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/�'�, ' <br /> APPLIC�ION FOR CONSTR�TION <br />�`;;�"' PE R M IT <br />�':... .. IAe Ewrpraen everett <br />.�,:" �� CITY OF � <br /> " everett <br /> t BUILDINC3 DEPARTMENT <br />'� 259-8810 TO BE COMPLETED IN INK— PLEASE �'RINT <br /> S�` � p,yqEp MBIL�OORESS CIiY 21V PHONE <br /> JULIA ANDERSON a.,�y�� �3•_'� 51 SE EVERET'P, 98201 252-0545 <br /> ���` ' TEN�NT MMLR�ORESS CrtV 21P PHONE <br /> ;_;: Same -- -- - -- _ <br /> J}� MCNRECTOHOESIONER MAIL�OORESS GIIY 21P PIIONE <br /> � Impression Design 225• Jackson Everett, 98203 355-3200 <br />�•,. <br /> - OENEMLGONTRACiOfl MAILAU�RE55 CIiY 21P PHONE UCENGEs <br />�, G.I .H. Const. , Inc. 4802 103rd P1 SW Everett, 98204 355-3506 GIHCOI*121K <br />:� <br />�: �� MECHIINICAI.CONTR�GiOR M�I��ODRE55 CIIY �IP PHONE LICENSE•� <br /> 1 <br />�::`?` N/A <br /> 4�.�. � PLb;ABINOCONTMCTOF MAILADORESS GIIY ZiP FMONE LICENSE• <br />�� � N/A __ <br /> i�� . G1A550FWORK <br />'s'i�.� � ❑ NEW ❑ ADDITION ❑ ALTERATION � REPAIR ❑ DEMOLI110N C� WOODSTOVE/FRPL INS[RT ❑ BUILDING RELOCATION _ <br /> 4�`. � TENNlTIMPROVEMENTORINTERIORREMOOELONLY CONiRCtPEP50NANDP110NEN0 <br /> ����- , CONTRACTPPICEOFWORk $15 , Q00 .00 + or - Gary I . Harstad, Jr. 355-350F, <br /> z�' DE RIBE WOR NO UME F UOE INVULV'_fJ <br /> ; �nst����Sqnd��tion under existing home • <br /> r;',�-'� - aroroseouseoFeuaowe IHEfiEBYCERTIPVTHATIHAVEREADANDEY,AMINEDTHISAPPLiCATIONAND <br />`' � � S1II �.2 Famil Residence KNOWTHESAMETOBETRUEANDCORRECT.ALLPROVISIONSOFLAWSAND <br /> F�� ORDINANCES GOVERNING THIS NPE OF WORK WILL 6E COMPLETED WITH <br /> C- , LEWLDEBCNIPf10NOFPPOPEPTYISHOWNBELOWORRTACMFOURCOPIES� WHETHERSPeCIFiEDHEREINORNOT.THEGRANTINGOFAPERMITDOE5N0T <br /> ���?� � <br /> ( PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br />��� � ,� �oi�s-e�otK� oF �1� � � ` --'� � � ' ^' � ANYOTHERSTATEORLOCALLF,WREGULATINGCONSTFUCTIONORTHEPER• <br /> t � FORMANCE OF CONSTAUCTION.THAT I AM AU��HORIZED BV THE OWNER OF <br /> 1 / � �� THIS PROPERTV TO PERFORM TNE WORK FOR WHICH APPLICATION IS MADE <br /> � '(; � I 1 ' � I� � 1�5 AND I COMPLY WITH THE STATE CONTRP.CT RS LAN' 18.27 RCW AND <br />'�. : 296.20D WA . � <br />�. � � , SIGNRTURE ONTHRCLG80NAUiNOR AGENT DB � ' �� <br /> / L//J' <br /> 3'.�..�.. t X �.J�[� <br />�'.�'�_ t � .�G�. <br />�.,�� � PROJECT�DPRE55 pPp piYB �NESSLICENSENO.RNO USIN oNP� <br />� ' � a3� �� (-r 601 074 234 GIH Construction, Inc. <br /> t ,. �, <br />��`` ,� PWMBINO MECHANICAL <br />�'��� �� NO. TYPEOFFI%TUOEORITEM FEE N0. TYPEOFEOUIPMENT FEE <br /> £' WATERCLOSET(TOILEp A/C—A/HNDLGUNITS—H.P. <br />- t� BATHTUB FORCED AIR SYSTEMS—9T.U. M EA <br /> tl LAVATORY(WASH BASIN) _ UNIT HEATERS—&T.U. M <br />���'�� CLOTHES DRYERS <br /> SHOWER <br /> r KITCHEN SINK6 DISP. VENTILATION FAN ' <br /> � DISHWASHER RANCaEHOOD _ <br /> y IAUNDRYTRAY WATERHEATER <br /> �� CLOTHES WASHEH WOOD STOVE <br /> I�� URINAL METALFIREPLACEBCHIMNEV <br /> DRINKIN4 FOUNTAIN FIREPIACEINSERT _ <br /> S FLOOR DRAIN HEAT PUMP <br /> � BACKFLOW PREVENTERS GAS PIPING __ <br /> .. ROOF DRAINS—RAINLEADERS E%HAUST FAN_ <br /> ' SINK(SERVICE—BAR,ETCJ <br /> SUBTOTAL 5 SUBTOTAL S <br /> ' PERMIT $ _ PERMIT $ <br /> TOTALFEE S TOTALfEE S <br /> FRONTSETB�CK flEAfl5ET8RCK SI�ESEiBACK PUNCNECK UMBEfI FEE AEGEIPTNO. <br /> Zo � Zm� S� �$ 01 / S� � <br /> uSE20NE �otnqEn VRCRNTSIIE FEES VALUATION FEE I <br /> R-^ C1 VE5 O <br /> � BWLDING � ) �;C.���t__� � � � <br /> TYPEOFfANST. OCGUPANCYGROUP NOAFOYIELIINGUN1t5 - ' <br /> ALLOWe GTu� �'7 . "� � PLUMBING _ <br /> � <br /> 91ZEOFBLDQ / NOAFSTOHIES BSMi. OCGLOAD <br /> 17OS�F. f�Jpy�,a � � Y -- MECHANICAL _ <br /> N <br /> r�emHrurnirnuon OTHER <br /> FIRE 9PNINKLERS REOUIRED ❑YES NO STATE BUILDING SURCHARGE �r <br /> STATE ENERGY SURCHARGE ��. <br /> APPLIC�tIONACGBY PLANSRPPR.BY PUBLICWORK$ I <br /> I��� �� TOTAL �(;��� �� 1 I <br /> I <br /> i I <br /> �. \ <br /> � <br /> � _ _ ... <br /> �,:.r ...... .. ... ... .. . .. . . .. . . . ., .. .. , _ . _ . . ... . . .. <br /> ,�"" <br />