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.-...w.q <br /> ,-� ,�, k <br /> APPLICATION FOR CONSTRI..:T10N "°"'� <br /> . PERMIT � <br /> � fM Everpiem ��verrll <br /> CITY OF � <br /> everett <br /> BUILDIN6 DEPARTMENT <br /> 259-eeto TO BE COMPLETED IN INK— PLEAEiE PRINT <br /> ��� • . . .r OWNFP M�II��DNE55 GI�Y � IIV PNONE �� � <br /> o � 3�,t3i Y A�a�u��c� Co„n oa�—���_IA.L;.�``�► I'1 '��1��— �� /_r -- — <br /> IEH�Ht <br /> ��� ��HIIECiOR0E9qHER —" MMl lO0RC5S -- ---- --��fv-----SiG V��ONE —— -- <br /> ��� CRY — 21P — PNOHE LICENSE• <br /> OEHGR/.LCOHTP�GTOO MNL�OORE54 <br /> � MECM��LGOH1HILiON 1.IAlL�ODPE55 — GIIY ZiP P��ONE IICEHSE• <br /> �R <br /> �i RUMBINOG011iR�CtOR MAIL��UPE55 CIIY (iP PMONE UC[NSE• <br /> n �J �rL��s����--�3 �.� �r►-rn6 ��1�2=7�d�_�3�y��cn l.u-��mc* <br /> QW cueaorwon. 3V3N9 <br /> �H ❑ NEW ❑ ADDITION �ALTERATION ❑ PEPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL INSERT ❑ BUILD�NO RELOC�7iON __ <br /> y IEN�NfIMPRP/EMkHiON:HiEP10RPEMOUELOHLY CONULIPEASONANDPHON[HO <br /> H fANTRALT VRICE 0i WONK __ - <br /> (A pE9C i EWORN�N090UMEFOOtAOEINVOIVEU <br /> �y� [ous Or tD�Ha IMEREBYCERTIFYTHATIHAVEi7EADANDEXAMINE0TNI5APPLICATIONAND <br /> ov Ip'^I/A, KNOW THE SAML TO BE TRUE AND CORRECT ALL PROVISIONS OF UWS ANO <br /> �� 1I 1I u OROINANCES GOVERNING THIS NPE OF WJRK WILL DE COMPLETED WITH <br /> � � vnoNOr EnTrieHOW�'��MORAR�CNfO11NGORf51 WHETNERSPEGFIEDMEREINORNOTiHEGRANTINGOFAPERMITDOESNOT <br /> ✓ PRESUME TO GIVE AUTHORITV TO VIOLhTE OFl CANCEL THE PROVISIONS OF <br /> �pT eiot� or _ ANVOTHERSTATEORLOCALLAWREGULf.�INaCONSTRUCTIONORTHEPER� <br /> FORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZEU DY THE OWNEfl OF <br /> AND I COMPLVTW iMRT�ME STA EWCONTRACTJORSH`�L'BZT�OR�MANO <br /> �96.200 WAC <br /> giONATUAEOfGONIP�CiORnR 110iZE�A6EM DetE S//7/� <br /> \ <br /> PROJECi�UDRESS �PPUC i9W1YBU iN SLiCENSENO�N BUSMESSN�ME � <br /> L� •� <br /> VLUMBINO MECHIINICAL <br /> NO. n'PEOFfIXTU1IEORITEM FEE N0. TYPEOFEOUIPMENT FEE <br /> WATERCLOSETITOILET) NC-A/MNDLG ITS�-M.P. <br /> .���'�s FORCEDAIRSYSIEMS-HTU. MEA <br /> '� BATHTUB UNIT MEATE(iS-6T.U. M <br /> , _ LAVATORVIW�HBASIN) - — — <br /> 4 SMOWER CIOTHESDRVERS <br /> KITCM'N SINK 8 OISP. VENTILATION FAN <br /> � DISHWASMER RANGE MOOD_ _ <br /> C� UUNDRVTRAV ___ __ � WATERMEATER — <br /> CLOTHE9WASHER __ W�DSTOVE _ <br /> URINAL ____ METAL FIREPLACE 8 CHIMNEV <br /> DRINKINO FOUNTAIN _ FIREPLACE INSERT <br /> ' FLOOR DPAIN __ NEAT PUMP <br /> �� GAS PIPING _ <br /> BACKFLOW PREVENTERS — <br /> IROOFOFAINS—RAINLEADFRS_ __ E%HAUSTFFN <br /> _ f 91NK�SERVIpE—BAR.ETCI —_.- - <br /> i �� _ _...._ — <br /> ' I' �'� SUBTOTAL S ___ SUBTOTAL 5 _ <br /> ' . PERMIT 5 '____ PERMIT 3 _ <br /> TOTAL FEE S TOTAL FEE 5 <br /> � IIELlI/f MO. <br /> UiRON18EiBIiLN �E�RSEi6l�CK S�OfSEIBAGK P4NCNECIIMUMB[P fEE <br /> us¢zoNe �orenc� vec�N�sne FEES VAIUATION FEE <br /> ]YES '� NO <br /> — BUILOING ___ <br /> rypEp{Cpngi OGGUo�NCV6NO11F NC Of DWELIiNOUN115 ----- -'---"'----'— — <br /> euoweB�fiecrua P�UMBING <br /> sitEovu�uo NoovsioeiEs esur occiu�D MECHANICAL <br /> nr __ — <br /> C N ----" <br /> — r�uGe�ueauuoe OTHER <br /> FIRE9cnINKLEP4REWIPED '��ES uN0 _ STATEBUILDINGSURCHARGE ___ _ <br /> STATE ENEFGV SURCI!4RGE _ <br /> ♦FVLIGAIION�GCBY RAN9�PPA6Y PUBLICWORNS <br /> TOTAL <br />