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145'o-Z (3 u3 r L ! <br /> ,^"') I <br /> �` APP6.IC�ION FOR CONSTRII�TION � <br /> ,; <br /> ;? PERMIT <br /> �'� IheEverpreen everetl <br /> i GTY OF <br /> � everet� e <br /> BUILDING DEPAHTMENT <br /> 259•8910 TO BE COMPLETED IN INK— PLEASE PRINT <br /> ., OWNEF � MAILADORESS CILY 21P PNONE <br /> Pac i �c_ {-��S S L� as�t-F� /y2o /1rw CxL,..�,arr 13<✓o¢zZ -r Z <br /> � TEN�NT � MAILp�DRESS GItY ZiP PIIONE <br /> /sJ���c- 9�az7 3 �z �ior <br /> ANCHITECTOFOESIGNEit MAI�PDORESS CiiY Z�P nMONE <br /> � QENEN�LCONi(iACTOR MAILAOOfiE55 CItY ZIP GHONE LICENSCv <br /> �-Jti.J� +� �'�C/F /_�i� <br /> MECHr1NICALCONTPACTOR MqILAD�RE55 CrtY ZIP PNONE LICENSE• <br /> � PLUM6INOCONTRACTOR MRILPODPE55 CIiY 21P PIIONE LICENSE• <br /> � �1�530F WOfiK __ _ _ <br /> - �NEW ❑ AODITION ❑ ALTERATION ❑ fiEPAIR ❑ OEMOLITION ❑ WOODStOVE/FRPL.INSERT ❑ �UILDIN�RELOCATION <br /> �fENRNTIMPPOVEMENtORINiENiORREMODELGNIY GONfACIPER50NnHUf9�ON[NO <br /> , GONTFFCTPRIGEOFWORK S�WO.00 `-���� ��UC� � [ Z ����_ <br /> DESGPI�E WOI�K�Np SOUAPE FOO PGE INVOLVED <br /> � N�w Co�zTcu��o�! /rso=scz�_ _ <br /> ; PHOVOSEDU9EOF9l11LDIN0 IHEREBYCERTIFV7HATIIIAVE(iEADANDE%AMINEDTHIEAPPLICATIONAND <br /> �� S/NC�+C- [, �• JZ� S KNOW7HESAME70BETRUEANDCOFRECT.ALLPROVISIONSOFLAWSANO <br /> �eoA�oescaiPnoruuranovenrvis�wwN ee�owon nnnci�rouncor•iesi - ORDINANCES GOVEqNING THIS TYPE OF WORK WILL 8E COMPLETED WITH <br /> /' WHETHERSPECIFIED HEREINOR NOT.THEGRANTINGOFAPERMITOOES NOT <br /> � �or �� e�ocK or I�J�F�•J^ra0� �L✓��- PqESUMETOGIVEAUTHORITYTOVIOLATEORCANCELTHEPROVISION50F <br /> ANY OTH ER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PER� <br /> ' FORMANCE OF CONSTRUCiION.THAT I AM AUl"HORI2ED BY THE OWNER OF <br /> THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE <br /> - AND I COMPLY WILH THE STATE CONTRACTORS LAW 1827 RCW AND <br /> 296.200 WAC. <br /> � SIGNAtUqEOFCOhiBAC:OFORAUtHORIZED�GENT DATE <br /> x ��� . �I,T �� <br /> , PPOJEGTADUflE55 qPpLICRNiSCIiYBUSINE55LICENSBNOANpBUSW[SSNAME <br /> � <br /> PLUMBING MECHANICAL <br /> NO. TVPEOFFI%TUREOFiITEM FEE NO. TYPEOFEOUIPMENT FEE <br /> WATEHCLOSET�TOILEn � A/C-A/hINDLGUNITS-H.P. <br /> BATHTUB ____ =y FORCLD AIR SVSTEMS-&T.U. M EA <br /> LAVATURY(WASH BASIN) _ -_� UNIT HEATERS-B.T.U. M <br /> � SFIOWER ! _ _�_ CIOTHES DRYERS <br /> ; KITCHEN SINK 8 DISP. ___ = y_ VEN7ILATION FAN � � <br /> � DISHWASHER _ _ _�_ RANGE HOOD � <br /> '� LAUNDRYTRAY �_ WATER HEATER <br /> CLOfHESWASHER ' WOODSTOVE <br /> ' _ URINAL _ _ __�_ METAL FIREPLACE 8 CHIMNEV � <br /> . DRINKING FOUiJ7AIN FIREPLACE�NSEfiT <br /> ' FLOOR DFiAIN HEAT PUMP�_-�_...�� ���-�--- - — <br /> BACHFLOW PREVENiERS GAS PIPING <br /> � ROOF DRAINS-RAINLEADERS E%HAUSi fAN <br /> ' SINK�SERVICE-BAR,ETC.) <br /> SUBTOTAL 5 T SUBTOTAI $ . <br /> �,7 . _-._ -_ _ , <br /> � PERMIT 5 PERMIT S ' <br /> , TOTAI FEE S - TOTAL FEE S <br /> , FHONiSETpRGqK _ ` tiLARSEtfl�CN SIOESEippCN PIANCI CNNIIM�ER FEE t NECEIPTNO. <br /> G� ZA� � � � Z -�' <br /> � usezone �ornnea vqcnr�rsne FEES VALUATION PEE <br /> � l�T VE5 ❑ NO Q�/ <br /> � r �� � <br /> . TYPEOFCO�L� OGCUP�N�GROUP NO.OFOY/ELUNGUNIIS - BUILOING _- _ ��^_ .' 1 / = <br /> _� 1/ I <br /> ALLOWFBLE/�f,T� � / PLUMBING _��j �" <br /> �' 3 � — <br /> �' SRE OF BLDp. NO.OF StORIES BSM11i. OCG LOAO <br /> �� uv _ MECHANICAL � � <br /> �� 30 � Dt" _ - -- <br /> �� H[iWrtLIMIINIIDN OTHEF <br /> , FIf1E SPHINNtERS f1;i0U'RED u ves i o STATE BUILDING SURCHAFGE � l\ <br /> b� <br /> $TATE ENERGY SURCHARGE _ I � <br /> APP4CAilONRGC.BY PLANSAPPROY � -, <br /> � � PUBLIC WORKS � <br /> c <br /> TOTAL � <br />