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4 �-�., <br />APPLIC�ION FOR CONSTRIi` ��TION <br />. PERMIT <br />;%� N� Ewrpresn <br />GTY OF <br />` everett <br />BUILDING DEPARTMENT <br />259•8810 <br />TO BE COMPLETED IN INK— PLEASE PRINT <br />21l�„ <br />everett <br />e <br />, ....,.._ ` <br />iiln 3 3,i 3-� 7�/7e <br />ARCHITECTORDESIpNEP , M�IL�DDHE55 CI:Y 21P PNONE <br />��R'THwfc/t� 1'T�+�wIE �1'z�5/G N I d�Jol f32nx�fw�a�r fVMf-- ! T�yCc.�N WIL � S`S'i -63�9 _ <br />OENEMLLONTi1ACTOR MAILAOORESS CITY 21P iHONE LICENSE• <br />^J � C,�,�R,e,n, �„�µ„�.�„ys ;L.S't � 1�*'Y u2 n!1 F v W-r y � Lu'• 35' "S'7 V� 2 uk �- 13! •[ <br />MEC4�NIC�LGONTMCTOP M�IL�D�RE55 GITY ZIP PHGNE LIGENSE• <br />PLUM&NOCANTP�CTOR �ILAO�RESS pTY 21P PHONE UGENSE• <br />S pF NOqF <br />IEW ❑ ADDITION ❑ ALTEFATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVFlFRPL INSERT ❑ BUILOING RELOCATION <br />�p7J.3�� BLOGNLL_ OF <br />�c . a Zo� <br />1 H� y, Mc IJc:�uaLc� <br />PLUMBINO <br />NO. T'PE OF FIKTURE OH ITEM FEE <br />WATER CLOSETITOILEn <br />BATMTUB <br />LAVATOriY (WASH BASIN) ' <br />SHOWE9 � <br />� KITCHEII SINKd DISP. <br />� DISHWA3HER - <br />� -� LAUNDHYTRAY <br />I CLOTHFS WASHER ' <br />URtNAL <br />. DRINKIN(i FOUNTAIN <br />FLOOR OPAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS- RAINLEADERS <br />SINK�3ERVICE- BAR, ETG) <br />SUBTOTAL E �' <br />PERMIT 5 - <br />TOTAL FEE S � <br />` �� sZ' ?� <br />iF. LOTAPEA <br />2- z_ ssx�z� <br />CON9T. OCCUPANCYUROl1P <br />BLFJACT� <br />v_�J L�-3 <br />I� � <br />I HEREBY CERTIFV THAT I HAVE PEAD AND E%AMINED THIS APPLICATION AND <br />KNOW THE SAME TO BE TRUE AND COFRECT. ALL PROVISIONS OF LAWS AND <br />ORDINANCES QOVERNING THIS NPE OF WORK WILL BE COMPLETED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE ORANTINO OFA PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORIN TO VIOLATE OR CANCEL TIiE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW REOUTATING CONSTRUCTION OR THE PEFA <br />FORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORRED BYTHE OWNER OF <br />TH�S PROPERTY TO PERFO�M THE WORK FOR WHICH APPLICATION IS MADE <br />AND 1 COMPLY WITH THE STATE CONTRACTORS LAW 1827 RCW AND <br />286200 WAC <br />SIONITVPEOFCONiR�C10RORnU7NORREDAOENT DATE L�— Z(� �}i9 <br />X "?�►�„� _ � _ � _ <br />�PPIIC�NTS GItY BUSINE59 LIGENSE N0. �ND BUSINESS N� <br />MECHANICAL <br />NO. <br />AIC - AIHNDLG UNITS - H.F <br />FORCED AIR SYSTEMS- fiT <br />UNIT HEATERS- &T.U. M <br />CLOTHESDRYERS <br />VENTILATION FAN <br />' FEES <br />6UILDING ��,yxKIY <br />PLUMBING _ <br />MECHANICAL <br />STATE BbILDING SURCHARGE <br />STATE ENERGY SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />u <br />SUBTOTAL S <br />PERMIT S <br />TOTAL FEF E <br />FEE 11ECEIPTNO. <br />a56 � aaP3 <br />VALUATION FEE <br />So4.e � <br />� <br />� <br />� �'• � <br />. . �.... '� J ' 7 : � .t..1t11'r::�} 1� y -i`f:�� � . , . .. .. � .r �. �. ;..;�NiLTii ��.14�. <br />