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[�7 h7 � <br />A�x <br />C, H <br />9HCn <br />� <br />H�� <br />K C] <br />H xl <br />'�UH� <br />VJ N <br />�x� <br />OH <br />H�g <br />�r n <br />9H� <br />ryH <br />g H <br />C]l7W <br />xH�n <br />H O V� <br />mo e�crg�cc� <br />CRYOF <br />everett <br />BUILDING DEPARTMENT <br />259•8810 <br />APPLILATION FOR CONSTRiJCT10N <br />PERMIT <br />TO BE COMFLETED IN INK— PLEASE PRINT <br />MEc?fA14i'cn[-�"�nc�o�—Y_K19_I—�+�aaooaess - cnr na rro�+� — ucer�se. <br />FLUAIO�NGGONiRPGtUR MAIIADOP[SS CItV 21P PHONE LIGENSE• �. <br />CLASS OF 140PK <br />❑ NEW ❑ ADDITION ❑ ALTERATION ❑ PEPAIP ❑ ❑EMOLITION ❑ WOODSTOVE/FRPLINSERT �BUIIDINGRELOCATION ' <br />i[N4N11MPPOVEMENTORINTEFiOl1RLA10DELONIY ^ C(�JT�{AG�T����ERSOA NO P��ON NO <br />��u.o.ctoaicEovwoe� %i nl`�uP.10\ ��MGI i�f . ��"� 1_� �"JY- —��— <br />�or eiocK or <br />. �oP,r <br />PLUMBING � <br />VO. T'PE OF <br />WATER CLOSET ITi <br />KITCHEN SINKS �I�. <br />DISHWASHER <br />LAUNDRV7RAY <br />CLOTMES WASHER <br />UPINAI <br />DRINKING FOUNTA <br />FLOOR DRAIN <br />BACKFLOW PREVE <br />ROOF OFAINS— R <br />m.�v �ccov�rc _ c <br />o� <br />nnC SPPINKlERS REOUIR[D <br />TOTAL FEE <br />I SE111AOIX <br />NO <br />�«.�, s� a / <br />ft YES ���0 <br />2�c'i_C�� ` i <br />1 H EREBV CERTIFY f HAT I NAVE READ AND E%AM W EO THIS APPLICATION AND <br />KNOWTHESAMETOBETRUEANDCOFRECT.ALLPROVISIONSOFLFNSAND �I <br />OADINANCES GOVERNING THIS TV � OF WORK WILL BE COMPLETED WITH <br />WH[THERSPECIFIEDHEREINOR OT.THEGRANTINGOFAPEFMITDOESNOT <br />PRESUMETOGIVEAUiHORITVT VIOLAIEORCANCELTHEPROV1510NSOF <br />ANYOTHERSTATEORLOCA . REGUCATINGCONSTRUCTIONORTHEPER� <br />FOR1dANCEOFCONSIR �O .THAiIAMAUTHORIZEDBVTHEOWNEFOF � <br />THISPROPERTVTOPE -0RM�jFEWOR RWMICHAPPLICAiIONISMADE <br />AND I COh1PLY WIT TIj�STATE CONTR CTORS LFW 1827 RCW AND <br />296200 WAQ. ` � ' <br />sicr+nruncorCON < On�i+AUP10R¢[OAGErvi OATE , <br />� �' , <br />X i � �i ,. t��i�% <br />MECHANICAL <br />NO. 7YPE OF EOUIPMENT <br />A/C— NHNDLG UN17S— HP. <br />FORCED AIR SYSTEMS— B.T.U. M EA <br />UNITHEATERS—BT.U. M <br />CLOTHESORYERS <br />VENTILATION FAN <br />RANGEHO00 <br />\NATER HEATER <br />1N000 STOVE <br />METAL FIREPLACE 8 CHIMNEV <br />FIREPLACEINSERT <br />_ HEAT PUMP <br />GAS PIFING <br />EXHALIST FAN <br />SUB TOTAL <br />PERh11i <br />707ALFEE <br />FEE <br />�77'C.s i �'.. <br />BUILDING <br />NO.OfOWELLINGU1L15 _----- <br />PLUMBING <br />BSMt. acc �Ono MECHANICAL <br />❑Y <br />❑N <br />NEIGIIiLIMRPTION piHER <br />STA7E BUILOING SURCHARGE <br />STATE ENEPGY SURCMARGE <br />�PUBLIC WORKS <br />� TOTAL <br />ei�• <br />FEE <br />1� <br />ELE'TT NO. 1 <br />FEE II <br />.sc° — , <br />.l C� I <br />