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/^� <br />APPLICATION FOR CONSTRV.:TION <br />P�RMIT <br />M� Enryroen everett <br />qTY OF � <br />everett <br />BUILDING DEPARTMENT <br />259•eStO TO BE COMPLETED IN INK — PLEASE PRINT <br />Ep M�IL���PE55 GiTx ZiP FNONE <br />�RGHRECfOR0ES16NFR MMLADUPESS dTY ZIP PNONE <br />6ENERFLGONTR�CTOF M�ILADUPE55 CITY 21P PNONE LICENSE• <br />MECII�NIGN.GONTR�CTOR M�IL��UHE55 dTY 21P PMONE IICENSE• <br />❑ NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOlIT10N ❑ WOODSTOVE/FflPLINSERT LJ BUIL�IN�REIOCATION <br />CpNiMGT PRICE OF WOIIK <br />pEBCqIlE WORR �ND 80I1ME FOOT�GE INVOtVEU <br />P_..,.t, ,._ �- r�:,., ar,,., <br />LOT BLOCI( OF <br />PROJECT�D�PE39 <br />PLUMlINO <br />W�TER CL09 _T <br />FLOOR DRAIN <br />BACKFLOW PREVENTEHS <br />ROOPDRAINS—RAINLEADERS _ <br />SINKI9ERVICE— BAR, ETC) <br />SUBTOTAL 5 <br />PERMIT S <br />TOTALFEE 5 <br />ITAETB�CK RE�RSETB�GK &OESET9�CK <br />[ONE LOT�HE� MG�NiSITE <br />❑ res ❑ No <br />OFCANST. OCCUPANCYOPOUP NDAFDWELLV <br />W�BIE/�GTU�L <br />OF 6LIX1. NO OF STORIE9 BSMT. OCG 10�D <br />❑v <br />❑N <br />NEIGMT LIMIT�T <br />SPpINNLERSNEWIREO � YES ❑ NO <br />I HEREBV CERTIFY THAT I HAVE READ AND E%�MINED TH18 APPLICATION AND <br />KNOW THE 9AME TO BETRUEAND CORRECT. ALL PROVIStONSOF LAW9IIND <br />OR�INANCES 60VERNINa THI57VPE OF WORK WILL BE CAMPIEiED WITH <br />WHEiHER SPECIFIEU HEREIN OR NOT. TME6RANTINOOFAPERMRDOES NOT <br />P'�' cSUME TO GIVE AUTHORIN TO VIOLATE OR CANCEL THE PRONSIONBOF <br />+,�V OTHER ST�TE OR LOCAL LAW REOULATINO CAN9TRUCTION OR THE PER• <br />FORM�NCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BV THE OWNER OF <br />THIS PROPERNTO PERFORM THE WORK FOR WHICH APPLICATION 13 MI1DE <br />AND I COMPLY WIiH THE STATE CONTRACTORS LAW 18.27 RCW AND <br />288.200 WAC. pD <br />SIGNATUHEOFGONLRAGIONOHMIiNOHIiEO�GENT DAiE q- 2• p/ <br />�X 1//{)���l�/ ,L , � ',�(.� <br />�ppIIL�NTSGII�Y0U5iME IICENSENOANOBU51NES5NSME <br />MECMANICAL <br />NO. 7YPE OF EOUIP6 <br />NC — NHNDLG UNITS — H.P. <br />FORCED AIR SYSTEMS — B.T. <br />UNITHEATERS-6T.U. M <br />CLOTHES DPVERS <br />VENTILATION FAN <br />RANGEHOOD <br />WAiER HEATER <br />WO00 STOVE <br />METAL FIFiEPLACE 8 CHIMNE <br />FIREPLACEINSERT <br />HEAT PUMP <br />FAN <br />FEES <br />BUILOING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />STATE BUILDING SURCHARCaE <br />STATEENERGYSURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />70TAL <br />FEE <br />