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1 <br /> APPLICA.ION FOR CONSTRV..TION <br /> . PERMIT <br /> I�e Everprnon rvrmll <br /> GTV OF <br /> everett e <br /> BUILDIN4 DEPARTMENT <br /> 259•Beto TO BE COMPLETED IN INK— PLEASE PRINT <br /> OWNEP / �UiL�UUIiF 9 Illr !IP 1•nUNI <br /> ��1G q• L�61�'Jt't'�/�1---- , -- - _ C<!i_eft. p�j ,�'.� 36�0.5` <br /> . - - <br /> ,s /G'/!�I _...��G� 3--- - -- ---- <br /> iEN1N1 M�IL�D011fSS PIY I�P 1'BONF <br /> 7b'�� Fi Ci»inn Rd <br /> --------. - -- --- ----- — <br /> �qGNIIECIOROE510HER M�II����F55 C11Y lIP � f91ONF <br /> ,farr�Li ------ -- — — <br /> OENER�LLON�I'In�CIOR M�II�UUOE53 Ct1V III` MIOHE IICENSE• <br /> MECN�ON A����A M�Il�0Uf1E39 GfV TP WH)NE IICENSE• <br /> RUMflINOGON11UL1011 M�il�I1011E93 � -' - --CI�Y IIP.�. ._...__.-. 19m1rt---�---- IK:fN4I�. . <br /> — __ ___—____". _..._._"___-_____._._. _ . ......__. _' . _ ___ <br /> GL/�890i WORK <br /> ❑ NEW ❑ �DDITION � ALTER t10N ❑ REPAIR ❑�OEMOLITION ❑ WOODSTOVE/fRPlINSERT _O Bl'ILDINOf1ELOCA710N <br /> �TENMIIIMPRWEMENIOBII IORREM � (J" CONf�C1PfOSON�N01'110NEN0 <br /> COMTMCI PRICE Oi WONK���� �GOC �-�f ----------- - <br /> DElGRIBEW�AK�NDMU�AE�OOt�OEINVOLVED �.'I�� <br /> �1 PL.�Gf✓G s/SC� r1xt��'_1_��5�.?�G/�'D�f ---- --- ---- <br /> vnoroecuuscorawimHo IHERLBYCERTIFYTHAiIHAVEREADANDE%RMINEDiHISAPPUCRT10NAN0 <br /> ��Qnp�S�/ U./ KNOW TNE S�ME TO BE 7RUE AND CORNECT.ALL PPOVISIONS OF LAWS AND <br /> t¢w�oExnivtq�onorE�n,t�nsHowHee�owoa�rt�cr�rwncomes-- ORDINANCES GOVEPNING TNIS TVPE OF WO�K WIIL BE COMPLE7ED W�TH <br /> WHETHERSPECIFlEDNEREINPRNOT TIIE6HANTIN�OFAPEFMITOOESNOT <br /> �`� '^y,, ��N� o` � PRESUME TOGIVE AUTHORITV 1J VIOLATE OR CANCEL THE PROVISIONS OF <br /> >,L/r�L P��—������`I��-�- ANVOIHERSTAIEORLOCALL�WREQULATINdCONSTRUCTiONORTHEPEti� <br /> � FOAMANCE OF CONSiRUCTION.THAT I AM AUTr10RIZED Bv 7HE OWNF.R OF <br /> / ���/S•/� -_ - _ THIS PROPERN TO PERFORM iME W0�7N FOR WHICH�PPLICATION IS MADE <br /> fj�j� �---- AND 1 COMPLV WITH THE STATE CONTRaCiORS lPW 1927 RCW ANO <br /> 798.200 W.�C. <br /> 4aNe�un[orcoNtn�ctnnonnuuamzroeacH� n��r <br /> PfqJECf1100RE68 �p1�lIC�N�C�iVPUSM�45L�L[�ENO i0 U9ME99N�ME � <br /> � 7�.�d FA C�Q..rin -3 <br /> �LUMlINO MECHANICAL <br /> N0. TYPE OF FIKTUHE OR ITEM FEE NO. TYPE OF EOIIIPMENT FEE <br /> WATERCL09ET�TOILEI) A/C-/VHNOL4UNIT5-NP. __ _ _ _ <br /> BATHTUB FORCEOAIRSYSIEMS-B.T.U. MEA __ <br /> UVATORY�WASHBASIM UNITHEATERS--81.U._ M ____ _ <br /> SHOWER CIOTHE3DRVERS__ _____ _ __ <br /> KI7CHENSINK6DISP. VENTILATIONFAN_ _ _ ___ <br /> D19HWASHER RANOE HOpO _ ____ _ <br /> LAUNORYTRAV WATER HEATER __ <br /> CLOTMES WRSHER WOOD STOVE _ <br /> URINIIL METAL FIREPLACE 6 CIIIMNEV _ <br /> DRINKINO FOUNTAIN FIPEn�ACE INS€NT __ ____ __ <br /> - -- <br /> FLOOF DRAIN HEAT PUMP <br /> B�CKFIOW PREVENiENS __ - _- -�� -- O�SPIPINQ __ ____'_ __ ___,_ _ <br /> ROOFDRAINS-RAINLEADERS E%HAUST_FAN_ _ __ __ ___ ___ <br /> 81NK�SERVICE-BAR,ETCJ _ ____—__- -- <br /> . .._ ___._ -_ <br /> SUB TOTAL f SUB TOTAI. f <br /> —._—. __ _.-_- '___._—___-_-_ __ <br /> _-______-_. ___.-____. -_ <br /> PEHMIT S PERMIT f <br /> __-__.---.__--__.-_ _______- _-- — <br /> TOTAL FEE S TOTAL FEF f <br /> iRONI REIB�CK f1E�ReE191�CK S�UE SEIIUCn •U�N,�EC `M��� �E� �C7�L AE���� <br /> 1" � <br /> UeE1oNE lO1�NE� wceH�snt � FEEB VALUIITIOM FEE <br /> I/YE5 {YNO <br /> _ � BWLDIN� � � �'� � (�. l__��l <br /> __ _—____. � .. <br /> 1YPE0lGOHl1 OCWP�NCYOROUP NOOfOWEIUNON11�5 "_-_.. . _ .... . _ . .—.--"'\.-- - <br /> Niow.eieu -3 � r�uMeiNo <br /> �`�r K` - -� - _ _ - - - -- --- <br /> _. _ - <br /> 6REOf BLDO NO Of Bt0111E8 BSMI ULL LOAp MECHANICAL <br /> —`V�`, I1 Y ' ___ ___"._ .-- —_ <br /> h — n[im�tuMiuuoa. . _ OTHER <br /> —__._ ___. _ .. _ ._ __ --_._ <br /> iIPElPR�NI(IENSPEOUIREO ❑YF.9 ticHo _____ . srateeuaoiNasunainnce <br /> STATE ENERGV SURCHARGE <br /> ___ _'_'—."_'._._ _ _.'______ <br /> -______'_. _-_ ___-_ <br /> I�Pf�IIC���ON1LCflY PUN9�PfRBY pUB��LW�nK$ <br /> � � � TOiAL <br />