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Q'1: .:..:tii� <br /> APPLICI�►'�ION FOR CONSTRI:�:T10N <br /> PERMIT <br /> m�E�a�pme� evcre�t <br /> ,;ITY Or <br /> everett <br /> BUILDING DEPAR7MENT TO BE COMPLETED IN INK— PLEASE PRINT <br /> 259��810 <br /> — M�IL�DUitL55 GI 211• PIION[ <br /> � ,���i);�1F����1. �_t������ - �.�'��_:�U���< <� C'i�C�_�'��� 1` �X� d� — 1a�-7� <br /> ILN�NI <br /> uui�nnn[4a —� c��r nr �NONE � <br /> •RC�UI[GtOR005�6NC11 AI�IL�DUi1E5S CIfY ZIP %IONE <br /> ,�arunnirnsr�U1�•�4t+�_py,r�(�� GiY ZIp 1'110NE UGENSE• <br /> nf�rtn.icon�a�cion iG?_���°1���iii1C VIG',V Uf. <br /> Everett,.yVashington 9ii201 If <br /> M[LNWIG�LCONIRACIOR M�R !^S GIIY ZIP FIIOHE U M E• <br /> 2`?4�.�nnt /v�iC� '�� <br /> 1`IUMN��OWH1R�Cl0� MAlLMD11l59 GlY IIP PIIOVE LICEH9E� /�.>�� <br /> )i IL�( t 1 �l��� L���t'�i(' � Ilc ��,'���.Y l,illp �,51.L�Cc� �1�,��f ����d����j � <br /> �1—�— — <br /> cussorwone � � �, <br /> ❑ NCW ❑ ADDITION �ALTERATION ❑ REPAIR ❑ OEMOI.�T�ON ❑ VdOODSTOVFJFRPLINSERT ❑ �UILOINORELOCAt�ON <br /> 1CN4N�IMPR WCM[Nt OR�NilNOP RCMOU[l ONLY <br /> �o�r.���.�o�,�;�ii.i�c x� �58 —a�y/ <br /> CONiP�Gi 1'RiCk Oi NJRI — <br /> Of°C��OEN'OR%�Np50UM[f00�AOEINVDLVEO � <br /> � l� �z.f Y_1.0 e C I�c� >��tU '-.�(�-_ <br /> vnorosFouscoFom�oiNo_� --�— —� IHERL7VCEN1IFVTHAiIHPVEREADANDEXAMINEDiHISAPPUCATIONAND <br /> `,11.C�/ n — N,.1.-, — KNOWTHESAME108[7RUEANDCOFRECT.RLIPROVISION90FLAW9AND <br /> L f OfiDINANCES GOVERNING TNIS 7VPE OF WORK WILL BE COMPLETeD WITH <br /> iec.io[seAm� Nurrnor[mr15��oxr�oc�owon�n¢Nwuncorics y�HETNERSPECIFlEDMEREINORNOT.THEGRANTiN60FAPEFlMITDOESNOT <br /> PRESUME TO GIVE AU1HO��n'TO VIOLATE CR CANCEI THE PROVBIONS OF <br /> ip� gipcn_ or ANYOTH[fiSTA1LOi7LOCALlAWf7EGULATINGCONSTRUCTIONORiHEPER� <br /> FORMANCE OP CONSI RUCTION.THAT I AM AUTHORIZED BY THE OWNER OF <br /> A'ND�I�CO 1P YTW 1LI�7OE STA EWCONTR C OHSHLAW`1B2T7ORCW AND <br /> 296200 WAC. <br /> S�GIUIU�C Of CO!1Il1AC�Oli OR AU1110�2[0��ENT D�iE <br /> X �� tia_�� �J—�7—Rcl <br /> Pf1pJELl�DORE55 APR1G� SCIIYAUSiN[SSIILEN5EN0.11N09114�NE55N�ME <br /> ` )/;�1'7L(� <br /> MECHANICFL <br /> PLUMBING <br /> NO. TVPEOFFI%TUREORITEM <br /> FEE NO. TYPE OF EOUIPMENT FEE <br /> N'ATERCLOSE7�TOILEn _ WC—NNNDLGUNIIS—H.P. <br /> BATHTUB __ � FORCEDAIRSYSTEidS—B.TU. ' � <br /> LAVATORY(VJASHBASIN) _ UNITNEFTEl75—BT.U. M <br /> CLOTHES ORYERS � <br /> SHOWER — <br /> KITCHEN�INK8171SP. VENTILA710N FAN <br /> RANGEfi00D <br /> DISI/WASMER - ydqTERHEAiER <br /> lAl1NDRVTRAV <br /> CLOTHESWASHER __ WOODSTOVE <br /> MET�L FlR[PLAGE 8 CHIAINEV <br /> UPINAL — -- — -- —"-' <br /> — FIREPL�CE MSERT <br /> OFi�NKING FOUNTAIN — HEAT PUMP <br /> Fl OOR DRA�N � � _ <br /> BACKF�OW PREVENTERS __ QAS PIPING <br /> ROOf DRAINS—AAINLEADERS _ _ E%HAUST FAN <br /> SINK(SERVICE—BAR ETC) <br /> -- cUBTOTAL S <br /> SUB TOTAL 5 _— <br /> PERMI7 s <br /> PERMIT s E <br /> TOTALFEE E 10TALFEE <br /> (ROMi5E10AGN RG�S[IBRLR <br /> Gi0[5[1AnGN Pl/�NCNECKHUMBEd fEE PECEIPiNO. <br /> vncemsne F[ES VALUPI'ION FEE <br /> u5E iCNE lOr MU � <br /> ❑YE9 ❑NO <br /> OUIIDING <br /> ivreorwna�. occurer+cranour HOOIUWRIINOW�1�3 — -�� <br /> nuow•oi�ieciu�i P W MDING -- <br /> sizebvewi. r+o.o�soe�es osMi. oce�o•o MECHANICAL — <br /> �i r <br /> UN <br /> NUGHfLIMIIAiION OTHER — <br /> nnesoAieK�ensn[auieEo ❑r¢s ❑rvo _ . STATEBUILDINGSURCHARGE _ <br /> STATEENERGVSURCHARGE _ <br /> "arvuc�nor+nccer ruuserrn.or FUBLICWOFKS <br /> TOTAL <br />