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APPLIL�TION FOR CONSTRJCTIO�N <br /> PERMIT <br /> Ne Ever9roon �•w�rrtl <br /> CITY OF � <br /> everett <br /> BUILDING DEPARTMENT <br /> 25s�88t0 TO BE COMPLETED IN INK- PLEASE PRINT <br /> , — <br /> owH rnanaunn[ss cuv m• �»�orv=_ <br /> ����lz��-,����i�io ,�',��l.-/���^'- �l-�f'-�'�uc�[..9'��i� 3>� �r�� <br /> iENAN MAILApURES G.1V IIP PIIOqL <br /> ��Y <br /> •RCNREC CFOCSiGNER MFILAD�RCSS C�tt DP PNON[ <br /> ��1��6�=�1� %325 S..�2-±��lv�_�t_'f��,�,q, `�Y�„1�f/ �s�- ��c r <br /> �-]QH� G EN�I ONi.IALIOR bi4RPDORL55 Ulv IIP P�IONE LIC[NSE• <br /> ��i �c�/ /Y7 •'_�✓9r��a�B/��1E'1__I_3-7���'f-'o�</, '/��'_��l�u�lLC�/ ���.9/i//7l� 'b <br /> A�x MECII4HIULCOYLRACIOR M41L POORC55 �CGY LP PIICNC��1��' LIG[NSC e� <br /> C ~ -- - -- <br /> a y� MAIL�D�RE55 GIiY 21i' f'HONC Uf.[NSC• <br /> PLUMpING CONIR�CTOP <br /> � C1A55 FIYORN <br /> O .�.0 ��V ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEh10LIT10N ❑ WOODSTO/E/FRPLINSERT ❑ BUILDINGFELOCAiION <br /> �{I yH t[NqN11MPROV[MENiOAMI RIOPNEMOD[LONLY� �� CON1AC�i/P�gSONANDPHONEnNO �j� ) <br /> H „L,� coNtAnttcaiccorwoarc�� Z ��l�+u'�_ __"_���_ G / _-�Y�-�-� " �C -�-��C�•e� ��"„Q�� <br /> "r DESGRIBG\VORNANDSOUFRLfOOtAGE VOWE� <br /> i <br /> [] b �j��l�io+c - '3.2 c7 s. -- — <br /> � n �EousEo BunoiNc � IHER[OYCERTIFVTHATIHAVEREA�ANDE%AMINEDiMISAPPLICATIONAND <br /> p.� [x]g ���� KN01V'HESAMETOBETRUEAN�CORRECTALLPROVISIONSOFLAWSAND <br /> �� (C�'y' - ORDINnNCES GOV[RNING THIS n'PE OF WORK WILI BE COM7LETED WIiH <br /> xN,3 �eea�oescaivuor�orrOPERttISHJWNBELOWORATiAC��fOURCOPICS� yyHETHERSPECIFIEDMEREINORNOTTHEGRANTINGOFAPERMITDOE5N0T <br /> i S/�,�������// PRESUMETOGIVEAUiHORITVIOVIOLATEORCANCELTHEPROVISIONSOF <br /> � y�� l0T_/� B�OCK Of � Q "�- ANVOTHERSTATEORLOCALLAWREGULATINGCONSTRUCTIOROR7NEPER� <br /> '� FORM1IFNCE OF CONSTAUCTION.THAT I AM AUTHORiZED BV TME O\VNER OF <br /> �J� THIS PPOPEPTV TO P6�FORM THE WORK FOR WHIG i APPLICATION IS M11ADE <br /> g ��„� �(�j/��.u-�'D�O,�3a�_�a_/J��� AND 1 COMPLV WIiH iHE STATE CONTPACTORS LFW 1827 RCW AND <br /> n d y . I 29s200 WAC. <br /> � �� �� D� //�j� /// /�,� l — SIGNAiUIi[OfLO4ifi.'.G��f�.-�I:nUll.(:�i',IC�AGENi 04i[ <br /> (� z v �ct.tL f <br /> H O Vi � � ' �Iq�WOOd ����(����t X - /�,h�---�/-^yd� <br /> vao�cc*aooeess �y/`�� �j� �/� � � AG � I �SiN[c<l�Qf!ISENO����U�� ESSNFRIE <br /> � -'� ) \��\.�V <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FII(TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATERCLOSETQOILEn _ A/C-A/NNDLGJNITS-HP. <br /> BATHTUB FORCEDAIRSYSTEMS-HTU. MEA _____ <br /> '� � _ UIJITHEATERS-BTU. M <br /> ' LAVATORVIWASH BASIN) <br /> �� SHOWER _ CLOTHESDRYERS _ , <br /> KITCHEN SINKB DISP. VENTILATION FAN _ i <br /> '�. .�� DISNWASHER __ �7ANGE MOOD = � <br /> � � LAUNDRVTRAY _ _ H'ATER HEATER <br /> CLOTHES WASIiER WOOD SiOVE _ _ <br /> UflINAL METAL FIREPLACE R CHIMNEY <br /> �� � __ FIFEFLACEINSERI' <br /> ' DRINKING FOUNTAIN — I <br /> �� FLOOR DRAIN HEAT PUMP _ <br /> BACKFLOW PREVENTERS GAS PIPING I <br /> � ROOF DRAINS-F7AINLEADERS E%HAUST FAN <br /> !I I SINK�SERVICE-BAR,ETCJ — — I <br /> � <br /> — I <br /> `�I � I <br /> l <br /> SUBTOTAL 5 SUBTOTAL S _ , <br /> � I PERMIT S_ _ __ _ PERMIT _ 5 _ I <br /> — TOTALFEE b � <br /> TOTALfEE 5 <br /> . .' �PONiSEi6AQLn' REPq5Li6�CN/ SIOES[iBP;N �NCIIpCNNIIM�H ,� FEE PECEIViHO. �, <br /> 2 � �l /��CCJS � �.�� '����� I <br /> usezor�e - �orn�+e� v�eeHtsnF FEES VALUATION FEE i <br /> � ❑YES ':NO y l <br /> /`� BUILDING ���� �JL�l 1��+�C`_ _ rI�_�-�1 I, <br /> ttl'EOi�. � OGGUV�Y�P � NOO�WELL�NGUNItS I <br /> nuowea�ueCtu�N rJ' I PLUMBING _______ _ — I <br /> r� <br /> s.i:oro�oa HOOFSiORIES 85Mr. occ�ano MECHANICAL <br /> F Z "Y � __ —. <br /> N <br /> 3zo �E,�„<<�M�,.�� OTMER — i <br /> �inCSPRINrcLEP5AE0UIqE0 ❑YES HO � _ _ ________1� r , <br /> - SiATc BUILDING Sl1RCHARGE <br /> STAT[ENERGY SURCHAFGE <br /> u�{'VUitONACC NY �UNSAf'PN pY p�BLIC WORKS <br /> L/� /� TOTAL `�- ���/ y <br /> � �1�'f'���-�: '`;. � " � �� il .� '�� � �� ����� 1.�� �C � �� ���� L��� ��. � ����� F., �l,� � <br /> �_ <br /> (' F l" 1(z � i i �l �' c' - <br />