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A <br /> PPLIC�.f10N FOR CON•5TR1.�:TION ��<<,� <br /> PERMIT <br /> I�e Evnrqreen ��°�«�� <br /> ��T�oF e <br /> everett <br /> BUILDING DEPARTMENT ' <br /> 259�8870 TO BE COMPLETED IN INK— PLEASE PRINT <br /> M'NCA !��•L�JDRE55 Ulv ZiP PMONC <br /> LGr� Srn �� �11f3 ,e. � ��c D_ r �e��# �'2D3 L 59�I(n2� <br /> 1EM�Nf <br /> IAMI�ODPE55 C�tY 21P PNONE <br /> ��nCMRECTOADESK+NER MAIL�DDAE55 C�TY 210 PNONE <br /> �GENEA�LCOHTA�CIOA MML�DOFE55 G�iv IiP VNONE UCENSE• <br /> ELN�N�CALCONfR1�GfOR /� M�UL��L�RE55 n f� �G��t�Y� v�ZIP �NO,N✓�E �j UCENSE• <br /> ,� I� I,��t.�-� (--}��'LS.E � I,GW a� �v..�'P-�,'� IG:7Jr ���%17 CC� �d�C7�s�_ <br /> G��v 2iP PnOME IiCE E• <br /> U�BiNG N���CTOP� MAII�OOAE55 . <br /> Cl/55 Of NOFK � <br /> ❑ NEW ❑ AODITION ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ �'DODSTOYUFRPL INSERT ❑ BUIIDING R=LOCAT�ON } <br /> TEry�NLIMPPOVEMENTDRINiE/HiO �f1O�[IONLV <br /> CONi�Ci PEPFON�M�PNONF NO. � <br /> CANLR�CTPRiCEOfN'ORK r �'.Cl __ <br /> OESCNiPEWONR�NO50WRClpO1�GEIN�OLVED � / <br /> �TI7 S"{c�.�- l�d(. C� f o1�t — � <br /> bl�oo05eouseoveui�owe � ) ' INEREBYCERTIFYTHATIHAVEREADANDE%AMWEDTNISAPPUCATIONAND <br /> KNO W 711E SAME TO�E TRUE AND CORPECT.ALL PROVISIONS OF�AWS AND <br /> O�DINANCES GOVERNING THIS TYPE OF WORK WILL OE COMPLETED WITH ,� <br /> l[WLOESCHIPTIONOFiROPERiY15NOWNEClO�'�OAATUGNfOURCORE51 WHETMERSPEC�FIE�HEREINORNOT.THEGFANTINGOFAPERMITDOESNOT � <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO�K�UNS OF <br /> �oi BiaK pp ANYOTHERSTATEORLOCALLAWREGULATINGCONSTRUCTIONORTHEPEF� : <br /> FORMANCE OF CONSTRUCTION.THAT�AM AUTHOR12ED BV TME O�NNER OF '�� <br /> qrylp PpCOpMP VTW THRTHE STATE CONTRACTORSHLAW`�B27ORCWMAND ! <br /> 29fi,200 WAC. . <br /> GIGN�iURCOFCONiRnG�OAOpi�U1NORl$ED iNT �ATG y <br /> // / Y <br /> X �t. /l � <br /> pR0.1Ki�ODRE55 �PFII HiSCItYBI15ME55UCEN5ENOANOBU5iNE9�N�ME � <br /> 1�1.1� � G2- (I �L�U <br /> MECHANIGAL <br /> PIUMBING <br /> FEE NO. NPE OF EOUIPMENT FEE � <br /> NO. T'PE OF FI%TURE ON ITEM a�_q�HNDLG UNITS—H.P. <br /> WATER LLOSET(TOILE7) � <br /> FOAGED AIF SVSTEMS—B.T.U. M EA <br /> BATHTUB <br /> LAVATOAV�WASHBASIN) UNITHLATEAS—BT.U. M <br /> CLOTHES DR�EFS <br /> SNOWEP — <br /> KITCHEN SINN 8 DISP. VEN7ILATION FAN � <br /> UISMWASHER RANGE HO00 � <br /> LtiUNDF7V TRAV N'ATER HEATEP � <br /> �LOTHES WASHEfi _ WOOD STOVE — — <br /> — METAL FIREPLACE 8 CHIMNEY <br /> UR�NAL <br /> FIREPLACEINSERT <br /> DRINKING FOUNTAIN HEAT PUMP — <br /> FLOOR DRAIN __ <br /> B4CKFL0H'PREVENTEPS � GAS PIPING <br /> ROOF ORAINS—RAINLEAUERS E%HAUST FAN <br /> SINK(SERVICE—BAR,E7C.) <br /> SUBTOTAL a �.3-J <br /> ` SUBTOTAI S PERMIT S <br /> ��n'.:'.: S TOTAL FEE 5 ' <br /> TOTALFEE S FEE NECEIPTNO. <br /> iPONTEETB�CN REARSEI9AGM1 SOESELBACI( PUHLMECRNUM9ER <br /> VACAHTSITE FEES VALUnTION FEE <br /> USEZONE ��T�AE� G YES ❑NO <br /> BUILDING — <br /> iVPEOFCqNST. CCNPANGYGROUP NO.OFOWELLINpUN115 <br /> �upw•ei�•cTu.� PLUMBING <br /> _— �izSeOro�W HOAFSTOHIES &5mt. oC[.w�o MECHANICAL <br /> ❑Y <br /> ❑ N <br /> H[icnruMir>rion OTHER — <br /> fIPE SVRINKLERSREOUIRED ❑rE9 a NO STATE BUILDINCa SURCHARGE <br /> STATE ENERGY SUACHaqGE <br /> ppp�ICATION0.GG BY FLRNSRPFN BV PU�iIC W��KS <br /> TOTAL � '� <br />