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Ir <br /> � APPL�C�r�ION FOR CONSTRI�TION <br /> ' PERMIT <br /> � N�Enryreen <br /> everetl <br /> CIN OF � <br /> everett <br /> BUILDING DEPARTMENT <br /> 259•68�0 TO BE COMPLETED IN INK— PLEASE PRINT <br /> owHen M�n�onncss / cnr rm vnone �O 7, <br /> (�EoR9C ��RJa// 8oa��9pf,eR� E�d. EvE� 98ao3 3s�� <br /> hq/�ry{ M�ILADUPk55 CIIV ZIP PIIONE <br /> S�q�v'E — - --- — <br /> ♦R�NrtECtOROE5IGNER MM��DD1t[55 CIIY t�P P110NE <br /> /U ON� <br /> OENEN�LCAN1PeClOR MML�ODRE59 C�IY . ZIP PNONE UCENSE• <br /> ' OwNE� <br /> � MECN�NIC�LGONTR�CI 11 MAILADD�ESS CIIY IIP PIIOHE UGENSE� <br /> VLUMB�NOCONiR1Gt011 M�II�DOR[49 CiIY 2�� 1'110NE 4CENSE• <br /> � <br /> QI34Of NORK <br /> ❑ NEW ❑ �DDITIUN � RITEPATION ❑ R�Pp�R ❑ OEMOUTION ❑ WOODSiOVE/FRPLINSEqT ❑ BWLOINGFELOCATION <br /> 1EryIJIT IMPROVEM.ENL OR INiENIOR REMOO[L ONIY CO�:tA�l PEP90N�NO��IONE NO <br /> I ,�,r�r p0 /� I / <br /> COMTF4GT Fn�GE Oi VNRK ` �� • �. V t�TJyL— ��E./` 3 SJ •3 0 7 S <br /> p[�RISEWJRIt�NO50U�AE�00i10EINWLVED y�'C( f /N� rS i <br /> R��s� 1?oei ovs� 33G, sa.Ft. ARtA � _ <br /> rOSEousEore noiya IHEREBVCERTIFVTHA7INAVEREAOANOE%AMINEOTMISAPPLICATIONAND <br /> HNOW THE SAME TO BE TRUE AND GOFRECT.ALL PROVISIONS OF LAWS AND <br /> W E �~ OROINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLETED WITH <br /> LE6KO�EBQCRIPTIONOfPROPEHTY1S110WHBELOWOP�iTACN(OMCO�IESI WHEIHERSPECIPIEDHEREINORNOT.iHEGRANTINGUFAPERMITDOE9NOT <br /> lot_J__L_ BtocK000 oF ��jrv[RI,�I�d L S� Ls P�ESUMEIOGIVEAUT110�ITYTOVIOI�TEORCANGELTHEPRONSIONSOF <br /> Ary V OTMEH STAT F OR IOCAI LAW REGUT ATINO CONSTRUCTION OA THE PER• <br /> FORMANCE OP CONSTRUCTION THAT I AM 4UTHOPIZEO BV THE OWNER OF <br /> TIIIS PROPFf71V TO PRR(ORM THE WORH FOR WHICH APPUCATION IS MADE <br /> AND 1 COMPIV Wlill 1NE STATE "ONTRACTORS LAW 1927 RCW AND <br /> 296200 WAC. <br /> siaHuuneorcorvrnnurn�v�wu�on�zco . osie <br /> X <br /> PNOJEGTSDOBE55 � �IG�NIS PUSMLSI¢lNSFNO�NOtlUSiN[SSNnME <br /> SAM[ AS •✓s <br /> �LtIM�INQ MECf1ANICAI <br /> NO. TYPE OF FIXTURE OP ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATERGLOSETITUILEn NC -A/NNDLGUNITS—H.P. <br /> BATHTU6 FORCE�Alli SYS7EMS—B.T.U. M EA _ _ <br /> LAWTORY�:.dSH BASIN) UNIT HEAT[RS—B.i.U. M <br /> SNOWER CLOTuES D�iVEiRS _ <br /> KITCHEN SINK 6 OISP. VEN 11LATION FAN_ <br /> Di3HWASHER tiANGEH000 _ <br /> LAUNDRV 7RAV W�TEP HEATER_ <br /> CLOTHES WASHER WOOD STGVE _ <br /> ��R�NA� METAL FlREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN FIREPIACE INSI:RT <br /> FLOOR DRAIN HEAT PUA4P _ <br /> BAC,KFLOW PREVENTERS GAS!`IPING <br /> fipOF ORAIt15—RAINLEADERS E%NAUST FAN <br /> SINK ISERVICE—BAR ETC.) <br /> SUBTOTAL S SUBTOTAL S <br /> PERMIT S /�i- P[RMIi S <br /> TOTA�FEE E � /(Y� +TOIAL Fcr. y <br /> iPONl6ETB/�LN �GRSEIO�LN Slp[5[IB�GY, VIAHGHEI'M UMOE11 F[E NECE!PTNO. <br /> � � �_ � .-1��'fT�a=' I3a3 <br /> u9Ezor+ �orenee wcr.n�si[ FEES VALUATION FEE <br /> �_ � ��E9 �o as � <br /> BUILDING �C�� <br /> TYPEOFCONSt. OLGUP�HGYGaOUP NOOFOWEl1.INpUNl19 -- <br /> u�ow�e��i�ctuw��� f�,,,7 � PLUMBING <br /> �1 .7 <br /> 6ZEOFBLDO NOOFSiORIE9 as!n*. occ�oA/� MECHANICAL <br /> N� N� �cN ,. — <br /> NEIG111LIMIl�tl(1N OTHEfi r <br /> RRESPPINNlERSREOVIR[0 UYCS � NO ✓�I STATEBUILDINGSURCHARGE � ✓U <br /> STATEENERGVSURCHARGE <br /> �ppu enoN�cC ev �LANS�PPR DY PUBLIC WORKS <br /> � W , /�.�- `_ <br /> TOTAL � � <br /> -��.; ' _ _ . . . . .. , <br />