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APPLICa�ION FOR CONSTRI..:TION <br /> - PERMIT <br /> fAe fvsrpreen everett <br /> CITY OF <br /> everett e <br /> BUILDING DEP4RTMENT <br /> 259•BB10 TO 9E CO P ETED IN INK— PLtASE PRINT � <br /> t/�,eniEv,A� �ivVn l'.. �i„�x �,����� V�fcJ �n� r,�.��.Tr 9gao8 �(�C�35�3 <br /> OWNEP � MRIL��OflE55 CITY ZIP PIION[ <br /> TENAN�~ M�II��ORES$ CITY 21P PHONE <br /> n/al��r�ir-�r lfi�M �Y-s��ni <br /> ARCHRECTOROE IGNER MAILAODHESS CITY 21P FMONE <br /> Hc:�l/Z??A/ UD�� �1rah �5 �nBeY� _ <br /> GENEPALGONTi1FCTOH M�ILAOOPE55 CITY 21P PHONE LICENSE• <br /> ME�H�NICALCONTR�GTOR MML�UDRE55 CIiY 21P PHONE LICENSE• <br /> PLUMBIHOGONTRACTOP M�IL�UOflE55 CI1Y 2�P PHONE 4CENSE� <br /> CLA.49 OF WORK <br /> NEW ❑ ADDITION ❑ ALTEPATION ❑ REPAIR ❑ DEMOLI710N ❑ WOODSTOVF/FRPL.INSERT ❑ BUILD�NG fiELOCATION <br /> IEN�NT IMPROVEMENT OR I.VTENIOR REMODEL ONLY CONT�CT PENSON�N�PIIONE NO. <br /> CONTRACTPHICEUFWOPK S <br /> DESCRIBE WORK�ND SOU�RE FOOUGE INVOLVED <br /> Nz�� n�rPii�7vnl �JoO � <br /> PROPOSED USE OF BUILOIN� 1 HEREPY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND <br /> ��/�L�����L� KNOW 7HE SAME TO BE TaUE AND CORRECT.ALL PROVISIONS OF LAWS AND <br /> �ea��oesCRIPTIONOFFROPENttISHOWNBELOWOR�T7�CHfOURGOPIES� ORDINANCESGOVERFIINGTHISNPEOFWORKWILLBECOMPLETEDWITH <br /> W HETHEF SPECIFIED HEREIN OR NOT.THE GRANTING OFA PERMIT DOES NOT <br /> � e�ocK. oF ��pFSTlLY7 PRESUME TO GIVE AUTHORI7Y TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> �oi qNY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR 7NE PER• <br /> FORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE OWNER OF <br /> ' 1 HtS PROPERTV TO PEfiFORM THE WORK FOR W HICH APPLICATION IS MADE <br /> AND I COMPLY WITH TIIE STATE CONTRACTORS LAW 1827 RCW AND <br /> 296.200 WAG <br /> SIQNATUREOFCONIflAf.TOt10qAUTNOP2E0�GENT O�TE <br /> F`�S,�a-ILY�PE, LU C� - X ��.�n� TY �a a�e� . //-��� <br /> PRQIECT AO[1PESS APPLIC�LIiY BUSINESS IICENSE NO�N�BUSINESS NAME <br /> I — � �. � l •� 1 , <br /> PLUMBIN6 � MECHANICAL <br /> NO. T�PE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> '7 WATERCLfSET(TOILE'f) � -- A/C—A/HNGLGUNITS—H.P. <br /> BATHTUB ` — FORCED AIR SYSTEMS—6T.U. M E0. �- <br /> LAVATORV(WASH BASINI ` 'i " UNIT HEATERS—B.T.U. M <br /> SHOWER �-� � CLOTHESDRVERS �C� �� <br /> KITCFIEN SINKB DISP. � '�/ VENTILATION FAN r <br /> DISHWASHER ` ' RANGEHOOD <br /> LAUNDRYTRAY WATER HEATEfl - � <br /> CLOTHES WASHER � �i �-' WOOD STOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEY <br /> DRINKINO FOUNTAIN FIREPLACEINSERT <br /> FLOOR[1RAIN HEAT PUMP <br /> BAf,KFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> SINKISERVICE—BAR ETC) <br /> SUBIUTAL S � � � SUBTOTAL S r- <br /> PERMIT S PERMIT 5 - <br /> TOTAL FEE S �l� � TO7AL FEE 5 <br /> FRONTSETBACN RE�RSETBACK Si0E5ETB�CN , PLANGNE KNIIMBER FEE C� AECLIPTNO <br /> Ze . � , L . ��h .�� ��31 -���� '=- I�I �'�1�, <br /> usezor+e LOT�RE� VAC�NISIIE FEES VALUATION FEE <br /> Pr ` X OS ES ❑NO <br /> TYPEOFfANST. OLOOPAONCYO OUP NOOFDWElLINOUNITS — BUILDING 2.�p pt� � ��� <br /> euoweBl��� � � _ / PLUMBING ��Z� <br /> . . <br /> SIZEOFBLD(i. NO.OFSTORIES BSMT. OGCLOND ` � <br /> /S`�S Z � q �— MECHANICAL <br /> NEIG11TlIA11TATI0N OTHER <br /> FIRESPRINKLERSNEOUIREU OYES O STATEBUILDINGSURCHARGE '�1 <br /> STATE ENERCaY SURCHARGE I I( <br /> �PPIICATIONACGBY PUNSAPPfl.BY ( <br /> � PUBUC WORKS � . � <br /> � �Y�—•J T�TA� R�C-'' � <br />