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APPLI�TION FOR CONST�CTION <br /> PERMIT <br /> �hs Everyrsen everett <br /> CIiV OF <br /> everett e <br /> BUILDING DEPARTMENT � <br /> 259•BB10 TO 8E COMPLETED IN INK— PLEASE PRINT <br /> pryqEp MAIL�DD�E55 L�Iv 21P PNONE � <br /> N�l��a ,�o ��a i ��„���:- n�o E,,�..++. �n 9a,,� � ss� �9c r <br /> tEN�Nf � M�Il�D011E53 GIY 21P PNONE , ' <br /> •IIGNIIEL(ONOE9qNER MeIL�ODPE55 G!Y 21P PNONE <br /> �ENERILCANfHI�GiOH IA�IL�UURESS GiY IIP VHONE IIGENSE• <br /> Uw� <br /> MECN�NIG�LCONIPGGIOR M�iL�DDRE55 WY ZIP VIIONE IIGENBE• <br /> PLUMBINOGONTiUCtOR M�4A0011E93 LIIY ZIP P110NE LICENlE• <br /> CUSS Of NORN <br /> ❑ NEW ❑ ADDITION ❑ ALTE�UT�ON � REPAIR ❑ DEMOLITION ❑ WOO�STOVE/FPPLINSERT ❑ BUIL���NQqELOCATION <br /> fENl1Nt IMPROVEMEMT OR INIERIp1 REMODEI ONLY fANIAGt VkR50H AND VNONE NO. <br /> f,pMTR�CTPPICEOiWORK ��� IVCII �I �(�VYIt � sg' 7l�i� <br /> OE9GRIBE WOHN�ND BOUME f001A0E INVOIVED <br /> fn.+nA.� 144u ,. {�. <br /> Pf10POSEDUlEMBUiLDINO � IHEREBVCERTIFYTHATINAVEREADANDEXAMINEDTMI9APPLICATIONAND <br /> R«�d� f LI ' S N�.IL F4�^-1I\ KNOd/THESAME708ETRUEANDCORRECT.ALLPROVIBION90FLAWSANO <br /> LEOALOEBGRIO1qNOfPROf�ENtY�9��OWNBEIOWOR�TIACNfOURCOf'ils� OROINANCESGOVERNINGTHISTVPEOFWORKWILLBECOMPLETEDWITH <br /> WHE7MER SPECIFIED HEREIN OR NOT.THE ORANTINQ OFAPEPMR DOES NOT <br /> �pi BtpcK oF '�. �} ��c1nla��v�ud4ail f PRESUMElOOIVEAUTHORITVTONOLATEORCANCELTHEPROV1310NSOF <br /> ANYOTNER STATE OR LOCAL LAW RE�ULATINO CANSTNUCTION OR THE PEP- <br /> �jJY��Y��� OYiIfIf e�II(tM1•1 IV l�/Wn��'� �'�ner# � r�. <S' ..t W_A., FOqMRNCE OF CON57RUCTION.THAT 1 RM AUTNORIZED BV THE OWNER Of <br /> de�t•�6.J �� �I �W4: l�• ae�w � ��+ + . 4a�F t��^i�!< <" ;"N" THISPROPEPTViOPEHFORMTHEWORKFORWHICHRPPLICATIONI9MADE <br /> w ��a--4' ,�—�,7i="�-'i�Q1Ltl°'�°�-�°�X ANU I COMPLV WITH THE STATE CONTRACTOR3 LAW 18.27 RCW AND <br /> 'erf�� ('�. 4�ylp�:�f aC dr���niw � b�a wryt /L�h.ij�4wt� 7wl4 298.Y00WAC. <br /> .• l��f' }�vqN MJ� �Lf��n�j���te /k Sa���? h IV /�'F •���J��•• . &ON�NNEOitONfPAC10NOPAUtH01111ED�0ENT D�TE � <br /> iti. klti.. �� • �l. w.♦ . CI Ay1�[c�l � I1u tr��l S,S <br /> �....�oL 7�.I..�;a4,5+.�. � wsr ��n. V <br /> /\ �..�.e w . 3�, /9n <br /> PROJECIADDRE89 �+P�ICANTBC�tYBUSiNESSLIGEN ENOANDBUBINEBSNAM <br /> zv �9 Bak� a��s��,�-r�, wn 9a�� - - <br /> PLUMBINO N ECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM F E 110. TYPE OF F.OUIPMENT FEE <br /> WATEH CLOSET(TOILE7) NC-/VH NOLO UNITS-H.P. _ <br /> BATHTUB FORCEDAIRSVSTEMS-dT.U./AdAEA _ <br /> UVAIORV�WASHBASIM � UNI7HEATERS-BTL. M _ <br /> BIiOWEH CLOTHES DRYERS <br /> KITCHEN 91NK6-01&P. �' VENTILATION FAN ��.�( <br /> DISHWASHER � �' RANGE HOOD <br /> LAUNDRVTNAV WATEN HEATEH <br /> CLOTNESWASME1i - �` N�OODSTOVE <br /> URINAL METAL FIREPUCE6 CMIMNEY <br /> ORINKINO FOUNYAIN FIREPLACE INSEHT <br /> FLOOR DPAIN HEAT PUMP <br /> BACKFLOW PREVENTER9 :OAS PIPIN� <br /> ROOF DRAINS-RAINLEAUERS EXHRUST FAN <br /> 91NK�SEFVICE-BAR,ETC) <br /> SUBTOTAL S SUBiOTAL S <br /> PERMIT S PERMIT S <br /> TOTAL FEE f TOiAL FEE S <br /> iPONI6EIB�GN PFANBEIB�GN 910ESEI9nCK �IANCMlCMMUMlE11 F[! R[CLIRMO <br /> �i� ,;� t�,. ' , �x_� �o ss � 13� s5 333 4 a <br /> usE2oN[ loieau � VeL�NIStE FEES VALUATION PEE <br /> ❑YES �U <br /> � �V� — BUILDI��O Q� � ' <br /> lYPEOlCAN9T. OCWV�NCYOROUP NOO�DY/ELLiNOUN118 -- <br /> AlloWe E/eC uAL ' I PLUMBIN6 <br /> r <br /> lREOFpLW NO.OFlOA�ES BSMT. OCGLO�D � <br /> c v MECHANICAL <br /> �VOp f,c 7. 2 �" 1�l <br /> Nea���i:��ior+ OTHER _ <br /> iIPE9PRINNLENlPEW01ED OY(.! JQNo _ O�_ STATEBUILDINOSURCHAROE <br /> STATE ENEROY SUNCHRR(iE <br /> Ai'PLIG110N�CC tl��N9 A�BV <br /> �L PUBLIC WORKS <br /> ,i TOTAL � <br />