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I <br /> APPLICATIbN FdR CONSTRUCI .ON PERMIT <br /> everett <br /> �E.� e <br /> ��n� <br /> everett <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK—PLEASE PRINT <br /> �(DEMOLITION : �. COMBINATION i : BUILDING . �.MECNANICAL �. 'PLUMBING �:_� SIGN <br /> OWNEP IA�M1AOCRE55 CIIV SIP iNCV1E <br /> R,�•s5 $��v4 534i 6i<» N4��., Rd So��..l C.,. `i5o'l3 yo8— ��`-�Q4ff <br /> lE1UNi NALLAD�NE55 GIR' T I�P %ICNE <br /> No�c <br /> •PCXRELid1OE5qMP M14�WIIE55 CIiY ZiP PIqNE <br /> I�A REA.(aLUtl21 BO <br /> / GENENIit 11NL�011 MA4App E55 CIiY ZIP E .�CENSE� <br /> r T�cm�cu .,u� ��. �N3S .uc 1�1ti" Pl. �„�cLL (J+. Srai-vcso <br /> M�FCNIN.T4N1 ACfOf1 \'�M1AOOPESS CIIY IIP PIKKIE LICENif: <br /> RUMBWGCON1R�GtOR MA4I.ODNE55 Clry ZIP PHON[ LIL[NSE� <br /> CUSSOi WO�iK <br /> il NEW �. '� ADDITION �. � ALTERATION . REPAIR !XDEMOUTION �� � WOODSTOVFIFRPLINSEfiT iJ BUf DINGHELOCATION <br /> IEN�NL IMI'RWEMCNI IX1INi(]RM PEMOpEI CMLY CCNi�LT PEfl50N Nl0 PlqllE Iq <br /> CWiP�Li PP�,',E Cf W0�1R: <br /> �ESCfl9E W011Y.ANO SOU�flE f W IIGE INV0.VC� <br /> Z�p���yV 4DO <br /> rnovoscouseareuao�xc 1 HEHEBV CEFTIFY TW\7 I HAVE READ AND EXAMINED THIS <br /> '^'��, APPLICATION AND KNOW THE SAME TO BE TRl1E ANO CORFECT ALL <br /> i[a��ceunrvt[u+o�raov[qrviswwNe[�orvon�nncHrouncori[s� PROVISIONSOFLAWSANDORDINANCESGOVEFNINGTIi15TV2EOF <br /> WOPN WILL BE COMPLE?ED WITM WHETHER SPEC!FIEO HEREIN OH <br /> �or e�acK or NOT.THE GRANTING OF A PERMIT�OES NOT PRESUME TO GIVE <br /> AUTHOHITV TO VIOLAIE OR CANCEL THE PRO\9SIONS OF ANY <br /> W YL �.F W 1J,6 Fr OF .V �S of w�I �I.a OTHEH STATE OR LOCAL LAW REGULATING WNSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRl1CTION.THAT I AM All fHORIZED BY THE <br /> /JL�Iy ,V[ �Iy ,V w�I oF S�c,�S i.�u �1S /J. OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MAOE AND I COMPLY WITM TME STATE <br /> CONTRACTORS LAW f B27 RCW AND 296200 WAC. <br /> ROY� r f `y m, ��'Z�� 41(e� ���-- PTN $IGNAiUNFOiCQN1qACiOqOPllI1110RIIE��GENi P�lE <br /> � �' <br /> ,c w., � . F .0 ..n o F ro�....,b�.'. A.�• X �`.�-� / //-/b-90 <br /> PRyELi�W11E55 —L� .!��_s:.L__ �W <br /> ^ �O� /�O`µm 1^ AVPl6�4i5C�iYB115ME5F F NO.WD&14NESSNINE <br /> .% l. T <br /> PLUMBINO MECHANICAL <br /> NO. TVPE OF FI7(TUNE ON ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WAiEF CLOSET QOILET� A/C—AMNDLG UNITS—H.P <br /> BATM7U0 FORCEDAIRSVSTEMS—B.T.U. M E.A. <br /> LAVATORY�WASHBASIN� UNITNEAtERS—B.T.LL M <br /> SHOWER CLOTHES�RVERS <br /> KITCHEN SINK 8 OISP VENTIIATION FAN <br /> DISHWA5k1ER RANGE NOOD <br /> IAUNDRV TRAV N'ATEH MEATER <br /> CLOTHES WASVIEH �M1'000 STOVE <br /> URINAL ' M.ETALFIREPLACEBCHIMNEY <br /> DRINKING FOUN1pIN FIREPLACE WSERi <br /> Fl]OR OHAIN HEAT PIIMP <br /> BACNFLOW PR[VENTERS GAS PIPING <br /> ROOF DRAINS—RAINLEADER$ E%MAUST FAN <br /> SINK(SERVICE—BAR.ETC.� <br /> SUBTOTAL E SUBTOTAL S <br /> PERMIT E PERMIT S <br /> TOTALFEE 5 TOTALFEE S <br /> �P�'NTSEiBACN PGPSEiB1G: SDESEIB�CN FUNUQC6NUM9[F �EE NECEtPt1q. <br /> usezaie im.nee vncu+rs�i¢ FEES V�W�TON FEE <br /> I� VES �. �. NO BWIOMG <br /> TPfM:pI5�l.11CW.1&[ M'fIXLON!.IACIWI ¢aMK� tl��Mii�A4ukis <br /> �� PLUMBING <br /> SREOFBICO NOOiSiMiES BAS[MENi MECH�NIC�L <br /> ',��. YES I I NO <br /> CCLUP4ILYLOA� fiRESPflNMLEP5RC0D MEIGHTOA�R�iICN OTIIER <br /> '�, '. YES i ; NO SiAiE8UIL01NG5URCMARGE �f'Zj <br /> REASON FOR SPnMNtF115 <br /> STAiE ENEFGY SURCIIqRGE <br /> eonc.*wN.cc.ar vunseronoveoev CITYOFEVEflETT PUOIICWORKS <br /> LOC�L SALES <br /> bU(CODE IS 3105 rou� I j'a <br />