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0 <br />fhe Everpreen <br />CITY OF <br />everett <br />BUILDING DEPARTMENT <br />259•881Q <br />APPLIvAT10N FOR CONS1..-�UCTI�N <br />PERMIT <br />TO BF_ COMPLETED IN INK— PLEASE PRINT <br />rA� 9 / <br />everett <br />e <br />I.RCHITECtOR0ES10NER MRILADORESS CIIY ZIP PHONE <br />OENEH�ICONTPAGTOR MniIADDBE55 Cllv 2iP PIIONE LICENSE� <br />MECII�NIC�LCON/iJR�CIOR^CCC(I ��lStq�i,(����NOPE55 c LIIY c JZiP C PHONE I.ICENSE• <br />�L .L��Y� v L� V�! L � � /t'14_./ �LI�—J �10=L � [7 � � I � ��' �J / J� ��. vi.1/M�� ) � �C)'LICEN�b <br />�`LUMBINOGONiP�CtOR MAILADORE55 Cllv ���y�N�lP�-ii-9M� <br />�E -[-I -n5 -/-1y-37e.5 <br />c�nssorwonK -----�-----�-- - ' <br />❑ NEW ❑ ADDITION ALTERh110N ❑ REPAIR ❑ DEMOLITIOIJ ❑ WOODSTOVE/FRPLINSERT ❑ BUILDINGRELOCAiION i <br />CONTRACT PpICE OF WOPK <br />UESCRIBE WORN ANp SOU�RE GOpUGE INVOLVED <br />!A)CTd_/ 1 LIIOA//iCh r <br />r <br />V <br />lOT BLOCN OF <br />7J TApOHE55CJ �] �4 /� �^ <br />l I J // rr � J. <br />PLUMBING <br />OF FI%TURE OR ITEM <br />SHOWER <br />KITCHEN SINKB DISP. <br />CLOTHES WASHER <br />UFINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />SI <br />ALLOW�BLE/ACTUAL <br />�FPLICA�IONACCGti �- <br />r <br />1� <br />SUBTOTAL S <br />PERMIT 5 <br />YES ❑ NO <br />❑Y <br />n r� <br />❑ res n Ho <br />I HEREBY CERTIFY THAT I HAVE R EAD AND EXAMINED THI'i APPLICATION AND <br />KNOW TH E SAME TO BE TRUE AND CORREC7. ALL PROVI:>IONS OF LAWS AND <br />ORDINANCES GOVERNING TFIIS iVPE OF WORK WILL BE COMPLETED WITH <br />W HETHER SPECIFIED HcRE�N OR NOT. THE GPANTING OFA PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORIN 70 VIOLATE OR CANCEI. THE PROVISIONS OF <br />ANY OTH ER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PER• <br />FORMANCE OF CONSiRUCTION. TIiAT I AM AUTHORIZED BY THE OWNER OF <br />THU PROPERNTO FERFORM THE WORK FOfi WHICPi APPLICATION IS MADE <br />AND I COMPLY WILH THE STATE CONTRACTORS LAW 7P27 RCW AND <br />296200 W4C. <br />SICNaIDREolcONrRncronol;aulHom2E0nG[NT on1E <br />� / <br />x� , � �����.%PJ' 7 �lJ �` <br />APPLiC�N1,W1�U51N�EN5E 10�ND�USWESSNRM <br />MECHANICAL <br />FEE Nq. FEOUIPMENT <br />NC—A/HNDL. �NITS—H.P. <br />VIYII IICNICI��I� O <br />C�OTHESDRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP __ _ __ <br />GAS PIPING <br />E%HqUSTFAN <br />SUB TOiAL <br />_ ____ —_____-._.___ --_. PERMIT _... <br />iOiALfEE <br />BUILDING <br />PLUMBING <br />MECh1ANICAL <br />OTfiER <br />STATE BUILDING SUqCHARGE <br />STATE ENERGV SURCFIARG[ <br />auauc wonks <br />TOTAL <br />VALUATION <br />s <br />5 <br />FEE <br />/ 5 OG <br />3 d. �c� <br />FEE <br />