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.�y �.- -. <br /> APPLICATION FQR C�NSTRUCTIOlN <br /> PE�iMIT <br /> Ihe EverA�eon <br /> CI7Y OF <br /> everett ��'r`���``�'J ivcic1 <br /> ;v�1 pt^^����' � <br /> BUILDING DEPAATMENT G 2 Z_�'�37 <br /> 259�88to TO BE COMPLETED IN INK•— PLEASE PRlNT <br /> owr�cn �.�a�noon[ss cnr zm r.� <br /> v�T�e/L /a-GL/ // L,G, /� orie <br /> ✓O 1r.�0U✓ I /� / <br /> rEHnr�r n�ni�nooqEss ����tl(P�LjV�I _Q.,_/�SCL—.l�s��L[L4Ly.�_L_C rPn� <br /> cnr nr nwone <br /> SeW //��e 48ru�-( 3�Sij�/ <br /> A�CHrtEGiOR0E51GNER M411R00RESS CItY ZiP PbONE <br /> G[NEfULGONfBqGlOfi MNL�OUPE55 CItY LP PIIONC I.ICENSE• <br /> -No�i�/ �i� id-.�. i9zo� ���t.e w� �F�, _�i,r.T ���=i��s� ��✓✓Ae�3��� <br /> MECNANICALCONIqACTOR IdAILADDRE55 GI!V PIIONE <br /> �.� 21� LiCENS[• <br /> PLUMP�HOWNIRRCTOR MRILRflORE55 CIiY IIP PIIUNE UCENSF.• <br /> GVSSO�WOFN <br /> ❑ NEW ❑ ADDITION � ALTERATION ❑ REPAIP ❑ DEMOLITION ❑ WOODSTOVFJFRPL INSEFi ❑ BUILDING RELOCATION <br /> TEM1'RNi IMPROVEMENi OR INi[RIOR REMODEL ONLY COf�1ACT PERSON AND PHONE NO. ---- <br /> cor.rn�GraniceorwonK �.�t��_,��(�Z/O.CJ 3/F.f'—/c�/�1 <br /> DESC010[WORK ANp 50UARE FOOI/.G[111VOLVED <br /> PAOI'OSEO USE OF pUILOINO � — <br /> ���c 1 HEREBY C[RTIFY THAT I HAV[READ AND LXAMIh ED Ti IIS APPLICATION AND <br /> __ KNOW TNE SAME TO BE TFUE AND CORRECT.ALL PROVISIONS OF LAW 5 AND <br /> LEWLbESCFIPfIONOFPlIOP[NiY�SMOWN9ELOWORF1iRCNFOUliLOPIES� JRDINANCESGOVERMINGTHIST'PEOF\YORKWILLBECOMPL'cTEDWITH <br /> 1RHLiFIERSFECIFIEDHEREINOI7NOLTHEGRANTINGOF^,PERMI7DOESN07 <br /> � �or o�oCi< oc _ PRESUMETOGIVEAUTHORINTOVIOLATEORCANCELTHEPqOVISIONSOF <br /> ANV OTHEfl STATE OR LOCAL LAW fiEGULATING CONSTRUCTION OR THE PER� <br /> FORMANCE OF CONSTRUC710N.TIi�T I AM AUTHOq12ED BV 7HE OWNER OF <br /> THIS PROPERNTO PERFORM THE'NO�K FOR WHtCH APPLICA710N IS MADE <br /> AND I COMPLY WITH THE STATE CONTRACTOF.S I.AW 1027 RCW AND <br /> 296.200 WAC. <br /> SIGNPIUREOfCONiRAG1000fiAUIHORl2[pAG[NL O�TE <br /> PROJEC1�pf`I'.E55 �✓U-«-�%�'/(�<���//L'f/r/T/L s�' ��_ <br /> PPPUG�MS ptY Bl15ME55 LICENSE NO Arv0�UStNE55 NR:d[ <br /> _4 . , l <br /> PLUMBING MECHANICAL <br /> NO. TYPEOFFIXTUREORITEM FEE NO. TYPEOFEOUIPMENT FEE <br /> _ WATF!iCLOSET(TOILEn A/C-A/hII1DLGUNITS-H.P. <br /> BATHTUB _ __ FORCED AIR SYSTEMS- B.T.U�jQ M EA <br /> LAVATORVIWASHBASIN) UNITHEATEA£-B.T.U. M <br /> SHOWER _ CLOTHESDRVERS � <br /> KITCH[N SINK&DISP. VEN7ILATION FAN <br /> �ISHIVASHER RqNGE HOOD <br /> _ LAUNDP.YTRAY Wq7ERHEATER <br /> CLOTNES WASHEF WO00 STOVE <br /> _ URINAL METALFIREPLACEBCHIMNEY <br /> DRINKING FOUNTAIN FIREPLACEINSERT <br /> FLOOR DRAIN HEAT PUMP <br /> _ BACKFLOW PREVEN?Efl5 �_ GAS PIPING <br /> _ ROOFORAINS-RAINLEADERS E%NAUSTFAI. — <br /> SINK(SERVICE-6AF,ETG) — <br /> SUBTOTAL 5 SUBTOTAL $ <br /> _ PERMIT $ PERMIT 5 <br /> TOTAL FEE E TOTAL FEE <br /> 5 <br /> FRONTSEIBACN pFRR56"TUACK SIOE5E113ACK PLANCH[CNNUM�Efl FEE pECEIVTNO. <br /> USElOHE — �OTAqE4 vncnNTsrte FEES � VALUATION FEE <br /> ❑YES ❑NO <br /> TYPEOI°GON9i. OGGUPANCYGROUP NOOFDWELLINOVNIiS — BUILDING <br /> O.LLOWR3LE/ACiURI <br /> PLUM6ING <br /> size oF oi.oa. r�o.ov s�onics osn+r. oca�ono — — <br /> °Y MECHANICAL <br /> ❑ N <br /> I:EIGIIILIMItAT10N OTHER <br /> FNESPpINNLER5PE0UIRE0 ❑YE$ ❑ ND v — <br /> STATE BUILDING SURCHAHC,E <br /> STATE[NEflGY SURCHARGE <br /> r1PPUCAT10NACC�iY PLANSAVPR.BY — <br /> PUBLIC WORKS <br /> � TOTAL <br />