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�.... <br /> i .1.).'. <br /> APPLI��►TION FOR CONSTf�':iCT10N <br /> � PERMIT <br /> M�Eroryrsen <br /> �,OF ev�rett <br /> everett e ' <br /> BUILDINO DEPARTMENT <br /> 26 -�eto TO BE�OMP4ETED�N INK— YL ASE PRINT , <br /> ll� ���_ �r/'� .z1iQ' R JP/s`de Or�Ue M'r �c�/.�/o�/ 4sz�3 ya4- 6G6� <br /> pryqEq MMI�DONES9 Gltv 21P PnONE �' <br /> 1 <br /> IEMAMT M�ILA�DRE55 CIiV ZIP PHONE <br /> 11qGNRECTOFDE5IANEN M.11L�UDRE9S C�IY 2�P AIONE <br /> 1. <br /> 17� ,P /Yle e Iti Y 4 O�.�b�,- Rd. Mr �e.�o�; �Bz�3 Yzy-v SY) cr�� n�vemor <br /> O�ME lCON1R�CTOH MAi��DORE39 QTY 2�P �NOHE 4CE S��Iy3;a ' <br /> IAEOINNIGKCAMTMGIOR MMLAODNE6S CITY 71P PMONE LILENBE• � <br /> RIMNNOCANTRACIOR M��t�DORESS G1Y Z�P 1'MONE LIGEnSE• <br /> GWBOiNOPI( <br /> ❑ NEW ❑ ADDITION � ALTERATION ❑ FEPAIR ❑ DEMOLITION ❑ WOODSTOVFJFRPLINSERT ❑ BUILDINORELOCATION <br /> 1ENN/T IMPRCVEMEHI OR INiEH10R PEMO�EI ONl' CONT�GT 1'ER90N�ND PMOHE NO <br /> CONTRI�CT P1110E OF M/OtIK <br /> pElCplsE WpHlt�NO SOU�PE f00T�0E INVOlVEO <br /> x ; 1�. � (' r- <br /> ►norosE USEOFBUILDINO IHEREBVCERTIFVTHATINAVEREADANDE%AMINEDiHISAPPLICATIONAND <br /> � �e5t�rry�J1' KNOH'THESAMETOBEiRUEANDCORf7EGT.ALLFROVI510N50FUWSAND � <br /> LEMLDEBCRIPTIOIIpFPBOPEHiY�8110WNBELONORATTI�CNfO11ROpvlE� ORDINANCESGOVER!JINGTHISNPEOFWORKWILLBECOMPLET6DWITH <br /> W HETHER SPECIfIED HEREIN OR NOT.THE GPAIITING Of A PERMIT DOES NOT <br /> PRESUTAE TO GIVE AUTNORITV iO VIOLAtE OP CANCEL THE PROVISION30F <br /> �pT etocK nF ANYOTHERSTATEORLOGALLAWPFGULA71N3CONSTRUCTIONORTMEFER� <br /> FOFMANCC OF CONSiRUGTION.THAT I AM AUTMOFIZED BY THE OWNEP OF <br /> THIS PFOPERTV i0 PERFORM THE WORK FOR WHICH RPPLICA710N IS MADE <br /> ANO I COMPLY WITH 7HE STATE CONTRACTORS L�AY 1827 RCW AND <br /> 296.200 WAC. <br /> SION�TUOEOFGONIRIw^TOROHAOIMONREOAG[Nt DA1E <br /> �RqJECTMOREBB � •/y`-�/ .�//J� }��lp IO�iT 0/D] <br /> pPP4C�Ni8 CRY BUSI�f.EN9E NO�N�BU��NESS N�ME—�r� <br /> c �e� <br /> rLUMlINO MECH�NICRL <br /> NQ, TYOE OF f'U(NRE OP ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILE� A/C—A/MNDLG UNITS—H.P. <br /> g�n{�g FORCEDAIRSVSTEMS—B.T.U. MEA <br /> L�VATORY(WASHBASIN� UNITHEATERS—B.T.U. M <br /> 3HOWER CLOTHESDRYERS <br /> � KITCHEN31r1K6Di5P. VENTILATIONFAN <br /> � DISHWASHER RANGE HO00 <br /> UUNDtiV TRAY WATER NEATER <br /> CLOTMES WASHER WOOD STOVE � <br /> URINAL METAL FIREPLACE 8 CHIMNEY <br /> DRINKINO FOUNTAM FIREPLACEINSE T <br /> FLOOR DRAIN fVEAT PUMP <br /> BACKFLOW PREVENTERS -" GAS PIPING <br /> ROOF ORAINS—RAINLEADERS E%HAUST FAN <br /> SINK�SERVICE—BAR,ETC.) <br /> SU6TOTAL '�i r"' SUOTOTAL S _ <br /> PERIdiT :C �— PF.RMIT S <br /> TOTAL FEE II � TOiAL FEf? S <br /> FPONTBEI9AGN RGR6EiBl1C1( SIpE5E1BACR PIANGNECIlNUM9EN FE[ PECEIFfNO. <br /> USE20NE IOTMFA VIiCANT6RE FEES VALUATION FEE <br /> , fl YES O NO — <br /> IYPEOFCONSi. � OCCUPM1CYpB0UP NO.OFOWELUNOUNItB BUILDIN� <br /> ���"8������ PLUMBIN6 r <br /> &LEOiBLD(i MO.OF9TORIE4 BSMI. OGGLO�O <br /> p r MECHANICAL <br /> ON — <br /> NEI�NTLIMITRTION OTHER <br /> flRESPRINNtEF5PEO111PED �YE9 ❑NO STATEBUILOINOSURCHARGE <br /> STATEENER6VSURCNARQE <br /> �PFIIL�TIONAGG81' PV.N9�PPRBY <br /> PUBLIC WORKS <br /> TOTAL �— <br />