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APPLICw:lION FOEi CONSTRI..:T10N <br /> PERMIT <br /> �hs Ereryroen c�rcit <br /> CITV OF � <br /> everett <br /> BUILDING DEPARTMENT <br /> 259-e8i0 TO BE COMRLETED IN INK- PLEASE PRINT <br /> � M�II��DRE55 GRY Zlp %IONF. <br /> o �ecx,;�/ '� , lY (3•-�nclU.��_ Cl��77� SP�a/ �.r� -7//�- <br /> E � M�R�OOiiE54 Ciir ZiP PMOME <br /> �uss g% pC�.� �, , , , . . . <br /> •NCHRECTORDES NEA M�ILADDRE59 GTY =�P PHONE <br /> (3EHENGLCONTP�GTOP MLIL�U�PE55 p1Y ZIP PHONE LIGc_119E� <br /> MECn1N�GU.CANTRnCTOR MNL�DORE54 GIIY LIP PMONE LIGENSE� <br /> ��. m�/ <br /> PL 01NOGOMi /iGiOR iMILADUf1E9S CItY 21P HION[ UGCNS[• <br /> CU�S6 0i WJHK <br /> �. NEW ❑ A�DITION ❑ ALTERATION C REPAIR ❑ DEMOLITION ❑ WOODSTOVFJFiiPLINSERT ❑ BUILDINGI7ELOCAT�ON <br /> 1EM11Hl IMPROVEMENI OA INTERIOR R[MOOEL ONLY COH��GT PERSON�ND PHONE NO <br /> CONTMCT ORICE OF WORK <br /> pC8Cp1eFWONK�N09OUAREfO0T�0E1NVOLVEO r�]S <br /> Y T" <br /> a�� K �G� x �o ' ,��Fa� v <br /> PROI'08ED U8E�Jf BUIL�INO I IIEREBY CERTIFV THAT 1 I1AVE REAO AND EI(AMINED THIS APPLICATION AND <br /> '-7'f/ �� P KNOWTHESAMETOBETRUEANDCOFRECT.ALLPROVISIONSOFLAWSAND <br /> � V ORDINANCES GOVEPNING THIS NPE OF WORK WIIL BE COMPIETED WITH <br /> IEWlDESCHiGTiON(NPROI'EPTYI6NOWN9ElOWONATTl1CNFOURCOPiEB� W�{ETNERSP[CIflE011EREINOFNOT.THEGRANTINGOFqPERMITDOESNOT <br /> NRESUME TO G�VE AUTHORITV TO VIOLRTE OR CANCEL THE PROVISIONS OF <br /> LN 9�p�N . OF ANVOTIIERSTATEORLOCALLAWREGULATINGCONSTRUCTIONORTHEPER� <br /> FpRMANCE OF CONSTRUCTION.THAT I AM AUTHOR12ED BV THE OWNER OF <br /> THIS PROPERTV TO PERFORM THE WQRK FOR WHICN APPLICATION IS MADE <br /> AND I COMALY WIiH 7HE SiATE CONTRACTORS LAW t827 RC�N AND <br /> 296200 WAC. <br /> SIONRUREOFLONiR�LtOROPnUiHOR¢[OPGENI DetE <br /> X , <br /> A10JEGTdODIPE S ' M �pPIICI� fG � U MESSLIC NS ��SSNFME <br /> �` ��..1� <br />� PLUM\INO MECHIINICIIL <br /> Np, TYrE OF 911(NRE OR ITEM FEE NO. 7YVE OF EOUIPMENT FEE <br /> WIITER CLOSET(TOILET) A/C–A/HNDLG UNITS–H P. <br /> BATHiUB FORCED AIR SYSTEMS–BT.U. M EA <br /> LAVATORV�WASNBASIM UNITHEATERS–BT.U. M <br /> SHOWER CLOTHES DRYERS <br /> KITCHEN SINKb.DISP. VENTILhTION FAN <br /> D�SHWASHER RANGE HOOD _ <br /> I LAUNDRYTRAY WATER HEA7ER <br /> CLOTNES WASHER WOOD STOVE <br /> URIIIAL METAL FIPEPLACE 6 CHIMNEY _ <br /> DPINKING FOUNTAIN fIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP _ <br /> B�CKFIOW PREVENTERS GAS PIPING _ <br /> ROOF ORAINS–HAINLEADERS EXHAUST FAN _ <br /> SINK(�EiiVICE–BAq,ETC.) <br /> I SUBTOTAL S SUBTOTAL 5 – — <br /> PERMIT S PERMIi S <br /> TOTAL FEE 5 TOTAL FEE S <br /> FIqNT5ET8�GN BFAqBETfl�CK SIUE6ETBM;N VLAMCNECI(NUMBEN FEE IIECkIPiNO. <br /> O 301 d <br /> U9EZONE LOT�REA �/ p vecr�Nrart- FEES VALU�TION FEE <br /> A3 �/` (O/ ❑YES �No <br /> BUILDING <br /> I lYPEOiCANST. OCCUPN/CYOfiOUP NOOFpWELIINpUHIT$ — — <br /> I �LiOW [/� tUSL � Z PLUMOING _ <br /> 61ZEOFBLDO. NOAfSTORIES BSMi. pCGLO�D <br /> ._ �� x �O� � o N MECHANICAL __ <br /> � ' NENiHTLIMIU110N OiHER <br /> FITE61'RWNIEHSPEOUIFEO OYE6 NO STATEBIIILDINOSURCHAfiGE I <br /> STATE ENERGY SVRGHFRGE � <br /> �vrt�wnoN�cc ev PU1N5�PPfl.BY <br /> PUOLIC WORKS <br /> 10TAL <br />