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l�PPLICwT10N FOR CONSTRliCT10N <br /> PERMIT <br /> Ine Ewrynan evrrrll <br /> pTV OF � <br /> everett <br /> BUILDING DEPAFTMENT •� <br /> ���+ 259-BBtO TO BE COMPIETED IN INK–PLEASE PRINT <br /> OWNER MeR�D0�E55 C�Iv 8P PNUNE <br /> � y� �'^�� An c �f}U�PN �?0, 13o,r �1�7 �K. S'T�vP.�.s p�5a' .�3y<l_3Yo <br /> MNL�D�RE58 CITY <br /> ��� S sr�s�,,, _FvP,ePTr ��ao3 �5h-�aoo <br /> � � �—v pir ziv vnonc <br /> � IIIC kGLONCEeqNEP M�IL�O PE 5 T� <br /> � �� �LI °c.c,'y1d�'-i�i o / <br /> y y OENER'1 TRKiOR���/ '1 M�IL�DOP 4.�� Gltt 2i� %IONE �GEMSE• <br /> (' � ��/ ,o, 9 /X S%Pvr.vf 9P'�� 3 •� : � <br /> [; Z� u cnsHKxw�//rO MAiI�U Prgy Ci1Y LIP YNONE 4CENSE• <br /> o� �f�� /�PGt/iN6 �O, r3ex 336 �� Src�a-�•�c >Pa� 3�yY/i/—/�-�1G�'/��80 <br /> � RU 4 i IOA MMLAOOPE55 C11Y ZIP VMOHE LIGENSE� <br /> ��'g �or�i����i.�o 6a7 S� �vP�ei? M�si�Tia�30� .J5.�6/�/-���7_2�-�'� <br /> � CL�.9tlOFWOPR <br /> ~ �NEW ❑ �DDITION ❑ �LTEMTION ❑ REP�IR ❑ OEMOLI710N ❑ WOODSTOVE/FRPLINSERT ❑ BWLDINORELOCATION <br /> � y TFMU111MoppyENENtORIHtERiONREMOOEI�MLY CqN1AGiPER50N�NDPMONENO <br /> H <br /> ��/1� f.lINIRACT%11f,EOFWORII __ <br /> �� DE�.%AiBEWOAK�NO80U�AEfODI�OEiNVOLVEO / <br /> � – G P 4 n --- <br /> � aocoaEDUE miowo / INEREBVCEfiiIFVTHATIMP�G'�E4DAN�E%AMINEOTHISAPPLICATIONAND <br /> �� �^ /%/ YN!�^/1L� KNOWTMESRMETOBETRUC��NUCORRECT.ALLPROVISIONSOFUWSAND <br /> y OR�INANCES GOVERNING'F IS 7YPE GF WORK WILL BE COMPLETED WITH <br /> it'on� E IPTIO orrnorcn OV�NBELOWOR�P�CNfOVACOTE61 WHETNERSPECIFIEDHEREINORNOT.TNEORANiINGOFAPERMITDOESNOT <br /> PRESUME TO GNE�UTHOR TY TUVIOLATE OR WNCEL THE PPJVISION80F <br /> �oi B�oCK_._ o� ANYOTHERSTATEORLOCALLAWREGULATINGCONSTRUCTIONORTHEPEH� <br /> FORMANCE OF CONSTFUC71O4.TNAT I AM AUTMORIZED BV iHE OWNER OF <br /> n.�y.��� TM13 PROPERTV TO PERFOFN fME WORK FOR W NICN APPLICATION IS MA�E <br /> /�( AND 1 COMPLV WITN THE STATE WNTRACTORS lAW 1827 RCW AN� <br /> 286200 WAC. �/�a�� <br /> ' $IQ �UNEO�GON101C10AOP/.OtNON12E��GENI WiE . <br /> — X�'✓' �� .�9✓�1,'tC��. <br /> wqJEC .-Y -� �P �Nl L B � 55/'��� 'SwF59NeMe <br /> ___-���.� � - � L��' 1 ��/�i f'� ��������y���� <br /> PLUMBINO MECHANICAL <br /> NO. TYPEOFFI%iUREORITEM FEE NO. TVPEOFEOUIPMENT FEE <br /> \ WpTER CLOSET 1TOILET) A/C—A/HNDL3 UNITS—HP. <br /> �� B�THTUB FORCED AIR SVSTEMS—fiTL. M EA _ <br /> I �I L�VATORV�WASNBASIN� UNITHFJdERS—BT.U. M <br /> 1 � SMOWER _ CLOTMESDPVERS <br /> KITCHEN SINK!DISP. VENTILATIOH fAN <br /> 1 �� OISMWASMER _RANGEHOOD <br /> �� LAUNDRV TR�V WATER HEATER <br /> '� � CLOTMES WASMER WOOD STOVE ' <br /> �, URINAL __METAL PIREPLACE 8 CHIMNEV <br /> i � FIREPLACEINSERT <br /> DRINKING FOUNTAIN <br /> �w fLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTEPS GAS PIPING _ _ _ <br /> RppFDRRINS—RpINLEADERS E%h\USTFAN __ _ <br /> ��'�' SINN�SERVICE—BAR,ETCI _.. .. —_ — �—�- _— <br /> �1�� __'__.. _ <br /> � � — '— <br /> I ��1 __ _ <br /> SUBTOTAL S SU9TOTAl f <br /> I PERMIT f PERMIT _ 5 _ <br /> I TOTAL FEE S TOTAI�EE S _ <br /> I _� iPOHl8E1BALM PE�PSEIBAG�t Si0EbElBIiGK PIAMCHE`�1tMOMlEII FEE--. _ 11ECEIRNO. . <br /> � '!� �� � � � � 1 � ������ � ��'C.� � �� <br /> ,'�',�- � .���- <br /> - usrzoMe � �aien[� )�cer�ien[ FEEB V�LWTION FEE <br /> ,(',vE6 �NO �,� <br /> j �•�.. BULLUING �1/�"� i �,. i � � ✓ � <br /> IWEO�CONST OCC'IO�NGVpIqUO NOO�DWEI MOIIN�tS ����J �� <br /> ♦uow �Cr e�� ��. 1 ! PLUMBING _ __ _ <br /> l <br /> 64E Jf B.DO HO 0�61URiE5 BSMI OGC��.)�D <br /> `� ��� ^l �+ MEGMANICAL <br /> / i� _� — <br /> y l i `� +` .--C' � <br /> � �EiO�tu`Miu�ioti OTMER <br /> ���E 9�HiNalEnSPFWiuED e vES .'NO �J�+ ____ STATE BU�LDING SURCMARGE � �� ' <br /> __'_ _— — . _-_ _— IL' �1_' <br /> STITE EN[NJY SURCNARGE <br /> �ivauci.i�0'.�..c bv �vlin:,u nd Bi� PUBUC WORN$ _____"—_ —— <br /> '_} '��' . .� I \ TOTAL I�i I .r.J, , � <br />