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, _�.: . <br /> APPLIC�.�ION FOR CONSTRVCTION � <br /> �ERMIT : <br /> IMErepmn everelt ,, <br /> CITV OF � �, <br /> evere�tt <br /> BUILDINO DEPARTMENT <br /> 269•8810 TO 6E COMPLETED IN INK— PLEASE PRINT <br /> �:. <br /> M�IL�O PE ! GRY IIP PH NE �; <br /> G�l:.�D�� CCverelf 3zvd C��%v C�.�f/ yzgzv/ Pas9 BB00 xZ/z�� �, <br /> R�T J M�II�DORE88 I9 <br /> t' <br /> MLNIT[Gi OR UE010NER <br /> M�R�DOPE9S GITY 21P PNONE ''! <br /> M111�00RES9 GiY ZIP PNONE lIUN6!• �� <br /> 0lMLMLCANTIUiGT011 ��'� . �f: <br /> C, �v/�Y•�rs��fti �ic�i�,� ,�I� Si���h S� Ev�'r��� 96'2D/ 259 7157 . �;; <br /> M[CN/�NICALCONTMGTOR M �UDAE80 CITY ilP PHONE LIGEN6E• ` <br /> +�.t: <br /> GIfY SIP PIIONE LICEN!!• !"� <br /> RUMMNOGONTMC�pp MML�UORE!! � <br /> Cl/W Of NOIIII ';�I <br /> ❑ NlYy ❑ ADDITIQN ❑ ALTEMTION � REPAIR ❑ DEMOlIT10N ❑ W(�D9TOVE/FRPL INBERT ❑ BUILDINO RELOGITION .,� <br /> MµT MI►p/lMtM d1�1110R M[MOCEL UNLY fANT�CT PENlOM�ND P1qNE NO <br /> N <br /> ppNTMCiN11GMY�V11 ��J� <br /> !l WOM(MIOlOIMI1l100TA0L NIYOLVED �l <br /> 0o an f of 0 SP - 'p a <br /> P <br /> u�c d Nuallo 1 HEREDV CEFTIFY THAT I HAVE READ AND E%AMINEU TNIB APPLICATION AND <br /> t,I <br /> NNOW THE BAME TO BE iRUE ANO CONRECT.ALl PROV1810NB OF LIWB ANG <br /> � p��C►MqNp� IIN�WqYN�fLOWOR�TT�LM�OURCOPIEW ONDINANCE860VEFNIN4THI9T/PEOFWORKWILLBECOMPLETEDWITH A <br /> WHETMERBPECIFIEDHEREINORNOT.THE�MNTIN(iOFAPERMRD0E8NOT �J� <br /> PqEBUMETOOIVEAUTMORIIVTOVIOLATEORCANCELTHEP110VISIONSOF ��.� <br /> �pT aouc or ANVOTHERBTATEORLOCALLAWREOULATINOCONBTRUCTIONORTMEPEIF <br /> � FQRMANCE OF CONBTRUCTION.iHAT I AM AUTHORIZEDlY ME OWNEN Of ' <br /> TMIBPNOPERiVTOPERFORMThEWORKFORWHICHAPPLICl1TIONIeMADE �;1 <br /> AND I CAMPLV WITH THE STATE CANTRACTORB LMN 1E.17 RCW AND N� <br /> 2�.200 WAC. �;rl <br /> &ON�TUPEOI PM1I�ONI AO[NT W7E �i. <br /> �' <br /> X �. <br /> C �/ r SH,ihi �a��r Ce,rh's, f, <br /> Mp;�[�{�pp�{0/ �PiIIGiNTDCITYsII&NEBBUCENBENOANOWNNE66NAAK T�� �� <br /> 6�r5✓�� BlG' � � <br /> �� MlCNANICAL �t <br /> i.t <br /> wo. rna a nxTu�t oe inr r�i Mo. Trri of iowrr�[nr rn �a <br /> WATEP CLO6ET ROILEI) NC—NHNOLO UNITS—HP. �i <br /> MTMTUB FORCEU AIR 8V9�EMS—HT.U. M EA �.� <br /> UNITMEATERS-6T.U. M �'�� <br /> uwrarvnv�eN e�sun `�� <br /> sHOWEp CLOTHE8DRYER8 .__ �.' <br /> KITCMEN BINKt DI6P. VENTILATION FAN �'� <br /> i�. <br /> 01lNVYI1aNER RANOE HOOD :'; <br /> UUNORY TRAV WATER HEATER l'�� <br /> CLOTHES WA6MER WOOD BTOVE ��' <br /> URINAI <br /> METAI FIREPLACE i CHIMNEV �' <br /> DRINKINO fOUNTAIN FIREPLACE INSERT ��� <br /> fLOOR DMIN HEAT PUMP <br /> NICKFLOW PREVEN?ER8 OA9 PIPIN6 �:�i <br /> ROOFDMINS—NAINLEADERB E%HAUSTFAN ;•;� <br /> BINK(BERVICE—BAR ETGI e`.' <br /> �, <br /> i' <br /> 9UBTOTAL { 9UBTOTAL • � <br /> PERMIT 5 PERMIT f �. <br /> TOTAL FEE i TOTAL FEE t <br /> e�canMo. <br /> M PUR6EfMGK 610EBflB�GN MANCNlLI{NOYOl11 I!! . <br /> U!lIONE IOTME� VAGNTlITE �(Et VALUATION RLL <br /> O YE! O NO / <br /> r , � <br /> BUILDINQ <br /> n.nqpp�7, OCGUiI�NCY0110UP NOOfOWElLIN6UN11! <br /> KLOMM�LU/iCiUK pLUMBINO <br /> i <br /> M1lOf�104 N0.W lTORIE! !lMT. OCG IO�D MECHANICAL . <br /> ❑r <br /> nn <br /> MEIONTIIMIT�TION OTHER �� <br /> ( <br /> FIRLeMIMMLERBNFWIPEO OYEB ONO STAiEBUILDINfiSURCHAR�E _ � <br /> STATE ENEROY SUFCMApOE � <br /> �VlLI.�TIONAGGlY PUHa��Pner pUBLICWORKS <br /> 1. <br /> I � t <br /> TOTAL � � <br /> � <br />