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.. <br /> � �, " � <br /> " APPLICQ710N FOR CONSTRUCTION <br /> PERMIT <br /> Me Ersry�een evrrcll <br /> GTY OF <br /> ` . , everett e <br /> �- BUILDING DEPARTMENT A� <br /> � P59_gg�p TO BE COMPLETED�N INK— PLEASE PRINT <br /> � . ayH�-� MAILPDOP[55 GI1Y ZIP FNUNE <br /> ��Y"�� �Ai(e� 7-l`( E��i�a!✓�1 ft�� �tl �`�3'�`��I� <br /> , <br /> TEN�NT � d/J MPILAODRE55 GiY Z�P PHONE <br /> .. . . �'Jf�/� 4l <br /> MCHOcCTOPJE5IG-N�GEF //��,+AIL�D�PESS CIiY ZIP PMONE <br /> � �/`7(u-�" 1,C7/L' � [0.�lZ—, <br /> GEN RAL"ONiH ID V�q� ��._I IAAILAD�RE55 Clrv ZIP PHONE - LICENSE• <br /> ///���y �.�,i`i� �, L�� r� �� ,g�� �-7O ��aLtow��sc C�aS'7 ldrUtS3b qor�i�1� <br /> ��{f .� ME�MZ'ALCONTRAGT R MPILA�ORE55 CIiY ZIP PIIONE 16EN5E�— <br /> .q <br /> � RUMBIN�,�n��' MAILA�ORE55 LIiY ZIP PIION[ LIGENSE• <br /> 'v v ' ^ <br /> ��� � C OFWOPK <br /> �NEW ❑ AODITION ❑ ALTERATION ❑ REPAIP ❑ DEMOLITION ❑ WOODSTOVE/FRPLINSERT ❑ BU'L�INGPELOCATION <br /> ��� tENANTI!ApROVEMENTORINi IORPfMO�ELONLY LO/Ni�AC[PORSON�f/y/'�CNONENO. '/� <br /> LONTRACt PPICEO.�WOPK � �O� _J�'��' • "��L/ ���— " ��� <br /> �� � 0 /IBLEWOR �N'D'yS�DYUAFEF(IOTC�E�NVOIVED /�}^ <br /> � y` �N`/���� LJ' O�7 �Q,� <br /> �Q PROPOSEOUSEOFOUILOING �HEREBYCERTIFY?MATIHAVEREADANDE%AMINEDTHISAPPLICATIOHAND <br /> 1] � /`�/1���_�(� NNOWTHESAMETOBETRUEANDCORRECT.ALLPROVISIONSOFLAWSANU <br /> �H �. ��Y OR�INANCES GOVERNING THIS TYPE OP WORK WILL 8E COMPLETED V✓ITH <br /> ao �ECMLOESGPIPiiUNUFPqOPEPlY15NOWN8ELOWOPATiACH�OIIPCOPiE51 yyNETHERSPEqFIE�HEREINORNOT.TMEGRANTINGOFAPERMITDOE5N0T <br /> Q� . PRESUtdETOGIVEAUTHORITVTOVIOLATEORCANCEL7MEPROVI�IONSOF <br /> u �pi B�OCK uv ANYOTHEP'sTATEORLOCALLAWREGU!ATINGCONSTRl1CT10NONTHEFER- <br /> �y p ��` ^� FOFMANCc OF CONSTRUCTION.TMAT I AM AUTHORIZED BY THE OWNER OF <br /> . G —/-- dD� `D�7'vv�z THISPRCPERTVTOPtRFORMTHEWORKFORWHICMFPPLICAiIONISMADE <br /> AND I COMPLV WITH THE STATE CONTRACTORS LAN 1927 RCW AND <br /> M � 296200�VAC. <br /> � $IGNIIURI.Of:ONiPACiCnppppplOA�' AGLNI OAiE <br /> �� r'^` ♦ <br /> rx y,e,E�__-^� /` ��—�`� <br /> GFOJECiA00RE 5 APP N15GIiTUU5ME55LICENSENOANC USINESSNAME <br /> � 2��.� ���. I �l-L'4 ��.�, <br /> PLUMBING MECHANICRL <br /> � . NO. TYPEOFFI%TUREOHITEM FEE NO. TYPEOFEOUIPMENT FEE__ <br /> . . � � WATERCLOSET(TOILET) A/C—A/HNDLGUNITS—H.P. <br /> � BATHTUB FORCED AIR SYSTEMS—&T.0 M EA <br /> I � � LAVATORVIWASHBASIN� — UNITHEATERS-6T.U. M — <br /> i <br /> SHOWER CLOTHESDRYERS <br /> � � KITCHEN SINKB DISP. _ VENTILATION FAN _ <br /> � DISHWASHER � RANGE HOO� <br /> � ! LAUNDRYTRAY _ WATERHEATER <br /> I ' � ' CLOTHES WASHER WOOD STOVE — <br /> URINAL METAL FIREPLACE 8 CHIMNEY <br /> .. i : DRINKING FOUNTAIN FIREPLACEINSERT <br /> ' ' FLOORDRAIN HEATPUMP <br /> il1_�' BACKFLUW PFEVENTERS GAS VIPING — <br /> �� RppF ORAINS—RAINLEADERS E%HAUST FAN <br /> � SINK(SERVICE—BAR,ETCJ <br /> �i <br /> I � <br /> SUBTOTAL S SUBTOTAL 5 <br /> ��. PERMIT 5 PERMIT 5 <br /> � '�OTAL FEE 5 � TOTAL FEE S <br /> FflONT5Ei6PGK FlPRSEiOACK SIOESEiOAGK PUNC ECNNI1MfiEP FEE PECEIPfNO. <br /> Z�o G � 5_� u �?1 � ��O '7��� <br /> USE20NE ioi�aen vnCervtsrte FEES VALUATION p FEE <br /> � �_�j ❑res �SNo BUILDING �� I�iO <br /> C.._ <br /> ttFEOFCANST OCCUPANGYGROUP NOOFOWELLINGUNIiS — <br /> ALLOWABLE/PCTUAt � � / — PLUMBING <br /> � <br /> srzEora�oc. no.ovsroaies eSYr. occiono — MECHANICAL <br /> ��C� ��.�''��0 w'V �7 �/ <br /> NUGNrurniratiOH pTHER P�U,yt p 7O <br /> FIRE SPRINNLERSPEOUIP[D ❑ve5 �o STATE BUILDING SURCHARGE l./ <br /> STATE ENEfiGY SURCHARGE <br /> A�'M'CFTIONACL�Y PLANSAPPFBY PUBUCWOflKS � V <br /> �J Tora� �5' <br />