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� A�pLIC�.T10N FOR CONSTRty�T10N <br /> PERMIT . <br /> Ms Ewryroen everett <br /> CITY OF � <br /> , everett <br /> j BUILOING DEPARTMENT <br /> 269-8810 TO BE COMRL TED IN INK— PLEASE PRINT <br /> N ^ M�IL�D�RESS G Y 21P PNONE � <br /> ��U•+..�,�c.��/fai�S�=,G9d'�.90 �6 d'- �/3_T ' <br /> � MAIL�DORE59 GItY Z� PNONE <br /> ARCMREI.RORpE81(iNER MAILIIDDPESS CITY ZIP PHONE <br /> OENE �L �GTOH I � .fl CITY IP PNONE UCENSE• <br /> Qd1'NN�- �''�0?.I /PBt,prv�/L/ �2� <br /> MECH�NICA�LCONTMCTUF M��LA OPE 9 C11Y 21P PNONE 4CEN9E <br /> PLUM&NOGONTMCTON M�IL��ORESS LIiY 21P PMONE IIGENBE• <br /> CLAlOOFN9PK <br /> NEyy ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVFJFRPLINSERT ❑ BUILDINORELOCATION <br /> NNlTIMVPWEMENTOPINTEHIOflREMOOEtONLY CANT�C7PER90N OPMONENO � (� <br /> CONTMGTPPIGEOFWONK n��•—� �'�/�h�J _ <br /> DFlCRI�lM'ONKANUBOU�REFOOT�OEINVOLVEO � — � <br /> ' fiJq//L o/!1 Gr <br /> ED U!E OF 9UIlUINO I HEREBY CERTIFY THAT 1 HAVE READ AND E7(AMINED THIS APPLICATION AND <br /> '� � HNOWTMESAMETOBETRUEANDCORRECT.AILPROVISIONBOFUW9ANU <br /> �E EB IONOFPROPERTY�BNOWNBELOWOP�TT�CNFOURCONE91 ORDINANCESGOVERNINOTHI57YPEOFWORKWILLBECOMPLETEDWITH <br /> WHETMER SPECIFIED H[REIN OR NCIT.THEQFtANTINOOFA PERMIT DOEB NOT <br /> � PRESUME TO OIVE AUTHOR�N TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> �pT�_ uocN� oF � � L� ANYOTHERSTATEORLOCALLAWREOULATINGCONSTRUCTIONORTHEPER- <br /> SNT'�/(G%TtI ADD�T/ON �D���sf�� �� � • 7HISPRO ERN O ERFORM'THEWORKF RWHICHAPP IC TEOW19MI1DE <br /> �'�,d',q�TJ�� �� ���" AND 1 COMPLY WITH THE STATE CONTRACTORS LAW 1827 RCW AND <br /> (/p�,y��S �� OF �L�TS /�i��f 9 ��p�/tl 29B200WAC. <br /> &ON�TUPE ONTP TOR AUT RI:.FDA3EI:: OATE <br /> ` ' �/'-r1 -� <br /> PIIO.IEC7�DDNE9S �V IC�NTSCITYBUSINESSIIC N0. OBUSINESSNAME <br /> � �sr /I"J e G-r� a cd�.e <br /> PLUMBING MECHANICAL <br /> Np, TYPEOFF�XTUREORITEM FEE N0. TYPEOFEOUIPMENT FEE <br /> WATER CLOSET(TOILET) AlC—AIHNDL6 UNITS—H.P. <br /> BATHTUB �' FORCEDAIRSYSTEMS—&T.U. MEA <br /> UVATORY(WASHBASIN� — UNITHEATERS—&T.U. M <br /> BHOWER CLOTHESDRYERS <br /> KITCHEN31NK8DISP. r VENTILAT�ONFAN _ <br /> DISHWASHER RANGE HOOD 1 <br /> LAUNDRYTAAY WATER HEATER <br /> CLOTMES WASMER WOOD STOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEY <br /> DRINKINaFOUNTA�ry FIREPLACEINSCRT _ <br /> FLOOR URAIN HEAT PUMP _ <br /> BACKFLOW PREVENTERS OAS PIPING <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> SINKI9ERVICE—IiAR,ETC.) <br /> SUBTOTAL S C " SUBTOTAL S � <br /> PERMIT S PERMIT S <br /> TOTALFEE E � TOTALFEE S � <br /> FRONI'OETBACN FEARBETB/�CK SIpESETB�CK RANCXECKNUMBER FEE 11ECE�IfNO. <br /> 20 � � � � '��� <br /> v8¢zone �or�nu VAC�NT6ITE FEES VALUATION FEE <br /> 21 O YES O NO <br /> � l �d BUILDI�G <br /> ttVEOFCANeT. OCLUP�N YOROUP NO.OFOWELLINOUNIT9 � <br /> /��pWABIE/ACTU�L PLUMBING � /� � <br /> P12EOfOLOQ NO.OFBTORIE9 BSMT. OLGLO�D MECHANICAL GK/� ^ <br /> OY <br /> ❑N <br /> �'— NEI4NTLIMIT�TION OTHER 2 <br /> iIREBPCMNLEB4PE0UIFE0 o res o r+o STATE BUII.DINOSURCHARGE �J <br /> -- STATE ENERGVSURCHARGE I �� <br /> MPLIC�TIONAGGBV PIANS�PPR.BY PUBI.ICWORKS , <br /> ��X � .-r <br /> ���`� TOTAL <br /> ..,...,,�.•"e ._,....r..� ,.,. .�'-.�,,. ..� ..;.,�::,.. ;..�.�.. . ._-.,:::-.. ,.. r.r:.. ...5.. - .,.�.,_ <br />