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;", , ., �G � <br /> APPLIC�;;fION FOR CONSTRI:i:T10N <br /> PERMIT <br /> fh�E�'s�preen everelt <br /> Gri OF � <br /> everett <br /> BUILDING DEPARTMENT <br /> 259-B870 TO BE COMPLETED IN INK- PLEASE PflINT <br /> OWHER MAII��DRE55 GTY ZIP i'NONE <br /> ; /k 1a s g:�r�ni-l- 1(av l CU1�2�r,�'�/v 1�+� ,�2DI 25'Z-9079 <br /> KN�NI M�II�O�RE59 GIiY ZIP PNONE <br /> •IICIIIT!!;TONOESIONER MAit�DOH[65 CIIY Zlv MONE <br /> OENER�LCOMTR�CWB MMlADD11ES4 CITY ZIP �ONE L�LENSE� <br /> MEp1�NIGILCONTH,ICTON M�ILAOONE59 LAY 21P PMONE UCENSE• <br /> V Cas 21no5 I✓leDor.c�,� A-� �:� � 2�599� V/-�c�lGl� <br /> PIUMBiNOC �A�GTOP� M�R�DDRE59 GIiY ZIP MIONE UGENS • <br />� CUBSOFMORN <br />�� O u'T a ENiDORTIMER/i�//RyEM�OD�AN ON ❑ REPAIH ❑ DEMOLITION CoO^W�OD�SN�NOPHONE oSERt ❑ �UILDIN6 RELOCATION <br /> CONTRAGTPPICEOiWOPK `��w' <br /> DE�GRIBE WORIt�ND BOU�RE fOOTMiE�NVOWEO <br /> ��1 Uf..�- <br /> vnovo9eo u9E or ewi t HEREB I CERTIFY TNAT I HAVE READ AND EXAMINED THIS APPUCATION ANO <br /> 6'r KNOW THE SAME TO BE 7 PUE AND CORRECT.ALL PROVISIONS OF LAWS AND <br /> lE0MUE8CHIPf10NOFV1!OPERIVIJHOWNBELONOR�TI�GNFOUNGO��E� OPDINANCESGOVERNINGTHISiVPEOFWOi7KWILLBECOMPLETEOWITN <br /> VIHE7HER SPEGFIEO HEREiN UR NOT.TME GRANTING OFA PERMIT DOES NOi <br /> PRESUME TO CaIVE AUTHORI7V TO VIOLATE OR CANCEL THE PROV�SIONS OF <br /> Lor Blocx aF qNYOTHERSTATEORLOCALLAWREGULATINGCONSTRUCTtONOA7MEPER� <br /> FORMANCE OF CANSTRUCTION.THAT I AM AUTHORIZED 9Y iHE OWNER OF <br /> TNIS PROPEFTV TO PEfiFORM THE WORK FOR W HICH APPLICAiION IS M�DE <br /> ANO 1 COMPLY WITH TNE STATE CONTFACTORS LAW 1827 RCW RND <br /> 296200 WAC <br /> SIGM�TUAEOFCONTpACTOBOnnU NOR12GOAGCNi UAIE <br /> x �. d Slv1 � <br /> pIqJEGiMORE88 AP �N CIiYBU9� 95LiL[NS�N BUSiNE55NeME <br /> lC�31 CoUo� . <br /> PLUMlINO MECHIINIGIL <br /> NO. T'PE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE I <br /> W�TER CLOSET�TOILEi) NC—NHNDLG UNITS—H.P. <br /> OATHTUB FORCEOAIRSYSTEMS—B.T.U. EA <br /> LAVATORYIW�NBRS�N) UNITHEAiEFS—B:LU. M <br /> SHOWER CIOTHESDRYERS <br /> KITCHEN SINK 6 DISP. VENi1lATION FAN � <br /> DISHWASHER PANGE HOOD <br /> UUNDRY TRAY WATER NEATER �. <br /> CLOTHES WhSHER WO00 STOVE <br /> UPINAL METAL FIPEPLACE 8 CHIMNEV � <br /> DiiINKINO FOUNTAIN FIREPLACE INSE@7 _ <br /> FLOOR ORRIN HEAT PUMP _ <br /> BACKFLOW PREVENTEPS QAS PIPINO <br /> ROOF DRAINS-•RAINLEADERS EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) — <br /> SUBTOTAL E SUBTOTAL 5 _ <br /> PERMIT S PERMIi S <br /> TOTAL FEE E TOTAL FEE E <br /> iRONt4ET8ALN REANSEIBAGN SIOE6EiBhLN PIaNCNECI(NUMBEN FEE PEGEIPfNO. <br /> usezoNe �orAnen WGNT611E FEES VALUATION FEE <br /> O YEB O NO <br /> BUILDING <br /> TYFEOFCANST. OCGUPAICYOROUP HO.OFDWEL4NOUNrt9 — — <br /> eLLowee�F�eGtuel P W MBING <br /> BREOi'BL00. ��60FSi0PIE8 oYr. occ�ow MECHANICAL <br /> oN <br /> HEIpMftIMll�iiON OTHER <br /> pIqESPNNKlER9RE011�BED ❑�Es oNo STATEBUILDINGSURCHARGE <br /> STATE ENERGV SURCHFRGE <br /> �PfRIG�tIOH�GGBY DI.�NS�PP0.BT PUBLICWORKS <br /> TOTAL <br />