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h. . . Q`ti y:"r' <br /> ��= ` APPLI�ATION FOR CONS�UCTION <br /> , ;� . PERMIT . <br /> � fM Ewrpn�n � everett <br /> � ' CITHOF , } _ _ � . <br /> ; ._:everett ��. : <br /> I BUILDING DEPARTMENT <br /> I 269-8810 TO BE COMPLETED IN INK— PLEASE PRINT <br /> I <br /> � p / MAILADORESS ` GTY ZIP PHONE , <br /> /(ON D�PxGNa�PR p t� �� � �/�h 1�J�0� 353� �3 �1,i�'" " <br /> l�70� �In� /oc <br /> � �N MML ADORE55 CITY 21P PMONE <br /> :� i! <br /> , �yp n,� <br /> � M�'�FOD�E55 GITY 21P PHONE ' '�! <br /> ARGMITECf OR DEBqNER <br /> ! ��Q ,�P ,�� ��x aoys- ����k ��6� 33��2� �. <br /> � MAIL�DURE53 GITY ZIP PMONE LIGENSE <br /> � " 4 . LI4LLCON7�'�TOR <br /> .����Ey�NqIOQCONTMCTOP MAIL�ODRE39 GITY ZIP PHONE , LIGENSE• <br /> _� <br /> rLUMMNOCONTRACTOR M�IL�D�NE55 GITY 21P PNONE �UCEN9E• <br /> � pWlOFWORK <br /> ,� :❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR L� DEMOlI710N ❑ WOODS70VE/FRPLINSERT ❑ BUILDI170RELOCA710N " ' 1 <br /> ' RWWfIMPROVEMEMOR�NTERIORREMODELONLY CONTACTPERSOhAiiOPNONENQ ��/ // <br /> ODNTINf7TMICfOFWOnIc �/SOO � Cl.G7NA/�O ? '��—YJ- �' <br /> ��>00�1 O�N NID WUME FOOTAOE INVOLVED ��— <br /> �.'t.�...Y�'�•:�� ,/ <br /> ;. t��.. A�l� L!/a/� <br /> .�`,;ryqp! EOFlUIlD�NO IHEREBYCERTIFYTHATIHAVEREADANDEXAMINEDTHISAPPLICATIONAND <br /> P � KNOWTHESAMETOBETRUEANDCORRECLALLPROVISIONSOFLAWSAND � <br /> OeecninqN�crnor¢nttlsHownee�owon�n�cNrouncoriEe; ORDINANCESGOVERNINGTHISNPEOFWORKWILIBECOMPLE7L'DWITH <br /> WHETHER SPECIFIED HEREIN OR NOT.THE4RANTINOOFA PERMIT DOES NOT <br /> PRESUME TO OIVE AUTHORIiV TO VIOLATE OR CANCEL THE PROVI910N8 OF <br /> �pT �poK OF ANYOTHERSTATEORIOCALLAWREGULATINGCONSTRUCTIONORTHEPER i <br /> FORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE OWNER OF j <br /> - THIS PROPENSY TO PERFORM THE WOP.K FUR WHICH APPLICATION 19 MADE , <br /> AND I COMPLV WITH THE STAlE CONTRACTORS LAW 1827 RCW AHD <br /> ... 298200 WAG ' � <br /> � &ONRUREOFCONTRACi000RAU1HOR12ED�0ENT DRE <br /> A <br /> � � �'qqJECT110GRE9S , I APPUC�NTBCITYBUSINE ENS N NOBU iE99NAME � <br /> ``��� � �'OI ►'r1,bIG� _ <br /> �'•"KUM�INO � . MECMANICAL , <br /> ' ►�Q,+ TY►[OFFIXTUREORITEM FEE NO. TYPEOFEOUIPMEkT FEE <br /> � ' "� WATERCL09ET(TOILEp NC—AIHNDLQUNITB—H.P. <br /> • � �TM�B FORCED AIR SYSTEMS—9T.U. M EA <br /> � � �UVATORY(WASHBASIN) UNITHEATERS—&T.U. M <br /> ' ` SHOWEH ' LOTHESDRYERS <br /> � �d >KITCHEN$INKB DISP. � VENTILATION FAN <br /> � ' •018MWA9HER RAN�EHOOD � <br /> � � NDRYTMV WATERHEATER , <br /> ; i17f :-,. - � WOODSTOVE <br /> ..,�;r �CLOTHE9WA9HER <br /> � � URINAC METAI FIREPLA�EB CHIMNEY �, <br /> � - DRINKINO FOUNTAIN FIPEPLACE INSERT ' <br /> � FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING <br /> - p00FORAINS—MINLEADERS EXHAUSTFAN � <br /> ' SINK�9ERVICE—BARETC.) <br /> SUBTOTAL S SUBTOTAL S <br /> PERMIT S PERMIT S <br /> TOTAL FEE S TOTAI FEE S <br /> I ,.fRONTBETMGK PEARBEiBAGN SIDESETB/�CK MANCNECKNUMBER F[E NELEIPfNO. <br /> � <br /> iWEZONE LOTMEA O E9Tg�ENO FEES VALUATION FEE ' <br /> ' BUILDING � <br /> � 7ypEpFCON$T. OCCUFANCYOPOUP NO.OFOWELLINOUNIT$ <br /> 'K��eL��'k PLUMBING <br /> i &ZEOfBIDa NQOF9TORIE8 OYi. OCGLO�O <br /> MECHANICAL <br /> ON <br /> � � MEIONTLINIT�TION OTHER <br /> - FlRESPRINKIERSREOUIPED ❑YE9 O NO STATE BUILOING SURCHARGE <br /> . � STATE ENERGY SURCHARGE <br /> ' APPIICATIONACGBV PlAN9�PP0.8Y PUBLICWOFKS <br /> TOTAL <br /> i <br /> �rri,.T.�,rsl�.n �.�i. .. —'�. �i.:Jia �. �. �'�( ' :1. .'�[.�i'�'f T^'.?G' yl. , . . . . � .'�. ' ' '.r_ .r : � �i,r:.•`•i' ^'�.. <br />