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� �l <br /> � APPLIC�-if10N FOR �ONSTRl�TION <br /> , <br /> ' PERMIT <br /> ; <br /> � fhs Everpreen everett <br /> CITY OF � <br /> ; everett <br /> j BUILDING DEPARTMENT <br /> 259•8810 TO BE COMPLETED IN INK— PLEASE PRINT <br /> � ONNEfl MAILA�DPESS GITY ZIV PMONE <br /> �g � F./JT7� 37l� 3..2 �f�r.�El�x�.�r <br /> i ��T ��� MRIL�ODPE59 ^ LIIY ZIP PMONE <br /> ; ��/✓ � �,✓ Wi�I.L�S' —�P,�� � ' �-r�a at��o <br /> �� MGH EGTONDE810NER M�ILA�ORES5 LIiY ZIP PHONE <br /> � �.{��1Lr.�'C��S� �I.stS7 GoJ,l��s�.�r ��a%�l° j 36/Yl� [✓�t>SC.Pl79o� <br /> � OENEMLCONTRACTOP MAIL�D�RE54 � CITY 21 PHONE UCENSEs <br /> 1 <br /> ,� MEGH�NICALCONTMCTOR � M�IlA00NES5 CItY ZIP PHONE LICENSE• <br /> I <br /> �� PLUMBINOCONTP�CiOF MAIL�D�RE59 CITV 21P PMONE 4CENSE• <br /> � <br /> � CUSSOFWORK <br /> i ❑ NEW � ADDITION ❑ A�TERATION ❑ REPAI7 ❑ DEMOLITION ❑ WOODSTOVE/FFiPL INSEf;T ❑ BUIIDING FEIOCATION <br /> � TENMITIMPPOVEMENTONINTERIORREMO')ELONLY GONTRCTPEPSONANDPbONENO. <br /> � 1I 15v � �'_' <br /> i CONTRACTVNICEOFWOPK ` - <br /> i �DEBCpIBEWOpKANDSOUARE T�0 INVOSVED <br /> '' rn�.��rv,<; <br /> j vPROP09EDUSEOFBUILDINO �HEPEBYCERTIFYTHATIHAVEREADANDcXAMINEDTHISAPPIICATIONAND <br /> � n KNOWTHESAMETOBETRUEANDCORRECT.ALLPROVISIONSOFLAWSAND <br /> � ORDINANCES�3pyERNING THIS TIPF.OF WORK WILL BE COMPLETED WITH <br /> LEMLDESGRIPTIONOFPFOPEFTY�SHOWNBELOWO�IRTfACNFOUHCOPIES� � / yyHETHERSPFCIFIEDHEPEINOPNOT.THEGFANTINGOFAPERM�TDOESNOT <br /> � �oir r 'L��oc..Z— oF �N� �Xl 'rR?f '�Cs'�Y� �� PRESUME TO GIVE AUTHORIN TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANYOTHER;TATE OR LOCAL lAW REGULATING CONSTPUCTION OF THE PER• <br /> � FORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE OWNER OF <br /> THIS PROPERN TO PERFORM THE WORK FOR W HICH APPLICATION IS MADE <br /> AND I COMPLY WITH TNE STATE CONTRACTORS LAW 7827 RCVJ AND <br /> '; 298200 N'AC. /l � <br /> &ONATUREOFCONTRRCTORORRUTI/OPREO GEN7 DRTE 9�a/ <br /> ; ��Gr , <br /> ,� �PROJEGTADD37D3 �2 �,, �j� `r APPLI:ANiSCITYBU51NES5LICENS O.RNpBU51NES5N�ME <br /> l� R/.:� <br /> ,� PWMBINO MECHANICAL <br /> .:i NO. TVPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE _ <br /> f; WATERCLOSET(TOILE7) AJC—A/FINDL�UNITS—H.P. <br /> '� BATHNB FORCED AIR SYSTEMS—B.LU. M EA <br /> �.f <br /> :� LAVATORV(WASH BASIN) UNIT HEATERS—6T.U. M <br /> $HOWER CLOTHES DRYERS <br /> � KITCHEN SINKS DISP. VENTILATION FdN <br /> � � DISHWASHER RANGE HOOD _ <br /> 1 LAUNDRYTRAY WATEPHEATER <br /> �� CLOTHESWABHER WOODSTO`IE _ <br /> UHINAL METAL FIREPLACE&CHIMNEY <br /> "� ORINKINO FOUNTA�N FIREPLACE INSERT <br /> � FLOOR ORAIN HEAT PUMP <br /> `� BACKFLOW PREVENTERS GAS PIPING <br /> �1 ROOF�RAINS—RAINLEADERS EXHAUSTFAN <br /> �,� SINK(SERVICE—BAR,ETC.) — <br /> I <br /> SUBTOTAL S SUBTOTAL $ <br /> ; ' PERMIT 8 PERMIT S <br /> ' TOTALFEE E TOTAIFEE $ I <br /> � FflONTSEf9ALK AEAN9ETB/�C SIpESETBACY. PIANCHECN MBER FEE flECEIPfNO. � <br /> ?� 'c Zo 1` �o' v"" 5 ' ZoB�G �� �'I <br /> , uae2 ^ LOTARFA �yEST511E FEES VA UATION FEE � <br /> ' �� BUILDING /� 3 <br /> TYPE FCAN9T. OCCUFANCYOROUP NO.OF WELUNOUNIi9 , <br /> ,u�OW�a���cru � IZ_� � PLUM6ING . II <br /> srzeoFe�oa NO.OFSTORIES BSMT. OCGLOr10 MECHANICAL i � <br /> Z7,Z � ❑v _� — I <br /> NEIGMTLIMITATION OTHEfl S % . ��' <br /> FIRESPPINNlEB5PE0U1BE� ❑YES O STATEBUILDING:iUFCHARGE I <br /> � STATE ENERGY SURGHARGE �'i <br /> APPLIC�TIONACGOY PLANSAPPR.BY PUBLICWORKS <br /> '/' � M . . TOTAL <br /> '::3L[01R5Yi.L`)3:L'�ClN` ._.-�...... ......�i' ...._ .. .�1..�".. .�. ";C.1,. •-:�_�.'L. - .'1 '`��. -i-: _ :'�� � � <br /> .... .. ..�.. ._, , ..... ..�.:..i . d.:_ •�r� p <br />