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�� �� I�i � Y / U� 1 �� <br /> APPLIt..�►TION FOR CONSTAJCTION �.��� ����-� <br /> PERMIT (/�" p(��^1 � <br /> IhoEvorp�een �--✓'+ 1� . I <br /> GTV OF i•w'u�ll <br /> ��� everett e ' <br /> BUILDING DEPARTMENT <br /> C � * 259-8810 TO BE COMPLETED IN INK— PLEA�E PRINT 33 7 ti o o.rr <br /> ayy L � C�1� NnR �v� ArJ PD � nY 3 ) I� LXNv�Wonr C��A?�C , <br /> tY�c OW EN NAILAODPFSS CIIY P� I�nOML <br /> y�Z�-+ L,_,• �v. N e �i nn A�1 9 I 3 P�r�Q Ls EI�v_a,r_�tt 337 �l o o g <br /> IC (� TENA i M1141LADDRE55 CIIY ZIP PNONE <br /> � �� — <br /> � No� M An� <br /> y� C111iECiOR�ES�GNER MnILA0DNE55 CIIY 21P PNONE <br /> � x �Q�Q Q L�/L�►N <br /> O^� GENEN4LGONiRFLiON MRILAOOR[55 CILY ZIP FNONE UGENSE• <br /> � I�pr. td o R n�A N <br /> ���J MECN�NG�LGONiFAGiOR MAILAOONE55 CITY 21Y PHONE LICENSE• <br /> �• n t � oh \Jn � YtiNr� <br /> H PL PINGCONfRAGTOR MAilA00NE55 CIiY ZIP PNONE LICENSE� <br /> �y �pv. �J oK nn ah <br /> ��„� y CL�SSOFNq1iK <br /> gy ❑ NEW ❑ ADDITION T� ALTERATION ❑ REPAIR ❑ �EMOLIiION ❑ \YOODSTOVE/FRPLINSERT ❑ BUILDINCaRELOCATION <br /> H <br /> �] �/J iENANIIMPROVEMENiORIMERIORREMO�ECONLY CONLAGiPEPS011NNDPtlONENO <br /> ��►1 fANTPACTPRICE0F140PK J c�I OO <br /> y� OESLnIBEWOPNRND50UAPEf00iAGEINVOLVED <br /> HO�n W ' <br /> � vaovO5EDu5E FBUILOING IHEREBVCERTIFYTHATIHAVEREADANDEXAMINEDTHISAPPLICATIONAND <br /> HOu��_ Yr t'b PIfP KNOW'MESAMETOBETPUFANDCORRECT.ALLPROVISIONSOFLAWSAND <br /> IEGAL OESCRIPLIONOf PHOPENT'ISNOWNBELO1VbP ATiACH FOUBLOPoE51 ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COh1PLETED WITH <br /> �,,.p.� cp /�� WHEfHER SPECIFIEDHEREINOP.NOT.THEGRANTINGOFA PERMIT DOES NOT <br /> toi� B�oCKB�ov ��C F • `-K �S' PnESUMETOGIVEAUTMORITVTOVIOLATEORCANCFLTHEPROVISION50F <br /> ANV OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PER� <br /> A FORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE OW NER OF <br /> P E R �w'�' R n�d �h THIS PflOPERNTO PERFORM THE WORK FOR WHICM APPUCATION IS MADE <br /> N 3, N—� � AND I COMPLV WITH TNE STATE CONTRACTOFS LAW 1827 RCW AN� <br /> 296200 WAC. <br /> VO�UhtF �b OF l��A�S Orl !� swr+nruaeoFcoHin.ctoaouaun�oaizco•cer+r onre <br /> R L'r �R�s o r' s IJ a hl rv�<s h c n u t' X ��u�z_��� ��1�`L <br /> VRQIEGIAppPRS r qppU SCIIYBU$NESS ICENSE�OAN BUSINE551U <br /> � � �n <br /> PLUMBING MECHANICAL <br /> '�' NO. TYPE OF FI%TURE Ofl ITEM FEE _ NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET�TOILET) N/C—A/HNOLG UNITS—HP. <br /> ' = BATHTUB FORCEDAIRSYSTEMS-9TU. MEA _ <br /> � <br /> LAVATORV�WASHBASIN) UN!THEATERS—aT.LL M <br /> '�1 SHOWER CLOTHES DFYER$ <br /> ' ' KITCHEN SINKB DISP. � VENTILATION FAN I , <br /> _ DISHWASHER FANCE HOOD <br /> � LAUNDRYTRAY WATERHEATER <br /> '�1 ; CLOTHESWASHER _ WOODSTOVE _ <br /> ' ' URINAL _ METALFIREPLACEBCHIMNEV _ <br /> � ORINKING FOUNTAIN FIREPLACE INSERT <br /> fLOOR ORAIN HEAT PUMP <br /> 1 BACKFLOW PREVENTEFS GAS PIPING <br /> ' ROOF DRAINS—RAINLEADERS E%HAUST FAN _ <br /> SINK ISERVICE—BAp,ETQ) <br /> '-; — <br /> ' t SUBTOTAL 5 � � SUBTOTAL S � <br /> PERMIT S PERMII S <br /> '�' TOTAL FEE 5 TOTAL FEE 5 <br /> _ fPO��iSEiBAC�C / REARS�% SIOESEiBP K PUMCN C NYi U�{BFN .� FEG� "')F' ME[���� <br /> �" /�n ���\��� 1i /_ <br /> �l <br /> useloNE� � LOiAFE� vec�r�rsrte FEES VALUATION FEE <br /> � �YES `HO <br /> ttPEOiCANST. OCCUPANCYGRO�P NOOfpWELlIN4UNIi5 fil11LDING Q'OOO � <br /> AIIOWABLE4� <br /> ��S � PLUMBING <br /> SIIEOfBLDG NOOFSTONIFS BSMi. OCGLOAO /�' <br /> � T � � MECHANICAL '/ � <br /> � <br /> — HE�a�ruMir�no�+ OTHER <br /> i <br /> iIRESPRINNLEH5PE0UINE0 ❑ve5 o STATEBUILDINGSURCHARGE _� +II <br /> STATE ENERGV SURCHARGE I <br /> AFV4�C BY VLANSAPFP BT PUBLIC WORKS I <br /> 4� 70TAL � " <br />