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� � <br /> �lPPLIC�.fION FOR CONSTRI►.:TION <br /> PERMIT <br /> rno cvcrumoo <br /> CiT Y OP ��cr,�.l l <br /> everett � <br /> BUILDING DEPARTMENT <br /> 259•BBtO TO BE COMPLETED IN INK— PLEASE PRINT <br /> <'.\NEN 1.YILMDPG55 OfY ZIF PMON! <br /> � � >>�� A.�, �� �.�s. <br /> iENANT �ILMDHE58 GLY IIP P11pNE <br /> � � -,ar�, 9� �'ACI�IC �.�� zSo-176� ,' <br /> y y y �acMttEcionmsqHER u�n+oonEss utv iw arolle <br /> � <br /> K � (� GENEMLGOHiHI�CiOR 1AUL�D�HE55 GITV 21P RIONE IICEHSE• - . <br /> H �A <br /> O S O <br /> � y �.�j 1nGGH�NIGLLCON1pACtOP suit�ow+cas crcr zro wqv[ ucEr�sc• <br /> " � � 1���`��� CO, �70� � �JI�� ,�TI���'i�,?.5 54�-f�l(� Lc1��Cl74kn <br /> � � 1'LUMBMOGONiMCIGR 1MI/ADOPE94 CITY � 21V PHONE LICCNSE• <br /> 0 H Q <br /> M � R� � p Q55504N9PN <br /> ¢ y i ❑ NEW ❑ ADDITION ❑ RLTEMt10N ❑ NEPAIq ❑ DEMOLR�ON ❑ WOODSTOVE/FRPLINSERT ❑ BUIIDINOpELOCATION <br /> C. � TEN1Ni1MVR0✓EMEHiORINiEHIOHREMOOEIONLY�_ LONtKTPEH90H1U1DR10NEHQ /�f y...��� � <br /> r�l n3 /�lV�LIV ��� � <br /> N N LONTMLT PP�LE OF wORK <br /> � y DESCRi6EWONNPNDSOV�HE(OOI�GEMVOWFA � <br /> � � � �F��AtL �uP.NncE s�L,-r s�M /e ��' - I r� -- — <br /> � y raoro5EDu5EorewmNG � � IHEREBYCERTIFV'HATII{pVEFEFDANDEXAMINEDTHISAPPLICATIONAND <br /> N � � n� � NNOWTMESAMETOOETRUEANDCARRECT.Al1.PROVISIONSOFLAWSAN� <br /> �EG�t�oHur OVEPttISnONNBELOWOR�IIIICNFOURCOPE& �AOINANCESGOV[FNINGTHtSTVPLOFWORKWILLBECOMPLETEDWITH <br /> WHETHERSPECIFlEDHEFEINOFNOT.THEGRANTINGOFAPERIAITDOESNOT <br /> PRESUTAE TO GN[aUTfipRITY TO VIOLATE OR CANG[L THE FROVISIONS OF <br /> �oT BLOGK ov qNYOTHERSTATEORLOCALLAWREGULATRaGCOIJSTFUCTIONORTHEPER� <br /> FORMANCE OF CONSTRUCTION.TMFT I AM AUTHORIZED BV THE OWNEA OF <br /> THIS PROPERiV TO PflAFORM iHE WORK FOR WHICH APPUCATION IS MADE <br /> AND I COMPLY WIP1 TkE STATE CONTRACTORS LAW 18.27 PCW AND <br /> 286200 WA <br /> 9GNR1U Of 'pY(�`i0 'npU}MOHI$[D4�iCNi pAIE <br /> X �� YI ,i���l� 12/1��? <br /> FROJEGTIICOPC55 �APPL�C<Ni5U1vBU5�Ni'S LNSENORNGUUSiNESSNMAE <br /> �E,l�L (`�L.Q� UL. /SJ1�.C/L� �� � <br /> PLUMBING MECHANICAL <br /> i���., NO. TYPEOFFI%NREORITEM FEE NO. TYPEOFEOUIPMENT F5E <br /> — WATERClOSET�TOILEI) A/C—A/HNDLGUNITS—HP ,jNP " � '�( � <br /> BATHTUB FORCEOAIRSYSiEMS—BT.LL EA ' (i�'�� <br /> 1 LAVATORV�WASNBASIW UNITHEATERS—BT.U. M <br /> I '�_ SHOWEF CLOTIIES DRYERS <br /> _ ' KITCHENSINK801SP. VENTILATIONFAtJ <br /> — DISMWASHER RANGEHOOD <br /> LAUNOr7V TRAV WATER NEATER <br /> CLOTHES WASHER 'NOODSiOVE <br /> '` URINAL METAL FIREPLACE 6 CHIMNEY <br /> I '__ <br /> � DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING — <br /> =1�' ROOF DRAINS—RAINLEADER9 E%HAUST FAN <br /> SINK(SERVICE—BAR,ETC� <br /> , �_'_' <br /> � � SUBTOTAL S SUBTOTAL S � � ^ <br /> � PERMIT S PEFMIT 5 _ �` 1 <br /> ���� iOTALFEE S TOTALFEE 5 '" � <br /> FFONiSEiB/�CR NEFRBEIB�CIt S��ESEtBACN PIANCHECI(NUMBEfl FEE PECEIPfNO. <br /> uSEZOr+E LOtPRE� wGnlsrtE FEES VAWATION PEE <br /> p YE9 U NO <br /> iVVEOFCOHSi. OCGUWINCYOHOUP NOOLDWELL�NppN119 BUILDING <br /> n��owAeiFi�cru�t PLUMBIN� <br /> S�ZEOFBLIX3. NOAFSLOWEB BSMi. OCG.LO�p <br /> ❑r MECHANICAL <br /> ON — <br /> n[iGHiLiMIAliON OTHER <br /> fiaE 9PHINKLERS REOIIiqEO ❑YES c r�o STA7E BUILOING SURCHARGE <br /> STATE ENEPGV SURCHARGE ' <br /> nrcuc�nor1 ncc.er PL�N9�PPR Bv <br /> PUBLIC WOFKS <br /> �� TOTAL <br />