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APPLICfaT10N Ft�R CON:�TRuCT10N <br /> PERMIT <br /> fne F�erprean rw�u•II <br /> CITY OF <br /> everett e <br /> Bl11lDING DEPARTMENI <br /> 259-8810 TO BE COMPLETED IN INF�— PLEASE PRINT <br /> lT\'Nln M11�11 PI�I�I11.::: 1.111' lll` 1'11(1�11 <br /> �NP__C-R�— J�I�d �� 4 ( � ,� j�Q. E3�Grt.=T�' �1�31a�s Z s?-C��i3 <br /> ' 7`��_' r.inii�m�. � �_ f/ _ �m� ni� vimpC- _' ___ __ -- <br /> .._ _ . . .__ _- _. ___'_ <br /> �qC�UlEC10RDLSIGNER A411 �P011155 GIY tIP CIIDN[ <br /> .. . _. . . _ ____ . . - _ . . ._ _ _'___.' ." _—_.__. _—_ <br /> GCNEA4CON1RAClOR �lep��lll)N155 CIIY � IIP M�ONE IIGF.NSC• <br /> MECN�NILAI CONTR�GIOR M�IL�OORESS ..--- CIIY 21P PIION[ LIC[NSE• <br /> RUMBINOCONiP�G10R MAII�011R[SS CIfY 71� P�ION[ UC[IIS[• <br /> C1A550{MORN ---__—___.__-_.—_ ____--_ . -__-__ __ <br /> � �EW ❑ AODITION ❑ ALTERATION ❑ REPAIR ❑ OEMOIITION ❑ WOODSTOVE/FRPL INSERT ❑ UUIL�ING RELOCATION <br /> IEH�NTIRIPPOVEMENfON1�dER10RBEMO�CIONIY ,�eP� �e��� romrcr"vcnso�eNnvr�or+�r�o <br /> oo��n�crvaiceorxenK ------C✓� s.37�1 _ __ l.�_��ek �--33�"_55_d0 (h a/7 <br /> OESLRIB[�VORN�NO SOUAqE fOOUG[INVOIV[� <br /> `JT 7�.k FC.tM E ZZ.� �.__ — -- --------- <br /> rnOrosEo USE of Huilni�+c I H6N&�Y CEPI IPV TIIAT I NAVE HEnD ANO EAAMINEO THIS FPPLICATION AND <br /> S.N�C,_ « �� _(„� ���� �.�Ie� NNOWTIIESAMLTOdETHUEANDCORRECT.ALLPROVISION50FLAWSAND <br /> Sr��^f..._ �" ORD�NANCES GOVEf7NING TIIIS NP[OF WORK WILL BE COMPLETED WITH <br /> LEGALOESCRIP➢ONOIPROPFfliY1511(TyNU[IONORAiI�CNf011 r,omt5i yy���T��[RSPECIFlEDREfiEINORNOT.7HEGRANtINGOFAPERMITDOESNOT <br /> A�� � PR[SU�1@iOGIVEAUT110FITVTOVIOLATEORCANCELTHEPROV1510NSOF <br /> IOT��__ BIOLrc Of .U_�5..'�`'�-" '� -� --� - ANYO711GRS1A1[ONIOCALLAWRGGUTATIN(iCONSTRUCTIONORTHEPEfl� <br /> PO(iMANCE Of CONSINUCTION.iHAT I Ald AUTHORIZEO(3V THE OWNER OF <br /> 71115 PROPERTY TO PERFOf;M iNE WORK FOR WNICH APPLICATION IS MADE <br /> __- -------- AND I COtdPLY W17M THE STATE CONTRAGTORS LAW 1027 RCW AND <br /> 29fi200 W4C <br /> siurunmioi corvuuctanni�Auuwmzenne[rvi ouE ',��D� '� y <br /> PROJECT�D'�AE55 ' Af`PIICnNI. ItY0U5M[SSIi (NSLNOANfI' D�SN�ME <br /> � <br /> IS �e� � • <br /> PLUMBIN6 MECMANICAL <br /> NO. TYPE OF FIXTUPE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATERCLOSET(TOILE� _ A/C-A/NNDLGUNITS-H.P. <br /> BATHTUB FORCED AIF7 SYSTEMS-B.T.U. M EA _ _ <br /> LAVATORY(WASMBASIN) _UNITN[ATERS-BT.U. M _ <br /> SHOWER CLOTHES URYERS_ <br /> KITCHEN S�NK 8 D�SP. _ VENTILF110N FAN _ __ _ <br /> DISHWASHER — �-__ RANGE HOOD __.'___._'._ — <br /> LAUNDRY TRAV WAT[R I IEAI ER <br /> -__ __ _"__ - -__ — <br /> _- '_'_ _'_ .._ . . __.. <br /> CLOTHESWNSHER ________ ___ . WOOOSiOVE _. __'__. __.__ _ <br /> _____ ._" __ ' . _ _ _ - <br /> _ .. <br /> URINAL . ._ ML1AL FIHH'LACE R CI IIh7NEV _ <br /> __ .____._ _ _ _ _. _ . . _ _ _- <br /> _-_- _ _ <br /> DRINKINGFOUNTAIN _ __ _ _ FIRBPLAC[INSERT _. __ __ __ <br /> FLOORDRAW - '- _ ' H[ATPUMP _____ ' — <br /> BACKfLOW PREVENTERS __ GAS PIPING _ __ _ — <br /> ROOP DPAINS-RAINLEADERS _ F%I IAUST FAN __ __ — <br /> SINK�SERVICE-BAR,ETC) _ _ _ . __ -----�- �- - — <br /> __ _ _._- ___. <br /> -.____.__._-___. ___—_ - — <br /> SUB 70TAL 5 _ ______.._._.__ . SUB TOTaI S _ <br /> - - PERMIT E -- -- .___ . .PERMIT_--��----5 _ ___ <br /> TOTAL FEE S TOTAL FEE $ <br /> fPONi5E18ACN RURS[iq�CN SIOESEiP�Ch PL�NCIIECRNUMNER FE[ PECEIP�NO � <br /> �,� --�'--- �I� ---- - �' aa.sE a �0 �5 a3 <br /> usczorte 1 iotnnen �'"�^"is�� FEES VALUATION FEE <br /> � � \ ����� �i r[5 1L1�o -. <br /> � eui�oir:� 377 j ____ (-� ; Ci<"l <br /> — ---- —-------- — <br /> TYPEOfLONST OGGUPAqLYG UP NOOGOWEI.IINGUN115 '-�- -. .-- --- ...-'--'------- --- <br /> _-_ <br /> ALLOw�BIE/�STLLL � PLUMDING <br /> � � ' ' --__ � ____-___.- -"__ _ "__- _-- _ -_ <br /> SrzEOFB�Da r+ooFsio iEs BSmr Occ�ono �,�ECHANICAL <br /> ❑Y - -- <br /> 2 2� / '"_ — —----- — — <br /> �� H[�GII1lIlAITAIION' OTIIEH <br /> IIRESPRINILLERSPEOl11RE� uvES T}rvo _ __ _� _�S_ __,_ �yTpTEdUILDiNGSURCHARGE _ _ <br /> S1ATC-ENENGV SURCHARGE _ _ ___ <br /> PM'llf,�iIONACL BY Pl�NSApPR�'! --_- - (�U�LIC W�f�K$ --- —�-� - � � <br /> /� I� -�Q�-J TOTAL <br /> t <br />