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AP�PLI��.f10N FOR C(�MSTR�rC�'ION <br /> PERMIT <br /> I�e Evacreun i�����ii�ll <br /> GTV O� � <br /> everett �r <br /> BJILDING DEPARTMENT '� . <br /> 25s-e810 TO BE COMPLETED IN INK— PLEASE PRINT � <br /> C.\:61 MAI�AOIJ{iESS GIIY iIP {'HONl. �) <br /> l/ n0 `%/ �� <br /> ��TH�C/J/`r� I/pr" J/E lu/l� ?�'�'�-�R� S�E. �iitL CQK-K `7�C/L ��/1 -4���. <br /> 1[ViNT / MAILPGDRE55 CILV 21V — PM01lE �� <br /> U <br /> A�tO� 1/i1OR�E5IGNEF MAILAD�RE55 �,LiiY ZIP '�/ PHO ���r // <br /> ynH 1 (�'Y", , s� � � - � ��� ! !1�-��'GC �7 • v�-,� <br /> �r� �AIL.V AE55 CILY ZiY P NE LICENSE• <br /> � E PLCONTRACiOP �%G'n� � <br /> .O'z s tL.� i f�/�,_�S/� ��L�.f�� %l-��� �G ���-����-' - <br /> (y H �AEC ANI P ONl ACiO� � ADOR 55 LItY �P P110 LCENSE <br /> Hx� ��_ _,�/S i `�`�2�-��-7.3 <br /> y �H PL ��iNGCO RACiOR MAIL�DDPE55 CiiY IiP PNONE LIfENSE• <br /> K n <br /> H�1 <br /> ❑SNEWOR❑ AODITION ❑ AUERATION ❑ REPAIR ❑ OEAIOLITION ❑ WOODSTOVE/FRPLINSERT ❑ BUILDINGRELOC�TION <br /> '�s� �'a] <br /> 1-3 z� iENRNiIMPR7VEMENTONINI-RIOR EMODELONLY CONtASioEPSONANDPMO 10 ' <br /> �p+ �/ /O� �� y <br /> l•J O T� LONTR�Gi PaiCE Of WORK c I' SqLy�U7�—� — ' � " — <br /> yd DESGRIBEWORFAN�S�UANEF iAGE iVOLEYD <br /> H �g ;VCw s `� __ -- — <br /> i�r:crosEouSeorBUa NG IHEREBVCERTIFYTHATIHAVEREADANDE%AM17INEDTNISAPPLICATIONAIJD <br /> 9H� � � I h ML KNOWTHESAMETOBETRUEANDCORRECTALLPROVISIONSOFLAWSAND <br /> LEGAL DESCR�I1ONOf VpOPEPTY;S WN BEIOW OP�ilnCM fOURLOPIES ORDINANCES GOVEFNING THIS TYPE OF WORK WILL BE COh7PLETEO WITH <br /> WHc7HER SPECIFlHD NERLIN OR NOT.THEGRANTINGOFAPEF�dIT DOES NOT <br /> r PRESU1dE TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> u yy �o*_.�...L e�ocK or ��rjrMO ANYOTH[RS7ATEORLOC.4LLAWREGULA7INGCONSTRUCTIONORTHEPER� <br /> oH "' 1 FORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE OWNER OF <br /> � d� iH15PROPLRTVTOPEFFORMTHEWORKFORWHICHAPPLICFTION151dA0E <br /> � �r _ AND I CO�dPLY �VITH THE STATE CONTRACTORS LAW 18:% RCIV A4D <br /> � 29G200 WAC. <br /> iGN4TltF0� CNiRl.ClOPli�1-J1��DPIZE�>GENi D4IE <br /> HOc�i� � �� <br /> --- --- -- - - !�' (/� I-51�'-,��9 <br /> aaaeer.00aess .,�, ,e. .- ur uswcssv�e�.se.�o o „s,a.��s i+ <br /> I7� C� ,�dqe�itCOr �ii�1Q _ <br /> PLUM1:BING MECHANICAL <br /> NO. TVPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> —' _J�_ WAiEliCLOSETITOILE➢ �U . ___ �vC-A/HNDLGUNITS-MP _ _ <br /> ' � �, BATHTUB __'.______ ___�Q __' ____ FORCEDAIflSY51[615-9T.U. _L1EA _"'__ __ <br /> LAVATORVI�NASNBASIN! _�S ___ UNITHEATERS-BT.LL M _ _ <br /> SHOWER �D_ CLOTHESDRYERS ___,__�p �(�__ <br /> �+ � KITCHEN SINKd�ISP. J _ _ � VENTILATIpN FAN __�_OCj__ <br /> �� DISHWASHEF � RANGEHOOD ,_ <br /> LAUNDiiV TFAV __, _!_ WATER HEATER _CD_SQ_ <br /> �_ CLOIHESWASNER S N'OODSTOVE _ <br /> '" � _,� METALFIFEPLACEbCHIMNEV _�(J Qa_ <br /> ' ' URINAL <br /> i i � fIREPLAL'E�NSERT <br /> ORINKI �G FOUNTAIN -- <br /> FLOCR DRAIN -- -- - -'HEAT PUh1P '___ _' <br /> BACKFLOW PREVEN7EPS � GAS PIPING ____ —_ <br /> .�' ROOFDRAINS-RAWLEADERS � EXHAUSTFAN —_ <br /> SINK�SERVICE-BAR.ETC) �..�-- - - <br /> '�.. ..�a —� --,–U �.—ff�L_1n!!ts?i�= G- <br /> �� <br /> ��I SUBTOTAL 5 _, _ SUBTOTAL _ S_ <br /> U- <br /> PERMIT 5 PERMIT 5 - <br /> TOTAL FEE S TOTAL FEE 5 �J <br /> h�UNISEttlALK fVEPHSlIOACN Si0lSL�B6LN PIANCNCC1tHb+�BEN fEE NECEIPlHO. <br /> � ��30� 2S'' �.S' ,� �� �� y �y �3 �r � <br /> usiZOHe �ornnen vsuntsrtc FEES VALUATION FEE <br /> rC ' ��� ❑VES ❑NO C ��, � ,,,�— <br /> ✓ BUILDING �(Qt D �✓ Q ���/ <br /> IYPCOFCONST. � OCLUVPNCYGHOU� NOUiOWELLINOUNITS . -- -- -- - <br /> n�IUY:AB�E/AGiU�r' � I !7� Q / PWMBING <br /> .l� M r'C J Q- C�Q- <br /> SitE OF BLUG NO.Of 510RIE5 �OS(r4/i. OLG LOAD D� f.� <br /> 3 55� sF f 2 !i n �� MECHANICAL o s _ <br /> 8�g SRGAud�E ����GHILIMIlA110N/ OTHER �IpN C�lP6� _ �Z7 _ <br /> �iR[SFPVINlEHSREOWREO ❑r[s no Z STATEBUILDINGSURCHARGE I JU <br /> STATEENERGVSURCHARGE _ 15 QU— <br /> ♦GVLif.AIiONACG.OY PLRNSAi'PPOY i ^ 1 „r' <br /> p / PUBLICWORHS a� vv <br /> ���� . `^I\ . I I!`� I TOTAL _ I �. I It � 7 � <br />