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. � 1 <br /> APPLIC:�►TION FOR CONSTR�::CTION C <br /> :, PERMIT <br /> me everomnn evcrcu ' <br /> CITY OF � <br /> everett e <br /> BUILDING DEPARTMENT <br /> 259-�810 TO BE COMPLETED IN INK— PLEASE PRINT <br /> OWNER� 7 / MAIL,A�D/�Rl55 GIIT / IIP PHDH[ / <br /> /7L/itl<I �Y/L'dt/ I?�l� ��Li- 1 �' �%['t.ri�f`/:{���).j c.�r`J�' ��L— <br /> IEN�Ni � MRIL�OUPE55 LIIY ZIP P110NE <br /> �PCIIRECTOFOESIGNEtl MAIL�ODFE55 Ci1Y ZiP O PoMO�NE <br /> i� � /i j:l�: ,(,�7 .7ft.lK/I.J pJ fr7lJ W� �u�`O"� <br /> �/. i�'/ �) l -:�- / O� � <br /> GENER�LCONiPACTOR MAIL�DDR[55 G1Y 21P PIONE IILENSE• <br /> �! � �6 ,(/arfl ° /t1a,�r/S ��s'� <br /> UoM�f l��C c �e. �«��f- (fl i N•7G 5 <br /> MECNANILALCON7RACTOfl M�ILAD�RE55 GITY .IP PIIOHE LICENSE <br /> PLIIM&NUCONiN�CTOR M��L�O�P[55 CITY ZIP PIIONE LICENSE� <br /> C�U,{SSOF WOHN <br /> 161 NEW ❑ ADUITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/�RPL INSERT ❑ BUILDING RELOCATION <br /> IENANT IMPROVEM[NT OR INLERIOfl REMODEL ONLY CONiAGT PEli50N AND PIIONE NO _+�/ <br /> CONTP�GTPIiICEOF WORK��"' r••/ F�G���� �IIIJI�/I (�O�C' �-y ��� �liT�+G� <br /> �ESCRIBEWONNANDSOWN[F TAGEINVOIVED <br /> ��y �R/"A�G .��I��, :,t {_!' _ — <br /> PROPOSED USE OF DURO W G Q I HERE6Y CERTIFY THAT I NAVE READ AND E%AMIN ED THIS APPLICATION AND <br /> V/� KNOW!HE SFME TO BE TRUE AND CORRECT.ALl PROVISIONS OF LAW S AND <br /> �ear��oescnivrlOno P E��SHOWNO[LOWORRRACNfOURGOIMES} ORDINANCESGOVERNINGTHISTYPEOFWORKWILLBECO�IPLETEDWITH <br /> WHETHERSPECIFIEDHEREINOR NOT.THEGRANTING OFAPERMITOOES NOT <br /> � o�ocn or �JI<<I l�/r {L��� PRESUMETOGIVEAUTHORITYTOVIOLATEORCANCELTHEPROVISIONSOF <br /> iaT ANY�1THER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PER� <br /> FORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORIZED BY THE OWNER OF <br /> (,(�/ /� fI� � � THISPf70PERTYTOPERFORMTHEWORKFORWMICHAPPLICATIONISMADE <br /> — AND I COMPLY WITH THE SfATE CONTFACTORS LAW 1827 RCW AND <br /> 29G200 WAC <br /> SIGN�IUREOF`�ffUGiOROHAUi110R1 [D�GENL Dni[ <br /> . x%��:� �J/���� �-�.-�ro <br /> � <br /> PPOJECT AOOPE55 �PPLICAHIS CITY DUSME55 LILENSE ND AND BUSMF55 NAME <br /> �d�/ U,C-� D� <br /> PLUMBINa MECNANICAL <br /> NO. TYPE OF FI%TUHE OR ITEM FEE NO TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) WC—A/HNDLG UNITS—H.P. _ <br /> BATHTUB FORCED AIR SVSTEMS—B.LU. M EA ___ <br /> LAVATONY�WFSHBASINI UNITHEATERS—B.T.U. M _ __ <br /> SHOWER CLOTHESDRYERS __ <br /> KITCHEN SINKB DISP. VENTILAiION FAN _ <br /> OISHWASHER RANGE I�IOOD _ <br /> LAl1NDRYTRAY WATER HEATER <br /> CLOTHES WASHER __ H'OOD STOVE _ <br /> URINAL METAL FIREPLACE 8 CHIMNEY _ <br /> ORINKING POUNTAIN __FIREPLACE INSERT ' <br /> — I <br /> fLOOR ORAIN h1EAT PUMP ' <br /> BACKFLOW PREVENTERS GAS PIPING _ <br /> ROOF DRAINS—fiAl NLEAOERS EXHpUST FAN — <br /> SINK(SERVICE—BAR ETC� _ — <br /> SUATOTAL $ SUBTOTAL S <br /> PERMIT S PERMIT E <br /> TOTAL FEE S TOTAL FEE 5 <br /> FRONTSEIBALN R[�RS`iDN SIOES[TB� PUNCNECKNUMBEN FEE NECEIPTNO. <br /> � L yo a�r��' 70. �..� :33oi <br /> uSEZOH � IOi�PEA vnCurtSrt[ FEES VAWATION FEE <br /> n v�s i i no <br /> BUILDING f' c G � 0 00 <br /> 1YPEOFCANSi. OCGUPANCYGROUP NOOFOWEIyINC '11i5 --/- <br /> ALLOWABIE/ACTU� �n y l PLUMDING _ <br /> N/ <br /> siteore�oa. No.oFsroaies osrar. occioeo MECHANICAL <br /> �T�c� �l ;� �,l A- . — <br /> M[IGIITLIMIGiION OTHER <br /> S� <br /> FIRESPRINKlEB5RE0UIPED ❑YES,�rvo STATE BUILDING SURCHARGE _ _� SZ <br /> STATEENENGVSURCHARGE �, <br /> APPLILAIION�CC DY PL�NS�PPR OY � <br /> /� PUBUC WORKS — C� <br /> TOTAL �j,� S� <br />