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.j�f . � '�• . <br /> :�;� �� APP���TI�N FOR CONST�CTIt�N � <br /> `:` PERMIT <br /> .'tM EnrprNn <br /> � GTV OF everett <br /> � everett � <br /> � BUILDING DEPAiiTMENT <br /> � 258-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br /> � EP �L�DURESS GTY 2�P PMOnE <br /> � <br /> � IENANT MA�L�DDNE59 _ GTY I�P PNf`NE �I � <br /> ��� ALCtC1j 1`:��� �.'�rCc�r1�.�.1Z �( . L—U�< <79„�C�I :�`.��,- 35$ ! ' � <br /> .� I1qCMITECTOqDESqNER M�ILAO�PESS • GiY ZIP PNONE � <br /> SOENEMLCANTRACTOR MML�DDRE55 CI7Y 21P PNONE 4GENSE• ' <br /> a A)A�Z��2 i;3/IOPL � <br /> � MECHAN�CALCONTRI1GtON CiTY ZIP PNONE LICENSE• I <br /> . s�e�+rr�.v e/9�� <br /> � RYM&NOCONTR�CTOR � ��0� C�TY ZIP PNONE LIGENS • I <br /> �'�• <br /> ^ CWlOFNORK.�// I <br /> 9 ❑ NEW L7 ADDITION ❑ ALTER�TION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPLINSEFT ❑ BUILDIN6RE�OLATION � ' <br /> � iE1NNTIMPIqVEMENTORIHiEPIORPEMO�ELON:Y CONi�GTPEPSp�N��!N{D�PHONErvO. /� (� <br /> y CONTRACTPRICEOFWORM �J� �L� �-l..Il-.���! <br /> � Dl�G111�EWJRNIINDBOUAREFOOT�OEINVOLVEp �� /` 1 j I <br /> (.C�� a�� G )'Y� d' � <br /> � rnorWEDuene'ole��oinn��C� IHEREBYCERTIFVTHATIHAVEREADANDE%AMINEDTHISAPPLICATIONAND <br /> � I <br /> W� � KNOWTHESAMETOBETAUEANDCARRECT.ALLPROVISIONSOFLAWSAND � <br /> � LE011LDEBCNIPt10HOFPpOPERTY�SNOWNBEtOWORATUCNFOURCOPIE51 ORDINANCESGOVERNINGTHISNPEOFWORKWILLBECOMPLEiEUWITH II <br /> � WHETHERSPECIFIEDHEREINORNOLTHEGHANTIN60FAPERMITDOESNOT I <br /> �m �aK oF PRESUME TO GIVE AUiHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANV OiHER STATE OR LOCAL LAW REGULATING CANSTRUCTION OR THE PER� <br /> FOFMANCE OF CONSTFUCTION.THAT 1 AM AUTIiOR12ED BY THE OWNER OF <br /> THIS PFOPERN TO PERFORM THE WORK i0P WHICH APPLICATION IS MADE <br /> 5 AND I COMPLY WITH THE STATE CANTRACiOf1S LAW 10.27 RCW AND <br /> � 298.200 WAC. <br /> 99 bION�TUREOFGONTR�LIORORAUINORIZED�GENT p�fE <br /> / � ` <br /> PROJECTADONE95 ^ ���[.L.d-� I/ �ld / <br /> � /� �PFl�T6CilY9USINE55UGEN5EN0.ANDBU5ME8S ME <br /> r'r}�-�- <br /> PLUMlINO MECHIINICAL <br /> � NO. 7YPE OF FiXTURE OR ITEM FEE NO. TYPE OF EGUIPMENT FEE <br /> �5 WATERCLOSET(TOILET) A/C—NIiNOIGUNITS—H.P. <br /> � BATHTUB FORCED AIR SYSTEMS—6T.U. M EA <br /> 1 <br /> � LAVATORV�WASHBAS�N) UNITNEPTERS—B.T.U. M <br /> SHOWER CLOTHESDRVERS <br /> KITCHEN SINKB DISP. VENTILATiON FAN <br /> DIBHW.�SHER RFNCaE MOOD <br /> LAUNDRVTRAY WATER HEATER <br /> CLOTMEB WASHER WOOD STOVE <br /> URINAL METAL FIFEPLACE 8 CHIMNEY <br /> � DRINKINO FOUNTAIN FIREPLP,CEINSERT <br /> FLOOR DRAIN ME'T��UMP 7�7 <br /> BACKFLOW PREVENTERS GAS PIPING <br /> � ROOFDRAINS—RAINLEADERS E%HAUSTFAN <br /> BINK(9ERVICE—BAR ETC.) <br /> , I <br /> � 3U'BT07AL 5 SUBTOTAL S I . <br /> PERMIT 5 PERMIT S <br /> ' TOTAI FEE E TOTAL FEE S <br /> fRONTBETBI�CK FEAFBEi8l1CN BIpESETB�CN PUNCY.ECRNUMlER F!E 11[CEIPfNO. <br /> ueEZONE wr�n� vec�ntBirE FEE9 VALUATION FEE <br /> ❑YEB O NO <br /> BUILDING <br /> iYPEOFCON9T. OCCUPANGYOROUP NOAFUWElLINOUNITB <br /> AlLOW1BLE/ACTU�L PLUMBING <br /> I 812EOF9L00. ND.OF?TORIEB B9MT. OCGIO�D l <br /> ❑v MECHANICAL p( <br /> � o r+ — <br /> MEIONILiMITATION OTHER <br /> � FINEBPRINKLEP9REOUIRED ❑YE9 O NO STATE BUILOII�G SURCHARGE — — <br /> STATE ENERGY SURCHARGE <br /> �VPLIC�TION/�CG BY PLAN9APPR.BY <br /> � � PUBUCWORKS <br /> TOTAL � <br /> ... m[x.wR�:-..n:.r '.�•-ir^:.'u- .• •_.r.n. .._ . . . �_.. _ .- . .�_I . . . � . .- '.'1:� .. . . ...' � , .. <br /> . ._ ... .. . � <br />