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APPLICATION FOR CONS1 riUCT10N <br /> PERMIT <br /> �neE�o,4,ea� ,�„•,,.�� ; <br /> GITV OF � <br /> everett � <br /> BUILDItJG DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK— PLEASE PRINT <br /> UWNEP ti"All FC�liLSS Oiv 21P PHUtiL <br /> ��1�,�'�i 2. ��,���aos_/�r�2 ��E�TT 9�o2a� ---�os�_-- <br /> MAILPDDRC55 CI1Y Z�P PMONE <br /> ��� ARCNIiECi0R�E51GNER MAILA��PE55 CIIY Z�P PHONf <br /> 1 <br /> 9�-3 <br /> dJ�I CC GCNERRLCONiR�LtOR MAILAD�PE55 Grv ZIC Fr10NE UCCNSE• <br /> a H C1iy 21,�03 .353 7/bl EV-�`F/73�/Ph' <br /> >�� ��1���;/dE2s s�nb E�����J��� 9P <br /> � x� IdELN>NiGAL LOYtPRCiOR A1A!L AODR[55 <br /> � �� FWMB�N6GONiRAC10R MAILAOOFE55 CIiV ZIp PNOHE LIG[NSC• <br /> o rri� � <br /> 'i1 H'� — I <br /> �/J�--1 CLASSOf WORK <br /> ❑ NEW ❑ ADDITION ❑ A�TEPATION �REPAIR ❑ OEMOLITION CoO CVOODONO!voc or+e oSERT ❑ BUILDINGPELOCATION <br /> LTI O� 1fN�NTIMGROYEMENTOAIM[PIOflPC1AODELONLY <br /> H C7 /7����' � �J <br /> O H G0.41RACiPRICLOFWOR� �p,?..� ' C�F�[.�/� _ � /LL��S �S�-�I�� <br /> � �g OESCAIBEWORKAHDSOUAAEFOOiaGEINVOIVEp <br /> I <br /> �" C��.' �•/�F �- S�� — -- <br /> zH'�i aaoros[ouseovom�oi�+� �NEHEB�CfRTIFVTH4TIMAVEH[ADANDEl�A1dINEDTH15APPl.�CAT�ONAND ' <br /> ,'� y[:] /�� KNOWTHESAIdETOBETRUEANDCORRECT.ALLPROVISION50FLAW5AND y <br /> C'� `L J(�G>/�� GRDINANC[S GOVERNING THIS TYPE OF WORK WIIL BE COMPLETED WI'IH � <br /> Hy �Ee�tocscaivri0r+oraaoaeFniSi�aWnBE�oWOA/•Ti�CnrDuneovRs�, WNETNGFSPECIFI[DHE�EINORNOT.TNLGRANTINGOFAPEF�dIT�0E5NOT <br /> gN Su � PRESUMETOGIVEPUTMORITVTOVIOInTEORCANCELTHEPROVI510NSOF t <br /> '"� �or—`�' �1�2. G'�a��b.� 1A(�ounes I I <br /> � �y I� � o�OCK OF — ANYOTHERSTATEORLOCALL WREGULFTINGCONSTRUCTIONORTNEPEP� <br /> � �� FORh1ANCE OF WNSTRUCTI .THAT I Ald AUTHORIZEO BYTHE OWNEP OF <br /> THIS PROPERTV TO PERFOFM�HE WOPK FOR W HICH APPLICATION IS MADE <br /> PND 1 COMPLY WITH\THE STATE CONTRACTORS LAW 1827 RCW AND I <br /> y H y z�s zoo�vnc. \ v <br /> y Q� � �PCO�COIApnL H �I:4U���G��ZEDAGP�i DA1E ���� <br /> yGbul � � <br /> X '`l �' —_ �_�^�l�C�-- - � <br /> PPOJEGiPDOAE55 acvu".f`SP � NLS EN.EN A�USINESSNAME <br /> / D5�c�� �d �7T' � / � � <br /> � PLUMBING MECHANICAL I � <br /> NO. TYPEOFFI%TUREORITEM FEE NO. TYPEOFEOUIPMENT FEE + <br /> ��+ 'NATERCLOSET�TOILEn h'C-A/HNDLGUNITS-H.P. __ ', <br /> ! ' BATHTUB _ _ FOFCE�AIR S�STEMS-BTLL M EA __ � <br /> LAVATORYIWASH9ASINI UNITHEATEPS-BT.U. M _ _ � <br /> SHOWER CLOTHESDRYEPS _ _ � i <br /> '�� `�' __ VENTILATION FAN _ � <br /> KITCMEN SINK S DISP. <br /> �� "' DISHWASMER _ __ RANGE HOOD _ . <br /> I.AUNDRYTRAV WATERIiEATER — I , <br /> t � CLOTHESWASHEfl WOODSTOVE _ j � <br /> �n ,! URINAL _ METALFIREPLACEdCHIMNEV _ ' <br /> DRINHING FOUNTAIN FIREPLACE INSERT _ <br /> FLOOR ORAIN NEAT PUMP __ <br /> ��� ' BACKFLOW PREVENTERS _ G/.5 PIPING _ <br /> ROOF ORAINS-RAINLEADERS E%MAU51 FAN _ <br /> SINK�SERVICE-BAR,ETCJ __ — I <br /> `-� 1' _ _ <br /> — � <br /> � �"� SUBTOTAL S SUBTOTAL 5 _ , <br /> PERMIT 5 — -- — __ �'ERMIT 5 _ . <br /> TOTAL FEE S � TOTAL FEE S ' <br /> iflON15Gi0AGK �ERP`OOACN SIOESGIB/�GM1 PLANCNEC1tNUMOCP FEE AECEIPTNO. i <br /> usezoHe iernaen vncer�rsne FEES �UATION FEE ��� <br /> ;; rE5 �i NO � <br /> BUILDING __I�"� QQ_ <br /> ttPEOFCONSi. OGCUPANCY6ROUP NOAfOWELLIHGUNliS --- ---- <br /> eu0wee�er�Ctu�� PLUMBING � <br /> srzeovo�oc. Naor9oeiEs esM�. occioAo MECHANICAL I <br /> r — <br /> �l N — <br /> �iemrrtuMiunorv OTHEfi (' �, <br /> ner srniNrc�Ensaeomaco �r[s �:No STATE BUILDING SURCHARGE � J O <br /> STATE ENERGV SURCHARGE �I <br /> �.rrucanoHaccev vurv5errcor PUBLICWORKS <br /> 1'L�.�'` � TOTAL �� S ✓ I <br /> V <br />