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b7 Ca�1 � <br />p�1S <br />ay5y <br />H x� <br />K n <br />H� <br />h�tl N'{7 <br />�p H <br />H <br />zo <br />OH� <br />H/��g <br />y�Y Cq] <br />� H [�7 <br />HH <br />gy <br />f] C y <br />��� <br />HO� <br />APPLIC.aTIQN FOR CONSTRI�CTION <br />PERMIT <br />Ne EverOreon �'��'«'�� <br />CITY OF � <br />everett <br />BUILDING DEPARTMENT <br />259•8810 TO BE COMPLETED IN INK— PLEASE PRINT <br />OWNEP <br />unanooa[ss urv `u' rHo�ve <br />rn�. ��� {7. < r��, i� Ili'71i. l-1.r'17C.�7F-}',L' �.�..7Y E-IGi E��t72�TT- y5'2G �9�� -�i ��i�� <br />,� A��E - - <br />•pCMli[CtOR005IGNER MAILAODRE55 LILY IP ONE <br />_ _ ' '__.. ..-�..�. ._ .-.r-n._�r (7.i-�..o '7Cc�"Z'if�P� <br />��� MMI�DURE55 CIiY IIP FNOHE ULENSE• <br />M[CN�HIGLCONiR�LTOR _ <br />LLRSSOF WOPN <br />�� NEW ❑ ADOITION ❑ ALTERATION ❑ REPAIR ❑ <br />tENI.NiIMPPOVEM[NTORINiER10PREMOOELONLY �-s.� � <br />GONTPnLTPRICEOFWORK I��� <br />OESCRIB,C�'�RNAHOSOU�REfOOtAGE1NVOLVE� <br />.�t'�C.-O n� /l;�uw (:ESfi�c�-E <br />�iN��-E F�r�� <br />LEGAL OESCNIPl10N OF PROPERLV ISe�04 <br />� ) I <br />LOT_J_ B�OCK �'� OF <br />PLUMBING <br />OR <br />KITCHEN SINKB DISP. <br />DISMWASHER <br />URINAL <br />DRINKIN� FOUNI <br />FLOOR DRAIN <br />BACKFLOW PREV <br />ROOF DRAINS — <br />ciue�ecomcr— <br />SUBTOTAL 5 <br />PEFMIT 3 <br />TOTALFEE 5 <br />iRONiS[19ACN REARSEiBACN S�C <br />S� ZU� � <br />USf,Iq[I[ LOi�REA WI <br />1VP�OiLOHSi � IX:CUPnNG�NOUP ix <br />ALION'AOLbAC1WL V �� <br />_LN_ �' <br />51160�8�, / NOOFSiORiES BSMi. OC <br />-..� � �N IIC <br />�_SPRINeLUiSPCOUIREO :' Y[S %NO _ <br />3306� �F SZe SP 4�R <br />q <br />❑ \NOODSTOVE/FRPLINSERT ❑ BUILDINGRELOCATIDN <br />I HEREBY CERTIPYTHAT 1 HAVE READ AND E%AMINED TNIS APPUCATION AND <br />KNOW'•HESAMETOBETRUEANDCORRECT.ALLPROVISIONSOfLAWSAND <br />ORDINANCES GOVERNING THIS TYPE OF WOFK WILL BE COMPLETED �VITM <br />WMETHERSP[GFIEDNEREINORNOTTHEGF7ANTINGOFAPERMITDOESNOT I� <br />PRESUMETOGNEAUTHORITYTOVIOLATEORCANCELTHEPFOVISIONSOF � <br />ANYOTHERSTAIEORLOCALLAWREGUTATINGCONSTRUCTIONORTHEPER� I <br />FORMANCE OF CONSTRUCTION. TNAT I AM AUTHORIZE� BV THE OWNER OP <br />THIS PROPERn' TO PERFORM THE WORK FOR WHICH APPLICA710N IS MAOE <br />AND I COMPLY WITN TNE STATE CONTFACTORS LAV� 1827 RCLY AND <br />296200 WAC <br />SiGH»unEor .O�:r�+�crnno�.:vu�o co<GErv� D<tE <br />X , � i-.s 9_� <br />qpPLl Ail5 �1VBUSINESSUCU.S �N OUSINESSNFME <br />MECHRNICAL <br />FEE NO. TYPE OFEOUIPMENT <br />A/C— A/HNDLG UNITS— NP. <br />�_ FOFCEDAIRSYSTEM1IS—BT.U. MEA <br />UNITMEAlERS—B.T.U. M <br />. (1 1 Cl OTHES DRVERS <br />r'JATER MEATER <br />wOODSTOVE <br />METAI FIREPLACE 8 CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />FXHAl15T FAN <br />PERMIT <br />;] NO <br />�UILDING �`Y"' u�� <br />ve�ur+ouHirs �- �-��t 15�5• <br />JPLUMBING <br />� MECHANICPL <br />�.nor� OTHER ____ <br />U <br />-- STATE BUIID�NG SURCMARGG <br />STATEENERGYSURCHARGE <br />PUBLIL' WORKS <br />TOTAL <br />FEE <br />g --Y_-:1— �— <br />S � <br />S � I <br />HECEIPfNO. <br />� 7--Z � -, � <br />fION FEE <br />�45 �� <br />�..�. li� <br />— i. � v <br />��'z�? �� ,. <br />i <br />'— � — <br />�� -' . .. �1.�� <br />��� <br />