN INK— PLEASE PRINT <br />OWNER MAILAD�RE55 GiiY ZIP PMONE <br />%iLHNk" N �'lfla-K' /i��.�,�f�r_, /?o. ii:,l:ra`( �"vc,�'c77 �x.f �i'��,, -.:/%,{`�. <br />TENANL MAILR��RE55 CrtY 21P PNONE <br />%J 1!/ L�� <br />� S�%'O � �f �f <br />UCENS[• <br />� t ..._ _ ./ •r �r.-, <br />PLUMBINGCONTRACTOR MAILRODPE55 GTY ZIF P110NC UC[NS[• <br />� NEN' ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPI INSERT ❑ BUIIDING FELOCATION <br />TENANT IMPROVEMENi OR INiERIOR FEM�OO�E/�L ONLY/ GONiACT PEFSON AN� PNONE NO / <br />CANiRAGTPRICEOFWORK L[J�J)L.L-L.J^ _ �LG C �L�/LR �"��'�'-�%�I. <br />C. <br />LEGAL pESCR�PTION OF PROPERTV ('iMOY <br />' LOi�J��'' BLOCK-l1— OF <br />LufS -x'�./..�<�, � <br />; /�'it/olirs ' �� �:e�ro' , <br />i, f <HT �'� Bic..'H� /"r_-C< <br />�� y'LM13 l3�ad � :�i/_ letH� <br />A'' :�: s� -%!':'' f t_= <br />PLUMBIN6 <br />SNOWER <br />KITCHEN SINK 8 <br />DISHWASHER <br />LAUNDRYTRAV <br />CLOTHES WASH <br />URINAL <br />3 <br />� <br />� <br />P <br />--�z <br />TVP OFGONSi <br />♦LLOWABLb�CT <br />�`-N <br />- SIZEOfBLDG. <br />� 1�.r7 <br />RR�� NNLERSREOUIR <br />RPPLICPTION AGG. BY <br />� <br />FIXTURE 011 <br />— RAINLEA�ERS <br />— BAR,E7C1 <br />nJ <br />TOTAL FEE <br />iSEiBACK <br />�o i <br />�E�'` <br />� (�0 <br />UPANCVGROUP <br />IZ- � <br />)FSiOR�ES 65M <br />❑r <br />I �yr N <br />� <br />c?i_ <br />� <br />� <br />I HEREBV CERTIFY THAT 1 HAVE READ AND E%AMIN EO THIS APPLICATION AND <br />KNOW'HE SAME TO BE TRUE AND CORRECi. ALL PROVISIONS OF LAWS AND <br />ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLETED WITH <br />WHETHEFSPECIFIEDHEREINORNOT.THEGP \NTINGOFAPERMITDOESNOT <br />P�ESU1dE TO GIVE AUTHORITY TO VIOLATE O�� CANCEL THE PROVISIONS Of <br />ANY OTH ER STATE OR LOCAL LAW REGULATINIi CONSTPUCTION OR THE PER� <br />FORMANCE OF CONSTRUCTION. THAT I AM AUTHORI2ED 9Y THE OWNER OF <br />THIS PROPERTY TO PERFORM THE WORK FpR WHICHAPPLICATION IS MADE <br />AND I COMPLV WITH THE STATE CONTRACTORS LAW 1827 RCW AND <br />296200 W4C. <br />SIGNA1��11lijj O,�/CONiRAC�Lpyj�ORAU1NOiiiZEDAGH1j/ ^ D E . <br />X�! � .V'G"�a % s %r � c.� j� � <br />l,'%s-JS'� N—���"/rft"' �e;I <br />MECNANICAL <br />I�EE NO. <br />rVC— NHNDLG UNI7S— H.P. <br />FORCED AIR SYSTEMS— B.T.U. M EA <br />—� � _ UNITHEATERS—B.T.U. M <br />_ �_ CLOTHESDRVERS <br />_�,� VENTILATIONFAN <br />� RANGEHOnD <br />WATER HEATER <br />� 6VOOD STOVE <br />METAL FIREPLACE 8 CHIMWEY <br />S <br />NrSnE <br />S ❑ NO <br />FAN <br />�_ PLUMBING <br />OGG lOAO <br />_ MECHANICAL <br />r�EiGeruu�rnoH OTHEH <br />� SiATE BUILDING SURCHARGE <br />STATEENERGYSURCHARGE <br />PUBLIC WORKS <br />TOTAL�� <br />�y% ,�r/I'1/(� «�_ � Gi <br />9 <br />� <br />L1L FEE <br />EF. � 2/� <br />( :.�, <br />✓ <br />J "1 <br />5 <br />FEE <br />(a� J <br />FEE <br />� <br />