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APPLrCA�'ION FOR CONS'i'Rl..,:T10N � <br /> PERMIT <br /> rhe Crergreen <br /> UTV Oi �•�.�••�•�I <br /> everett e <br /> BUILDING DEPARTMENT <br /> �'4 259�eet0 TO dE COMPL'-`"TED IN INK- PLEASE PRINT <br /> � � � �y/Nlfi MLILRU�FC�S fIIY ZIC I�II�I�L. <br /> ��,_��._r_/-�oi..�� �vc 24izo= 2•f �a. i .BKrc.t �`"8036 �497—i�5y- <br /> � y y EH�H� Mr,iinoonEss cnr zir rro�+[. <br /> H �� �.wmcc �1 DRNFri.�G _ — ---�a'2"572'L---_.-- <br /> q r�I1E6fO�0E5iGNER MnILR�ORE55 GIiY ZiP PrroNE <br /> � H 7�tl /�.4iit�..o.vT'�e..�5,��_�.oito� rg2„<,.i K� . /32/5.c 9 30 3 G. ��J'y Pil- /56rj — <br /> � M� GEN[R�ICONiR�CTOR IAAILAOOPE55 CItY I�P PNON[ UCEHSE� <br /> V1 M — <br /> H <br /> w�p MLCIIFNIGLLOMR4CiOR MAILADORESS CIIY ZIP PHOIIE LICENSE• <br /> � H O � - — <br /> � Fy RUMBINGCONiHAGTOR MML��DNESS Qif ZiP 1'HONE LIGENSE� <br /> � rog _ _ <br /> G7• C� CLRSSOFIMJNN <br /> H <br /> .�' y � NEW L ADOITION ❑ AUERAiION ❑ REPAIR ❑ OEMOLITION ❑ WOODSiCVElFRPLMSEflT ❑ BUILGINGRElOCATION <br /> C1LNANi1MFROVEMEHiORIHiEHiOBREM00ELONLV � WNt�CTPEHSON�N�PMONENO <br /> yy CANiRACTPRIGEOFWONK <br /> g �..� DESCa1BEWCPrcANO50U�REfO01AGGINVOLVED <br /> ��� _�)�nL�.�� =-lA---�—� <br /> o T�CvcTiaN - /�/�ak• ���00 <br /> rnGvo9¢ousEorem�oiuo I;tERCB"� '-�'���:b'.1'Iutt�EREADANDEBHMINEDTMISPPPL�CATIONAND <br /> � . •!0�77� '_ �:i�-. .i �'21r _'(,44DCORREC'i.ALLPROb'SIONSJFLAWSAND <br /> y � � leG�tDEScatvnoMorvnoveatt�5nov+NnEioAonnnncNrouncoflE51 '�'��'���A� ':l'. ;ci':LIl':IKG';d'.NPEOFWORNV.'IL.SECOMPLETEDWITH <br /> � NH51NEnEi7EGiFiLDMEHE140RNOLTHEGRANTINGOf�PPERIdITUOESNOT <br /> 'R[5�CdE TO GNE AUTHOFITV i0 VIOLATE OR CANCBL THE PROVISIONS OF <br /> I.oi� e�ocK oF � ' f.NVOTH@RSTAtEURLOCALLAWREGULATRJGCOV57RUr,llOh� qTHEPER� <br /> FOR(v'ANCE OF f,ONSTRUCTION.TNAT I AM AUTHOPIZED�V THC GWNER OF <br /> THIS FFOPERTY TO PER`-0RM THE W0f7K FOR WHICH APPLICATipN IS MADE <br /> AND�' GOIAPLV WITM THE STATE GONTRAGTORS LAW 1R27 RCW AN� <br /> 29G. 0 WAC. <br /> — ',9FcoHrnauonmiRvnroaizer.ar.[r:t oArz <br /> � '��__�r7 �I � <br /> M10JEGTADUNE55 �I .FFL�P ivBU51YG55�iCLpSENO�NDPU9NE53Nnld[ <br /> ��,.� a-.. _,� j! <br /> � i) <br /> PLUMBING � MECNANICAL <br /> NO. TYPE OF FI%NPE OR ITEM FEE NO. TYPE OF EOUIPMENT FEF <br /> ' . �� WATERGLOSETITOILE� � '� A/C-A/4NDI.GUNITS-N.P. <br /> /_.. - ' — <br /> I �'" BATHTUB � � FORCEDAIRSYSrEMS-BTL. MEA _ <br /> �� � LAVATORV�WASHBASIN) - UNITHEATERS-&T.U. M _ <br /> SHOWER � CLOTMESURVERS _ y_Yi? <br /> 1 � RITCHENS'NKdDISP. ��) " _ VENiILATICNFAN -' <br /> ! ��� DISHWASHEP ��� "- FANGEHOOD <br /> 1 LAUNORI'TRAV WATEPHEATER i� <br /> � � CLOTHESWASHER �"� � PJOODSTOVfl <br /> I URINAL METAL FIREPLACE d CHIMNEY <br /> � �RINKING FOUNTAIN — FIREPLACE IN3ERT <br /> �� FLOORDRAIN MEATPUMP <br /> - BACKFLOW PREVENTERS GAS PIPWG <br /> , ROOF DRAINS-RAWIEADERS E%HAUST FAN <br /> 51 NK�SERVICE-BAR.ETC.) _ <br /> IS�1 _- ' <br /> ��� �� � SUBTOTAL S �" ' � ___ SUBTOTAL S __'i � ;_l\ <br /> . PERMIT S PERMIT 5 - - <br /> TOTAL FEE 5 - � TOTAL FEE 5 ' '�� / '� <br /> ` FRONTSETBACR PEARSETBPCN Si0E5ETP GN '�� GIANCH CI(NUMBEfl FEE HECEIPiHO. <br /> �.,.1 l � . Z, � � � l�a�l U�i ° "1�-(5. <br /> - useioHe tornnen YAlANi51TE FEE$ VALUATION FEE <br /> J(YES ❑NO <br /> � �"'� �� BUILOINO < � ���C � � �� <br /> iVPEOiCONST. OGCUPAN�GNOUP NOOFOWElUNOUNILS 1' �_ <br /> ALLOWABLEiAGTURL"�I� 2� � I PLUMOING / _��I' '- � <br /> .r. <br /> SIZEOFBLD6 NOOFSTORI[5 0.5MT. OCGlOAO <br /> '01� c� 1 � ❑v � A MECMANICAL ,j � � <br /> .+ 1 � ~Y ! <br /> ��e�c�rtumnenoH OTHER I � "��� ,��� <br /> 3y2 s� �s►e��E c�, - , <br /> vinEsaaiHrcieAsnEowaeo Xres Z a STATE BU LDING SURCHARGE ��11 ' <br /> STATE ENERGY SURCHARGE �� <br /> FPtt!LR110N ACG BT PL�NS�PPR BY � <br /> � n PUBLIC WORKS <br /> � i <br /> /�' TOTAL ���,�� ;��. <br />