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APPLIl�TION FOR CONST�CTION <br /> �' PERMIT <br /> fM Ev�Nn�n cverett <br /> CITY OF <br /> �� everett e <br /> BUILDING DEPARTMF.NT <br /> 259-BBio TO BE COMPLETED IN INK— PLEASE PRINT <br /> i <br /> (q /MILADDRESS CI7Y 21P PlqNE <br /> T��ear�._��.�1N DEu. 6a6 ��� s.w. [.c,esrr 4B�o•F � � -y 33�3 . <br /> � TENANT 1M�L�ODPE55 CITY ZIP PHONE <br /> �UE�'/rQ�"6ty �-`xryy�l� /09// Ev�1„eFs,Vrur� s�:� tc !+ Eu,�r�tr �� 9Baoa <br /> AHCNITECTORDESIONER MAIL�ODRESS QTY 21P PHONE <br /> ;� 6ENEMLCONiNi1CTOF AWLAOUNESS CITY 21P PHONE LICENSE• <br /> c�+s�,4�,� eo��M E�c�;a � �sn �.f ��� ti,E . woal.�,u�u� 9Bo�3 �ov-aa+�� cw sc Ac � ��oeo <br /> MECNANIGILCONTRACTOR MNL�ODRESS CITY 21P PHONE LICENSE• . <br /> � PLUM&NOCONTfNCfOX 1MIL�DDNE55 CITY 21P PHOHE IICENSE• ; <br /> Y` AnorNeeoh w�n�rzv�P.u �o � �ia-4� Gr,w�cu�� G N Soa#�E 9Bro� �s�-v� a,vo`em avaor� <br /> «,1890FWOR1( �./ <br /> �� O NEW ❑ ADDITION L7 ALTEMTION . ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVEIFRPLINSERT ❑ BUILDINGRELOCATION <br /> t <br /> � iE/UNTIMP110VEMENT01iINTERIIXiPEMODELONLY GW�TACTVEP90N�N�PHONENO. <br /> 2� CONTRACTPRICEOFWpi1C <br /> }�' OESCpIBEWOflKAN090UAREFOOTA0EINVOLVED . <br /> j�� wqvos�ouseaeuuaHa IHEREBVCERTIFYTHATIHAVEREADANDE%AMINEDTHISAPPLICATIONAND <br /> KNOWTHESAMETOBETRUEANOCOHRECLAILPROViSION90FLAWSAND ' <br /> IEML DESCRII'fIONOF PROPERTY�SMOWN BELOW Ofl�TT�CH FOUN LORES� OROINANCES GOVERNIN6 TMIS TVPE OF WOFK WILL BE COMPLETED WITH ie <br /> WHETHERSPECIFIEDHEREINORNOT.TNE6RANTIN60fAPERMITDOESNOT � <br /> LOT ��N � PRESUMETOGIVEAUTHORITVTOVIOIATEORCANCELTHEPPOVI310NSOF � <br /> - ANYOTHER STATE Ofl LOCAL LAW REGULATING CANSTRUCTION OR 7HE PER- <br /> ° FORMANCE OF CANSTRUCTION.TMAT I AM AUTHOR12ED BY THE 01VNER OF y <br /> �� THIS PROPERiV TO PEHFORM THE WORK FOR WHICM APPLICATION IS MADE !f, <br /> �; AND I COMPLY WITH THE STATE CONTriACTORS LAW 1827 F!1N AND ;� <br /> rt 296200 WAC. ? <br /> � SKiNANREOFCONT OP�IITMOflIZEOAGENT AA7E B���J��JO ;`.� <br /> � � <br /> � PROJECfADDRE53 �pp��iW79GTVBUSI NSENO.ANDbU51NES5NAME <br /> � o aos 9 a- aN :K:.�, rY1r4Fku�.b1 2� . ;� <br /> r <br /> g, PLUMBING MECNANICAL '3 <br /> ?"� NO. TYPE OP FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> � WATEHCLOSET(TOILE7) i• /0• l'�o NC—A/MNDI�UNITS—H.P. �= <br /> � BATMTUB FORCEO AIR SYSTEMS—&T.U. M EA <br /> "y� LAVATONYQNASHBASIN) tl � � UNITMEATERS—&LU. M �' <br /> SHOWER CLOTHES DRYERS ��i <br /> e: KITCHEN SINK 8 DISP. VENTILATION FAN <br /> DISHWASHER RANGE HOOD " <br /> k <br /> ta, UUNDRVTRAV WATERHEATER . <br /> CLOTHES WASHER WOGD STOVE <br /> s. URIN:.L METAL FIFEPWCE6 CHIMNEY <br /> f DRINFiN(i FOUNTAIN FIREPLACE INSERT i` <br /> j FLOORDR�IN HEATPUMP <br /> ��� BACKFIOW PREVENTERS GAR PIPING <br /> RbOF DRAINS—R/UNLEADEHS EXHAUST FAN <br /> 31NK(SERVICE—BM,ETG) <br /> SUB TOTAL S O OD SUB TOTAL S G• `.+� � <br /> . PERMIT S PERMIT � S S. e0 <br /> TOTAL FEE S d-O od TOTAL FEE S �hI• SZ� <br /> FNONtSETBACN NEAPSEf&�CK SIUESETfl�CY, VIANCXECIINUWER FEE NECEIPfNO. � <br /> - USE20NE �o7u+E� vnc�e�isiie PEES VALUATION FEE <br /> O YES O NO <br /> BUILDING <br /> 7YPEOFCON3T. OCCUPANCYOROUP NO.OFOWELLIN6UNITS �' <br /> : KL0INABLE/AGN�L .. <br /> PLUMBINCa <br /> BIZEOFBLOQ NO.OFSTOflIES BSMT. OCGLOAD <br /> ❑r MECHANICAL <br /> ON <br /> . HEIfiMTLIMITATION OTHER � <br /> FIRE BMiINNLEP9 REOUIPED o ves o r+0 STATE BUILDINCa SURCHARGE <br /> ' STATE ENERGV SURCHARGE � <br /> � urouunor��cc ev runs,wva er - <br /> PUBLIC WORKS <br /> TOTAL <br /> r <br />