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�F: . � � . :� ' . <br /> a� � .. ppPLIC�ION FOR CONSTR�TION <br /> . �:'. ;;.: PERMIT � � <br /> ;:�" <br /> � everett <br /> EMrprNn � <br />�", �;OF;.. . _ . . . . . <br /> , �e.�uerett � <br /> ;�BUILDINO DEPARTMENT TO BE COMPLETED IN INK— PLEASE PRINT <br /> 266�8B10 , <br /> ..,�nt.-.r., � <br /> IMILAODRE89 CITY � 21P PMONE � � <br /> i� r <br /> T MNIADORES4 GITY Z PMONE ! I <br /> ' ��Ty 21P PMONE 1 <br /> ARCMRECfORDE8IONEP MAILADDPE55 { <br /> .•� . GITY ZIF PNONE UCEN9E• ; <br /> .'OENEMLCONiRACTOR MI�RAD�PESS <br /> CMANICALCANTRAGTtlR <br /> ' AUIL�DUPE55 GITY 21P PHONE UGENSE• �. <br /> AMRADORESS G�TY 21P PXONE UCENSE• L <br /> PLUMMNOCANTPAGTOR � <br /> _ f <br /> k <br /> GlM!OF wORI( �p� ' <br /> -❑ N�r ❑ ADDITION ❑ ALTEMTION ❑ REPAIR ❑ �EMOLITION CofolCWOpgONOANDFHONENOSERT ❑ 101NORELOCAT10N <br /> NNIT IMP110VEMENT ON INTERION REMODEL ONLY <br /> ,.;.WNTqACTPPICEOFN'ORK <br /> �.W,p{�CII�OE MqPKANG BOUME FOOTMIE INVOWED <br /> � '`��D'� s a s / a�in1 <br /> ;�.,;�i�wEo� i�pNo IHEREBYCERTIFYTHATIHAVEREADANDEXAMINEDTHISAPPLICATIONAND <br /> �,��`,��I� , KNOWTHESAMETOBETRUEANDCORRECLALLPROVI910NSOFLAWSAND <br /> OPDINANCES GOVERNING THIS NPE OF WORK WILL BE COMPLETED WITM <br /> �y�:L[M�DElCRIPfKK1WYROPEpn'�6„ON'NBELOVIORATTAGNFOl1RCOREq yyME7HERSPECIFIEDHEREINORNOLTHEORANTINUOFAPEPMRDOE8N0T <br /> t,.;.; PRESUME TO OIVE AUTHORIN TO VIOLATE OR CANCEL THE PROVISION9 OF <br /> �„ �. �p�. oF ANYOTHERSTATEORIOCALLAWREOULATIN6CANSTRUCTIONORTHEPER <br /> FORMANCE OF CONSTRUCTION.THAT I AM AUTHOR2EU BY THE OWNER OF <br /> 7�y�d� i.i�'a.; THISPROPERTYTOPERFORMTHEWORKFORWHICHAPPLICATIONIBMADE <br /> ��y!9e'�'=" �� � AND I COMPLY WITH THE STATE CONTRACTOPS LAW iB.27�BCW AND � <br /> :., . 288.200 WAC <br /> �y':_,•:�,�'; &aN�TUREOFCONTR�CfOROR�UTNORILECAOENT D�IE <br /> y.;.a: <br /> � ' X � � Q �J���_ <br /> ;;';,y '�5 � a��� � <br /> ,- �K���ys APPLICAN S T BU51 E9SL NS�ANDBU91NE64X�� <br /> ' ,�''1�� !i f <br /> MECHANICAL <br /> .', '."rKUM�INO FE8 <br /> .;-i-"pp,� TYPE O�ROI7UIIE OR ITEM FEE NO. TYPE OF EOUIPMENT <br /> .e WA�q�������� A/C—NHNDLOUNITS—H.P. <br /> '�'��'��•� FORCEDAIRSYSTEMS—flLU. MEA <br /> � <br /> 'l�Y���r� �TMNB UN�THEATERS—&T.U. M <br /> .:, .'�;y'°" LAVATORY A8M BA91M <br /> CLOTHESOHYERS <br /> '�i',`.°"� � BMOM/ER <br /> ''��"^�' `� KITCfiENSINK6019P. VENTILATIONFAN <br /> RAN�EH000 <br /> -Q;. ., DIBHWA9HER WATERHEATER <br /> �, LAUNDRVTAAY yyppDSTOVE <br /> ::�.'"' . CIOTME9WA9HER <br /> METAL FIREPLACE 8 CHIMNEY <br /> >.t✓�:� URINAL <br /> � � DRINKINOFOUNTAIN FIPEPLACEINSERT <br /> '��'�`�' . FLOOR OMIN . HEAT PUMP <br /> � BACKFLOWPREVENTERS OASPIPINO <br /> � ROOFDMIN8—?��NLEADER9 EXHAUSTFAN <br /> � � � SINK�SERVICE—BAR�G) � <br /> � . <br /> � � SUBTOTAL S SUBTOTAL s <br /> � PERMIT S PERMIT S <br /> �• ,�• TOTAL FEE S TOTAL FEE s <br /> .: f�� n¢eirrho. <br /> %f.^w"LSEre�cK_ <br /> p�B��K BIPEBET&�GN RANCNECKNUMlf11 <br /> ''`.;^,h-. . , . . <br /> W�C�NTSITE FEES VALUATION FEE <br /> y�W[20NE LOTMFA p YES ❑NO <br /> "-"� BUILDING <br /> rypEOFCONBT. OCCUPMlCYU110lIP NO.OFOWELLINOUNITS <br /> �pyMe�FiACruu. � PLUMBIN6 <br /> ��-OREOFBLDa N0.0FSTOPIEB BSMT. OCGIO�U MECNANICAL <br /> OV <br /> ON <br /> HEIOMTLiMITATION OTHER <br /> FlflESPRINKLER9REWIRED O YES O NO STATE BUILDING SURCHARGE <br /> . STATE ENERGY SURCHARGE <br /> AVFLIGTIONACGBY PlAN9�PP0.BV PUBLIC�iWORKS <br /> TOTAL <br /> . �� <br /> ,R�;_:�,j�� •�t� <br /> - _"p' ' ✓d: ^:�� il�4 l:l'�h�..E''���`i•. <br />