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;;.. <br /> ,, <br /> APPLICi���'ION FOR CONSTR4'LTION <br /> PERMIT <br /> fAe Ewrprsen � <br /> GTY OF everetl ; <br /> everet� e ' <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK— PLEASE PRINT <br /> �qy q M�IL�ODRE55 CRY �P PMONE <br /> `n'no�. � Fw.Sa�d 3 a �.v�"� _Dn �� ���d3 zS�. -3`/6a <br /> ANT MAIL�D�RESS CI1Y 21P PMONE <br /> I <br /> AfIGNITECfORDESIGNER M�IL�OONE55 CITY 21P PNONE I <br /> �,H-ws n•l/36,r/,� <br /> GENEMLCONIAACTOR MAIL�D�R'c55 CITY 21P PHONE LICENSE• ! <br /> �f p,��i so�� �P �3 c �o� 9�e� s �✓ �S 9 ,y•r�y.r dncP y's z�o_ 65�-z.s�.z . <br /> MECHI.NIC�IGONTR�CTOR MRILADOflESS CITY IIP PMONE LICENSE• � <br /> i <br /> Pl1�M&NOCONTR�GTOR M�IL�DORE55 GITY 21P PMONE LICEN9E• <br /> . I <br /> CLA9SOFNORK <br /> ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPLINSERT ❑ BUILDINGRELOCATION � <br /> 7ElUNTIMPROVEMEMOHINTERIOflflEMOOELONLY � CONTAGTPFfl50NANDPMONENO i <br /> � <br /> CONTPACT VNIGE OF VIOPK <br /> DEBCRIBEWO DSOU�NEFOOT�6EINWLVEO <br /> L a ., �3��.(,- � <br /> PIiOPOSEO U9E OF&11LOIN0 �y 1 HEREBY CERTIFV THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND <br /> �/ ti j e yz rc /C.�J KNOWTHESAMETOBETPUEANDCORRECT.ALLPROVISIONSOFUWSAND <br /> LEML DESCNIPTI OFPflOPEHTYISHOWN BELOW RATTI�CHFOUNCOPIES� ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLETED WITH <br /> WHEiHER SPECIFIED HEREIN OR NOT.THE GRANTINGOFAPERMITDOES NOT <br /> PRESUME TO GIVE AUTHORIiY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> �oi _ eiocK or qNYOTHERSTATEORLOCALLAWREGULATINGC�NSTRUCTI0NOR7HEPER- <br /> FORMANCE OF CONSTRUCTION.THAT I AM AUTHORI2ED BY THE OWNER OF <br /> THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE <br /> AND I COMPLY WITH 7HE STATE CONTRACTORS L.1W iB27 RCW AND <br /> 296200 WAQ � <br /> SIGN�TUREOFCONiRACTONOHAUIHOPI2ED�GENT OI.TE <br /> I � <br /> P110JEGT AWRESS �PPLIC�NTS GTY BUSINE55 LICENSE NO.AND BUSINE55 N�ME ( <br /> 3 0 � °�e�� �fz — <br /> PLUMBINO MECHANICAL <br /> NO. 7YPE OF FI)(TURE OR ITE7A FEE NO. TYPE OF EOUIPMENT FEE <br /> WATERCL09ET(TOILEn — A/C—lVHNDLGUNITS—H.P. <br /> BATMTUB FORCED AIR SYSTEMS—flT.U. M EA <br /> I LAVATORY(WASHBRSIN) — UNITHEATERS—B.T.U. M <br /> $HOWER CLOTHESDRYERS <br /> KITCHEN SINKB DISP. VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> LAUNDRV TRAY WATER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> IIRINAL METAL FIREPLACE 8 CHIMNEY <br /> DRINKIN6 FOUNTAIN FIREPLACE INSERT <br /> FLOOR OMIN HEAT PUMP <br /> BACKFLOW PREVENTERS GhS PIPINCa <br /> ROOF DRAINS—flAINLEADERS EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC I <br /> SUBTOTAL 5 "rj � SUBTOTAL E <br /> PERMIT 5 PERMIT S <br /> TOTAL FEE E TOTAL FEE S <br /> iPONTSETB/�CK PE�RSE7B�GK SIOE9ETBACN VIANCNECNNOMBER FEE PECEIPiNO. <br /> u5E2oNE �oinnE� V�C�NTSITE FEES VALUATION FEE <br /> ❑YES O NO <br /> BUILDING <br /> lVPEOFCONST. OGCUPANGYOPOUP NOOFDWELUN6UN1T5 <br /> ALLOWABIEMCTU�L PLUMBING � � <br /> 512EOFBLOQ NO.OFSTOPIES BSMT. OGGLOAO � <br /> ❑y MECHANICAL <br /> orv <br /> MEIGNTLIMITATION OTHER <br /> FIPESPPINNLERSREOl11flED O YE9 O NO STATE BUILD�NG SURCHARGE <br /> STATE ENERGY SURCHARGE <br /> APPLICATIONACGBY MANSAPPR.BY <br /> PUBLIC WORKS <br /> TOTAL `J�Q ;�J <br />