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.. '.� . . .. � ..... .. ' . . � . .. .. . . .'.. . ... . _ ' . . ' . _. '� _ ��.. ' .. . . . . . !.'. ,��^ , .'+'P.b..2+.:.. <br /> APPLIC.y.�ION FOR CONSTR�.CTION <br /> PERMIT <br /> tne Evero�een everett <br /> CITY OF <br /> everett e I <br /> BUILDING DEPARTMENT � <br /> 259-8810 TO BE COMPLETED IN INK— PLEASE PRINT I <br /> GiIY Z�P PIIONE � <br /> .u�R � M�II�UDRE55 i <br /> �'_ <br /> 7�.,�'I'� IU v� G�t a U;�cu Q��s�, �cefF 98z�3 I <br /> TENANT M��I��DRE55 LILY ZiP PNONE <br /> ♦f1LNITECTOR0E51GNER M�IL�O�RE55 CITY ZIP PIIONE <br /> GEMERAL fANTRGCTOH MNL��DNE59 qTY ZIP PMOHE LICENSE• <br /> MECNANIG�LCONTR�CTON M�ILADDRE55 G1Y 21P P��ONE IIGEHSE• <br /> RUMBINOCONTR�CTO MAIL���NESS CITY ZIP PIIONE IILENSE• <br /> VY�.O.Q� �a-N �,�ac. 3�zz-lo� rr�Al`3� �ce�,�/- 947n8 337 93�Z Mh-E<-�C. <br /> C�,LlA,9?OFWORN `s' '1 <br /> .d� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIP C DEMOLITIDN ❑ WOODSTOVE/FRPL INSERT ❑ BUILDING HELOCATION <br /> TENANT IMVROVEMENT OP INiER10R PEMDDEL ONLY LON1�Li P[RSON ANp P110NE NO. <br /> CONiR�CT VR�CE OF YIORK <br /> DE9CRIBEWOpNAN S �REf 1�OEIN/V�OVED /� <br /> /l �� II / ��_! - ��(. � ��� � <br /> 9EDu6Eo i� �Ho / �HEREBVCERTIfYTNATIHAVEREADANDEXAMINEDTHISAPPLIGTIONAND <br /> � li ��,�'�. KNOWTNESAME70BETRUEANDCORRECT.ALLPROVISIONSOFLAWSANO <br /> � aoe'CfUPTIONOFP ERttISMOWN�ei �on�n�cn ouacories� ORDINANCESGOVERNINGTHISTVPEOFWORKWILLBECOMPLETEDWITH <br /> WHETHERSPECIFIEDNEREINOR NOT.THEGRANTINGOF�PERMITDOESNOT <br /> PRESUME 1 O GIVE AUTMORITY 70 VIOLATE OR CANC'cl TME PROVISIONS OF <br /> LOT B�ocK OF ANYOTHERSTATEORLOCALLAWREGULATINGCONSTRUCTIONORTHEPER• <br /> FORMANCE OF CONSTRUCTION,THAT I AM AUTHORIZED BY THE OWNER OF <br /> THIS PROPERtt 70 PERFORM THE WORK FOR W HICM APPLICATION IS MADE <br /> AN� 1 COMPLY WITH TME STATE CONTRACTORS LAW 1827 RCW AND <br /> 206200 WAC. <br /> SIGN�iU ' �GONiR�CTOPON i110RiZED�GENT D�TE <br /> � � �-/S-g� <br /> PROJECT�OORE53 q ' � APPL�C�NiSCILYBU51NE55LILENSENO.�NpBUSMESSN�ME <br /> � <br /> PLUMBINO � MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSETITOILEn A/C—NHNDLG UNITS—H.P. _ <br /> BATHTUB FORCED AIR SVSTEMS—fi.TU. M EA <br /> LAVATORV(W�H BASINI UNIT HEATERS—BT.U. M <br /> SHOWER CLOTfiFS DRYERS <br /> KITCMEN SINK 8 DISP. VENTILATION FAN _ <br /> �ISHWA9HER RANGE HOOD <br /> LAUNDFiV TRAV WATER NEATER _ <br /> CLOTHES WASHER W�aD S70VE <br /> URINAL METAL FIREPIACE 6 CHIMNEY <br /> DRINKINO FOUNTAIN FIREPLACE INSEtiT <br /> FLOOR DRAIN MEAT PUMP I <br /> � BACKFLOW PREVENTERS �' GAS PIPING I <br /> ROOF DPAINS—RAINLEADERS E%HAUST FAN _ i <br /> SINKISERVICE—BAR,EfC.) — � <br /> SUB TOTAL S < <� SUO TOTAL S _ <br /> PERMIT b � � � PERMIT E <br /> TOTAL FEE S °� � TOTAL FE' a <br /> fPONTSETB�GK HE�RSETBrGK SI�ESETBAGK PUNCNECKHUMBEN FEE RECEIPTHO. � <br /> usezone iot�ee� WGANTSRE FEES VALUAT�ON FEE . <br /> ❑YES ❑NO <br /> BUILDING � <br /> TYPEOPCANST. OLCUP�NLYOROUP NOOFOWELLW�UNITS l <br /> ALLOWABLE/�CTU�L pLUMBING � <br /> � <br /> sizeoFe�oa NOAfSTORIES esM*. ocG�o�o MECHANICAL I <br /> ❑v <br /> ❑N <br /> NEIONTLIMIT�TION OiHER • <br /> FlRE BPRINKLEP9REOUIPED ❑rE9 ❑No STATE BUILDING SURCHARGE � <br /> STATEENERGYSURCMARGE � <br /> .�PPLICQIOH�C`G6Y PL�NSAPPP.BY PUBLICWORKS f <br /> �.'4 TOTAL I �� j <br /> � <br />