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APPLIC�►��'ION FOR CONSTR46:TION <br /> PERMIT <br /> fhs Erorynsn rvrrrll <br /> GTV OF � <br /> everett <br /> BUILDINO DEPARTME�JT <br /> 259-8810 TO BE COMPLETED IN INK— PLEASE PRINT <br /> H M/IL�OURESS Cllv !iP PHOME <br /> � �-/ �^ �,.d <br /> 1/M �fNN�$S� /� Yv ;Mc /V��[�L/�S Y_SUILct e21t7 <br /> �irv bP vNONE <br /> 7�EI�Nf M�i I. 0 ESS ��� ' ��� <br /> S�` MML�DDFE59 Crtr DP ��ONE <br /> MGNItEGT ON OEBqNER <br /> I � <br /> OENE COMTH�CIOR MML�UOPE99 GIIY 21P PNONE IIGFNBE� <br /> S�� CRY I�P �NOHE IICENlE• <br /> I.IECNIIN GONIRI�GION M�IL�OONESS <br /> RUMliN000f1 MC�OR <br /> M11l�pOREB! GIIY SiP VNONE L�GEHlE• <br /> N <br /> fAAD!Oi WORN <br /> NEW ❑ �DDITION ❑ ALTEMTION ❑ AEP�IR ❑ DEMOLITION ❑ WOODSTOVE/FPPL INSERT ❑ BUILOINO RELOC�TION <br /> 1E NTIMPROVEMFYTOPINIEPIORPEMOOELONLY �(J CANUCfVE�50H�NpPNONENO <br /> � CONTp�CTVRICE0FWO11K <br /> � � �['1�n �'w�IJ�Su.I b��.-�C23 <br /> D[lCRIO[WOpRµDlOU�NE i001ME INVJIVED <br /> 3�z � - -- <br /> ppovoeEDUnE eundNo IHFREBVC[RiIFVTNATIHAVEREADANDE%AMINEDTHI9APPL�CATIDN�ND <br /> KNOW THE BAME TO BE TRUE AND CORfiECT.ALL PROVIOIONS OF L�V.S AND <br /> LEMIDE��r NOiM�OPE�E��RI1CHfOUPCARESI OROINANCE9OOVERNINaTHISTYPEOF WOAN W�LL B[COMPIFTEL'WITM <br /> WHETHER SPECIFIED IiEt7EIN OR NOT.THE 6NANTINOOFA PERMIT DOE9 NOT <br /> II 1 PRESUME 7001VE AUTHORITV 70VIOLATE OR C�NCEL THE PRQVI910N90F <br /> �m /.� µp�K�QyL� �� �,--��— ANVOTHERSTATEORLOCALLAWHEDULATINOCONSTRUCTIONORTHEF`ER� <br /> —'� rtcn 6808 roSecy FOfIMRNCE OF CONSTRUCTION.TN�T I AM AUTHORIZE�BY THE OWNER OF <br /> � I y Th19 PROPERTV TO PERFORM THE WOFN FOR WHICH APPLICATION 19 MADE <br /> • 7 AND I COMPLY WITH THE STATE CONTRACTORS LAW 18.2' RCW AND <br /> �6c,,,a,u.y q,.a� k 3 voL �o �. 83 zse xoo wnc <br /> 910 EOFWNtRI�CiOROO�UTNORi1[D�OENT D�iE <br /> X �s_a�9 <br /> .ppJlC/T11DORE!! �PMICANt 9 � EBSIILEN9EN0�ND0U9ME88N�ME <br /> b� � <br /> PLUMSINO MECHhNICAL <br /> NO� TYP!OF FUfTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> � WIITERCL09ET(TOILET) NC—NMNDLOUNITS—H.P. <br /> � BATHTUB FORCED AIR SVS7EMS—BT.U. M EA <br /> LAV�TORY�VJASHB�SIM _ UNITHEIITEFlS—B.T.U. M _ <br /> BHOWER CL01HE90RYERS __ <br /> NITCHEN 91NK 6 DISP. VENTILATION FAN <br /> DISMWABNER RANaE HO00 _ <br /> LAUNDRVTMY WATERHEATER _ <br /> CLOTHES WA9MER _ W�D S70VE _ <br /> URIN�L METAL FIREPIACE 6 CHIMNCV <br /> DRINKINQFOUNTAIN FIREPLRCEINS Ri <br /> FLOORDRAIN _ HEAiPUMP <br /> BACKFLOW PREVENTER9 OR9 PII`INO __ _ <br /> ROQF DRAINS—RAINlE1DEH8 E%HAUST F�N <br /> 81NK(9EPVICE—BAR ETC.1 <br /> SUBTOT�L S 9UBTOTAL S _ <br /> PERMIT S PERMIT S __ <br /> TOTAL FEE S TOTAL FEE f <br /> flqNllEIBIiCK PV118E/BA'K BiOEBEiB K VUNCNlC NUM!!R F!! � ./ �[Ctl[TM�� <br /> �/ � ��' i /if'�J �1 <br /> �7 ► 5�w�' o�' <br /> UbEior�[ � LO1�RE� wc�Hrelt� FEEB VIILU�TION FEE <br /> ry 'I�� � ❑rEe iYN� BUILDINO <br /> !r <br /> IYPEOfCAH9T. OCCU� NLYOROUP NOOfW/EILiNOUNifS <br /> �uow�BLU�CT11��N M �� � '�_ FLUMBING _ _ <br /> eiz[ore�ov uoo�eioniea B9Mt OGGl0�0 MECNAMC�L <br /> 3 �2 �� � °" N� - - <br /> MEIONILIMII��ION OTMER <br /> iIPElPRINMLERlREW�AED O YES [�O /�' _ STR7E BUILDINO SURCHAROE � <br /> STATEENEROYSURCHAR6E _ <br /> �av��c�noH�ccey ruHs�vnnv PUBLICWORKS <br /> o ��j� TOTAL <br />