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��� AP�LIC�rr1AN FOR CONSTR1i�TION <br /> P�R�IAIT <br /> tM Ewrynen rvcrett <br /> GTY OF � <br /> everett <br /> BUILDIN6 DEPAR7MENT <br /> 269•8810 TO BE COMPLETED IN INK—PLEASE PRINT <br /> M M�IL�UDRE54 I 1 G��I/♦� Z1�(Y/' PMONE <br /> �l�lll��.�..�{�, 1 "Ll.11�f��. � � II 1 �1...1.¢�GIIY � _ �IVT � N� �3S/ <br /> �cr�NT MMi�00RE95 <br /> NIGNITEGTOROEBIONEH M�il�00PE59 Ci�Y ZiP PNONE <br /> OEN��nnEMLLON(PIiCTOR MA�LADONE55 CiAv ip 0 'P�o N�/1�� ��� N9E• <br /> ,r�,, � ^ �� m ^QQ.,G1 .� I � C:/1 /)!_�C <br /> � � y IT' / 1 s���_����C..'-� '�_���4A��>c � <br /> MEGHANIWL40 A�R"� ' M�L� IRf[ � � i �� ���LICjHSE <br /> � _�3�, <br /> --��r���_— � <br /> rIUMlINOfANTfUC1011 M�iL�OD11E99 Ci�� Z�i' PNONE IiGEM1 • <br /> GABe OF NVRM <br /> ❑ NeW ❑ ADUITION �ATION ❑ NEPAIf1 ❑ DEMOLI710N co❑�WOODON�No/PwwE oSERt ❑ BUILDINOHELOCATION <br /> IlIUN71MPROVf.MEHTOR�NT P FMOOELONLY <br /> WNTR�CTPRICEOFWOPK W 1 -- <br /> OClCNIBE OR0.� 0 U F TM INV VEU <br /> ���_� .�� �l ! - -- <br /> ��u9E of euaoir� I MEREAV LERTIFY THAT I HAVE REAO AND E%AMINEO THIS APPLICAiION AN� <br /> Y) KNOW THE SAME TO BE TRUE AND CORRECT.ALL PHOVISION90°LAWSAND <br /> �, OfiDINANCES GOVERNIN6 THIS 7VPE OF WORK WILL BC COMPLETED WITH <br /> LEMLOEBLIIIPTqNOfpPOPEHTYIBHOWNBEIOWOP�T1�:NiUUNGOPiFBi WHEiHEFSPECIFIEDHEFEINORNO7.THE0RAN71NOOFAPERMItDOE8N0T <br /> PRESUME TOOIVE AUTHORITV�O VIOLA7E OR CANCEL 7HE PROVISIONS OF <br /> ��--- B��µ �r FOFMANCE OF CONSiRUCT10N HAT�I AM'AUTHOR ZED BVITHE OWNEF OF <br /> THIS Pi70PERTV TC�PERFORM THE WOAK FOR WHICH APPLICATION IS MhDE <br /> -- AND I COMPLV WIPI THE STATE CONTRAC70P5 LAW 1827 RCW �ND <br /> 29B.1W WAC <br /> S�ON�IUPEO(LON�N�StOf1URWI�IORISED��ENt U�iE <br /> �U-t�'�;aMCI(�Cj - -�/o�.l �� <br /> PIqJEGiMLPee iGAN18CIfvBI'9i 95 NSENO�NDBU9ME9SN�ME <br /> VLUMlINO MECHIINICIIL <br /> NO. TYPf Of FU(TUR!OR ITEM FEE MO. TYPE OF EOUIPMENT FEE <br /> WATER CL09ET(TOILE7) NC—A/H 4DLa U_•15—H.P. _ <br /> BATHNB _ FORCED AIF SYSiEMS—fiT.U. M EA <br /> LAVATORV(WA9H OA91N) UNIT MEATERS—B.T.U. M <br /> 9HOWER CLOTHES ORYER9 <br /> KITCHEN 91NN 6 UISP. VENiIIAiION FAN <br /> C19HWASHER _ RANGEHOOD _ <br /> LAUNDRVTAAY WATER HEA7ER _ <br /> CLOTHESWASHER _ WOODSTOVE _ <br /> URINAL _ _ METALFIREPLAGE6CHIMNEV <br /> DRINKINO FOUNTAIN _ __ FlNEPLACE 1NSEIlT _______ <br /> FLOOR DRAIN —� HEAT VUMP_ _ __ _ <br /> BACKFLOW PREVENTER9 OAP PIPIN(7 _ ___ _ ___ _ _ <br /> ROOF DRAIN9—FAINLEAOER9 _ 7�E%]�HAUSi FAN 1� <br /> 91NK(SERVICE—BAR ETC.) _�— 111� 1 -�--�"--�`"-'-'-- <br /> SUBTOTAL S ____. ___�UBTOTRL S _ <br /> PERMIT S ______ . PERMIT _ S <br /> TOTRLFEE S TOTALFEE S <br /> ��AOVTEEtBACIt NE�R9E�GCK &OEBEIMGM IV�NCMEC6NIIMlER F[[ �!C[IPiNO. <br /> ueEioNE LOI�RE• WCAN191Tf FEES VRLUIITION PEE <br /> 11 vF9 I1 NO <br /> BUILDINO _ <br /> TYPEOiCONBT OCCUP�NCYOROII� MOOfUWelliNOUNrtS -------- <br /> KLOWABIE/ACTWI PLUMBINO _ <br /> &lEOiBLDO Noo�sroarts BSM� ucc�o�o MECHANICAL <br /> ❑Y -- — <br /> ❑H _—'_ __ <br /> TIEIONILIMII�f10N OTHER _ _ <br /> i1RE8P111NkLER°PEWiAEU ❑ vE9 nr+o ___ BTqTE8UIL01NaSURCNAR�E <br /> STRTE ENERGY SUACNAROE <br /> �oPLIGUION�LC BY PLANS�PPf1 BY PUBUC WORKS <br /> TOTAL <br />