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A�PLICA ION FOR CONSTRIb+CTION <br /> PERMIT <br /> Ihs Erorpnen rve�ett <br /> CITV OF � <br /> everett <br /> BUILDINO DEPARTMENT <br /> 269•8810 TO BE COMPLETED IN INK—PLEASE PRINT <br /> qYNkR M�R�D�RE53 CiLY I�� PMONE <br /> 74 i��iocEnnr�r�� C'oco _� la�C ��r����S��L(X2_�I.�ey��e 98�� <br /> IEN�NT MAIL ORESS �C�i`�� 2iP PHONE <br /> �` ^ / � M 7. � t1^.�^1I t� 1I <br /> I IIGTORDETp C`� LY�C �I��J'1PE59dC)c) W.l�(1��, p �U(.CC��ILVIP-l�-/V�Y'VNOHE �`JJ���FS� <br /> OENER�LCAHTf1�CTOR M�q�O'1NE55 CIiY SIP PHOHE ��CEH$E• <br /> MECN�NiGLGONiRI�GTOR MML�ODRE59 G�1V ZIP PMONE UCENSET <br /> RUM&NOCANTRI�CTOH MMI�DOHE59 CIIY 21P PMONE 4GEN9E• <br /> GLA880f NORIt p( <br /> ❑ NEW ❑ �DDITION p. ALTEMTION ❑ REPAIR ❑ DFMOUTION ❑ '�OOOSiOVE/FRPLINSERT ❑ BUILDIN6RELJC�TION _ <br /> IENMiT IMPIIOJEMEM OR INTERiON REMOOEL ONLY GONT�Ci VERSO1N�Np P�qN� \ <br /> GONlMGTPRICEOFW011A I Q�� �QC \\ Dr \C��,� Vv�a .�I�.IV�� <br /> pEBCp1lE RR�N08011�REFOOTI�OEINVOLVED <br /> f>c��� �Ui����o�n uJo��� 3��_�� I <br /> aavon[ousea i�owo IHEREBVCERTIFYTMATIMAVEREADAN�E%AMINEOiMISAPPLICATIONAND <br /> �.( �(� ) 1(OOYY� _ KNOWiHESAMETOBETFUEANDCORREGT.ALLPROV1910N30FUW9AND <br /> LEWLDElCNIPfpNOFW� MT'19NOMNBELOWOPIR�CN�OORLOME41 ORDINANCESGOVEFNINGTMIS7YPEOFWORKWILLBECOMPLETEDWITM <br /> W HETMER SPECIFIED HEREIN OH NOT.THE GRANTING OF�PEPMITDOES NOT <br /> PRESUME TOOIVE AU7HORITV TO VIOLATE OR CANCF.L TYE PROVISIONS OF <br /> �CT e�xK or ANVOTHERSTATEORLOCALLAWRE6ULATINOCON�TFUCTIONORTHEPER� <br /> FORMANCE O�COI:STRUCTION.THAT I�M AUTHURIZED BY THE OWNER OF <br /> iH1S PROPER7V TO P[RFORM THE WOFK FOR WHICH APPLICAT'ON IS MAOE <br /> AND I COMPLV WITH THE StATE CONTRACTORS LAW 1B.2I RCW AND <br /> 296.Y00 WAC <br /> l�� ',� /� /��IIIT � f—�`CQlS� qB�c� S�ON�lU11fO�CONiR1C10R��RAUtMO1ULfDAOCM p�1E <br /> `�� i \ \( l f -��C/ . <br /> PRQIECT/�UONESS ♦ ICA4TSC11 BUSINFSSIICENSENO�N�E ��� <br /> M.UY/INO MECXANICAL <br /> Np, TYK OF flKR111E 0111TEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CL09ET(TOIIEI) NC—NHNDLa UNI f5—H.P. <br /> BATHTUB FORCED 111R SYSTEMS—HLU. M EA <br /> LAVATORYIW�H BA91M UNI7 HEATERS—B.T.U. M _ <br /> BHOWER CLOTHESORVERS __ _ <br /> KITCHEN 81NK 6 U18P. VENTIIATION FAN _ _ <br /> D18HW�9HER RANOE HOOD <br /> LAUNDRYTRAV WATERNEAIER _ <br /> CLOTME9 W�44HER WOOD STOVE . <br /> UPINAL METAL FIREPLACE 8 CHIMNEV _ <br /> DRINKINO FOUNTAO� FIREPLACEINSERT <br /> FLOOR DRAIN MEAi PUMP _ <br /> BACKFLOW PREVENTERS OAS PIPINO _ <br /> qOOF ORAIN9—RAINLFhDER9 E%HAUST FAN _ <br /> SINN(9ERV10E—BAR ETC.1 <br /> BUBTOTAL S 3UBTOTAL S <br /> PERMIT S PEPMIT S _ <br /> TOTAL FEE 5 TOTRL FEE S <br /> ppNTBFTMCI( PURBETB�C1c BIDfBF�MCIt IIANCM[CItNUM�l11 f![ �f�[IRNO. <br /> ueeZo��e �oTu�u VAC�HiBRE FEEB VALU�TION fEE <br /> ❑YE! ❑NO <br /> IYPEpCONlT. OCCURINCYOPWP rauraw[iuwouvirs BUILDINQ __ � G� O <br /> utawRv�cruu D �.L PLUMBIN6 _ _ <br /> P <br /> MiEQfBIDp NOOF6iOfl1Ee R1Mt. OCGLWU MEriH�NI�iAL <br /> Zf� <br /> � y� -- <br /> MfqNT4MI1�lON OTHER <br /> FlRElPIIMIKIERlREOUIRED ❑rEe Je+�o STATEBUtLDIN09URCHAROE Jr <br /> 6TATEENENaY9URCHAROE <br /> �ppi�GrqN'CGm Ft�N6APPRNY pUBLICWORN3 �` <br /> /3a �"'-•�'.� TOTAL B V <br />