Laserfiche WebLink
�!' '.1c <br /> APPLIC�.'°�ION FOR CONSTRV�' TION <br /> � PERMIT � <br /> f6�EroryrNn everetl <br /> everett e <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK— PLEASE PRINT <br /> OWNER h _y�M�IL�DORE55p I �y�JI�y C�ITY n /.(i1P PHO'N/E rryry <br /> ��I l� ���� l� b� (J�� �lC.'�lk�4CJ ���VLQLI �7 rl�'eJ / I rl <br /> ��T M�IL�OD E55 CIIY 21P PHONE <br /> ARCIIITEGTORDESI(1NER AWLADORE93 GITY 21P PNONE <br /> �E���Tp�{Op GWLAODRESS GTY 21P PHONE IICENSEe � <br /> lU11���E���UyIP��NkIIt a,�N�. ti��zc2c�c�ao�ut� <br /> MEpMNILKGONfMCTOP •!O5 E. IINI����� urt 'f <br /> afK <br /> � EuarNt.WMhb"31D�98201 i <br /> RUMlINOCONTMCfON /f�.��RDREl9 GTY 21P PHONE LICENSE� ' <br /> L <br /> I <br /> GAl60FNONK ,�,� , <br /> ❑ NEW ❑ AODITION l9"ALTEMTION ❑ REPAIR Ci DEMOLITION ❑ WOO�STOVEIFRPLINSERT ❑ BUILDIN6RELOCA710N � _ I <br /> 7[NiWT IMPNOVEMENT OR IMERIOR XEMOUEI ONLY CqNT�CT PERSON AND Pf10NE N0. <br /> ppMq�CT PRICE OF WORK ��_� /� <br /> p�ACllllEWOqKMlOBOUMEFOOTAOEI YOWED /{i�Q/� y/ <br /> n � ✓ILQCI� L�/CAt d- �Q ��� o <br /> n�ovos[o uae or euaouw I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEO TH13 APPLICl1ilON ANO <br /> . � �) � KNOWTHESAMETOBETRUEANDCARRECT.ALLPROVISION90FLAW3AND <br /> pEecn�PrroN AOv[rm'18H BEIOV/ORATTACMFOURCOPIES7 ORDINANCES�OVERNINGTHISTVPEOFWORKWILLBECOMPLETEDWI7H <br /> WHFfHERSPECIFIEO HEREINOR NOT.THEORANTINdOFA PERMRDOE3 NOT <br /> PRESUME TO GIVE AU7HORITY TO VIOUTE OR CANCEL THE PROYI810N9 OF <br /> � p�pCK OF ANYOTHERSTA7EORlOCALIAWREGULATINOCONB?RUCTIONORTHEPEFF <br /> FORMANCE OF CANSIRUCTION.THAT I AM AUTHORIZED B'7THE OWNEH OF <br /> THI9 PROPERNTO PERf'ORM THE WORK FOR WHICH APPLICATION 13 MADE <br /> AND I COMPLV WITH THE STATE CONTRACTORS LAW 7827 RCW AND I <br /> � 298200 WAC. <br /> SIONIRUREOFCANTMC70RORAlITMOPIZE0�0ENT DATE <br /> X, ���- �1�-�1�� � <br /> ry�p,lEFfADDRE88 �VPUCN1T8p BU91NE LICEN9ENO.ANOBU&NE99N�ME � <br /> c�CD'�'�— � <br /> . �M�� MECHANICAI <br /> pp, TYPL O�RI)ITUR!OR ITEM FEE NO. � ' TYPE OF EOUIPMENT FEE <br /> � WATERCL09ET(TOILE7) NC—NHNDLGUNITS—H.P. _ �, <br /> ���8 FORCEO AIR 3YSTEMS—6T.U. I <br /> � UVATORVIWA9HBA91M UNITHEATERS—&T.U. M �I <br /> . ��Ep CLOTHESORYERS � <br /> VENTIUTION FAN <br /> 1(ITCHEN SINKB DISP. . i <br /> � DISHWABHER RANCiE HWD <br /> LAUNDRY7RAV WATER HEATER <br /> �� CLOTHEB WA9HER ' � ' WOOD STOVE I <br /> '� URINAL METAL FIREPLACE 8 CHIMNEY <br /> � DRINKItiO FOUNTAIN FIREPLACE INSF,�iT <br /> FLOOR DMIN HEAT PUMP <br /> � BACKFLOW PREVENTERS GV3 PIPIN�3 i <br /> ' ROOF DRAIN$—RIUNLEADER3 EXHAUS7 FAN <br /> � SINK(BERVICE—BARETG) <br /> i <br /> SUBTOTAL S SUBTOTAL S <br /> PERMIT S PERMIT S <br /> TOTALFEE S TOTALFEE S <br /> �y�K p�pgE7g�K 910ESET&�CN PIANtMECKNUM�[11 FEE �«E�PT�• <br /> WE20NE IOT�REA veuNTarte FEEP VAlU11T10N FEE <br /> O YE8 0 NO <br /> BUILDING <br /> 7YPEOFCON9T. OCCUVMICYOROUP NO.OFWVELLINOUNITS <br /> K��'���� PLUMBING <br /> &IEOFBLOQ NO.OF9TOPIES esMr. xc�o�o MECHANICAI 0 <br /> pY <br /> ON <br /> HEIOHTLIMIT��ION OTHER <br /> FIREBPfi�NKlER9RE0UIRED ❑ves orvo STATEBUILDINOSURCHARGE <br /> ' STATE ENERGV SUPCHARGE <br /> IIYPLIGTION�GGBY PL�NSAPPR.BY PUBLICWORK6 <br /> � TOTAL <br />