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,.�., <br /> APPLICAf10N FOR CONSTRI,a�T10N � <br /> PERMIT <br /> fho Ev0/p�oon ovrr��11 I <br /> CITV OF O <br /> everett S <br /> BUILDING DEPARTMENT , <br /> 259�8870 TO BE COMPLETED IN INK— PLEASE PRINT <br /> ' UWNE I.IAILAUUHESS p � IItY LIp VHONE 'l <br /> �/il/f%/'JF !' _Gf�!�Jf�� ��6 C'� /JIU�� /�JUE L U�E;� J�f-'�3 �5 `��'G1�/ <br /> TENAN MA/�II!�ODRE55 � CIiY ZIP PI.ONE <br /> �����MAII.RODNE55 <br /> ��PLIIIIECTOROESIGNEB PiV Z�P fl10NE <br /> MAt�FDOfl[SS GIIY Z�� PHONE IiCENSE• � ' <br /> ��� GENER�LGONLPnCTOR . <br /> YH MEQI4NIGLGONtPAGiON MNIL�DDRESS CIiV ZIP FHONE LiCENS[• <br /> a�'H js( U�9 61�� i.���ii�I•It•cq /Gis'�,hAk'i,c��/c'«,I,YL. � _ ,. j�G! �Sts-�yV/ /✓R�u��,Faci�i. <br /> 9 y y FLUMB�NGCONTPAGTOR hIPILAD�RE55 CRY IIP P��ONE LiGENSE• <br /> � GLn550F\SqRn <br /> O x O ❑ NEW ❑ AODITION TG ALTERATION ❑ REPAIR ❑ DEMOLITIOPI ❑ WOODSTOVE/FPPL INSERT ❑ BUILDING RELOCATION � <br /> � H� TENANTIMPROVEMENTORINTEPIOPREAIODELONLY CONIAGIPERSONANDPMONENO <br /> �H 5vv <br /> Hry+ CONiflAGT PRICE OF WORK <br /> p O OESGRIBEWORNANOSOWREFODIAGEINVOLVEO <br /> C'J <br /> H t7 <br /> PROPOSEO USE Oi BU�L�iNO I HEREBY CERTIFV'HAT I HAVE READ AND E%AMINED THIS APPLICATION AND <br /> � [�iJg _ O KNOWTHESAMETOBETRl1EANDCOFRECT.ALLPROVISION50FLAWSAIJD <br /> ORDMANCES GOVERNING TNIS TYPE OF Y:ORK WILL BE COMPLETED WITM <br /> Z H LEfML0E5CNIPTIONUFFROV R ISNOWNOELOWONATTPLNFOURCOPIE51 WHETHERSPECIFIEDHEREINORNOT.THEGRANTINGOPAPERMITOOESNOT <br /> PRESU�dE TO GNE AUTHORIiY TO VIOLATE OR CANCEL THE PROVISIOMS OF <br /> � Hz �oT BIOCK OF ANVOTHERSTATEORLOCALLAWREGULATINGCONSTRUCTIONORiHEPER� <br /> H y FORRIANCE OF LONSTRUCTION THAT I AM AUTHOR12ED 9Y THE OWNER OF <br /> � � THIS PROPERTV TO PERFOH�d THE WORK FOR WHICH APPUCaTION IS MADE <br /> H AND I CO�dPLY YlITH TNG STATE CONTRACTORS LAW 1827 RCW AND <br /> n ty y 296.200 WAC. <br /> � qr swr+niur rcaurracrcr.� , ;HonizconcEvr ouc <br /> yo� X � /3-9� <br /> PROJEGTPDORE55 � / ✓ qPp�� ANiSCI� 'SSLI 6EIIOAN�BUSINESSNAME <br /> /� / C,lV �/ y <br /> C l-rl� � j <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FI%TURE ON ITEM FEE NO. TYPE OF EOUIPMEN7 FEE <br /> / WATEF CLOSET ITOILEp NC—A/HNDLG U NITS—HP. _ <br /> � BATHTUB � FORCEDAIRSv57EM5—B.T.U./(Gd.6EA <br /> � <br /> I � LAVATORV(WASH BASINI UNIT HEATERS—H7.U. M <br /> SHOWER CLOTHESORVEFS <br /> KITCHEN SINKB DISP. VEN71LAtION FAN � <br /> '�" �► DISHWASHER RANGE HOOD ' <br /> +�! �AUNDRY TFAV WATER HEATER <br /> CLOTHES WASHER WOOD S70VE <br /> � URINAL METAL FIREPLACE 8 CHIMNEY <br /> I ' DRINKINGFOUNTAW _ FIREPLACEINSEfiT <br /> �— _ <br /> FLOOR DRAIN HEATPUMP <br /> BACKFLOW PREVENTERS GpS PIPING <br /> �' �. ROOF DFAINS—RAINLEADERS EXHAUST FAN _ <br /> !' ' SINKISEiiVICE—BAR.ETQI <br /> � �� — <br /> � SUBTOTAL 5 SUBTOTAL 5 � <br /> ''� PERMIT 5 _ PERMIT S _L= <br /> TOTAL FEE S TOTAL F':E S <br /> iRONiS[tOACN REAPSEIBACK SIDESE19ApN FUNCNEGRHUMBEP FEE AECEIPTNO. <br /> � j J'J/0 � <br /> usEZor+E �ouaE� WGANi51LE FEES VALUATION FEE <br /> C YES ❑HO <br /> BUILDING _ <br /> T'PEOifAN4. OCGUP�NGYGROUP NOOfOWELLINGI1N1i5 - - -- - <br /> 0.LOWABLE/AQWL pLUA7BING <br /> saeovo�oG �+ooFstoniEs BSMt oCcto�o MECHANICAL <br /> ❑v <br /> :]N <br /> NE�GN1lIMliAiION OTHER <br /> nPE SPRiNKlER5RE0UiPED ❑YES ❑NO STATE BUILDING SURCHARGE <br /> STATEENERGVSURCHARGE <br /> FPPCCAiIO�i�GCOT PL>NS�PI'POY I PUBLICWORKS <br /> � roTa� <br />