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APPLIC..�ION FOR CONSTRt�CT10N <br /> PERMIT <br /> ms Everonen overeU <br /> CIiY OF e <br /> everett <br /> BUILDING DEP�RTMLNT <br /> 259�8870 TO BE COMPLE7�cD IN INK- PLEASE PRINT <br /> owr�cn rnui eurn�u;ti cnr tm ruor+c <br /> K�'Y /)��__�/�r1/'0:..� f�C� /7J1�� _; L' t/�2/ �S�:OS_ ��f�'. </_�</�/__-�� 'J�yt�'��_�� <br /> TEN�NT M�p.ADPPISS ..—��� ��� ��f:11Y IIP VIION[ <br /> U�.1 �-�'t�L�i"�/�/C7) ' L�/vi"/ � � _-_ .___.___-__'- _— ____ <br /> ♦OGIIITELi OR pESIGNCR M4l��f1R155 ... —�—�-_-- CIIY IIP PIIONE <br /> OENER�LGOHiReCTOR <br /> MAqI,DpRLSS GfY ZIP PIION[ UCENSE� <br /> /��1 � i �ror /�f�; 7��. it.� - ' .sv�c� . i�'.27U E�S< • 7.?22 /*illCiYR%'2.�C,j <br /> /•'/'' L�Y �L1��G /.�1.� T �� CIIY ZIP PIIONE LIGENS[• �. <br /> MECH�MIPICONiR�LiOR MMI�D�RCSS <br /> .a,Js�.:� G<cJ� �%�i — — <br /> VLUM�NOCOHTp�G10R M�RADORE55 f,rtv ZIP PI�ON[ UCENSE� <br /> GUSS OF WOnn -_�.�"_"_-_--'.--.— � <br /> ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAI(i ❑ OEh10LIT10N ❑ �Y�ODSTOVE/FRPL.INSERT_ ❑ dUIL01NG REIOCATION ,I <br /> 1sH%JIT IMPRWEMEHT OR IMERIOR R[MOD[L ONIY fONIDf.f P(q50N�NO PIION[NO <br /> COXTflIiC:PRICEOFWOR6 _______ _ _._" __.._-_--__.__-_ -- <br /> pE�q�g[WpFK�NA SOUeqE fOOt�GC INVOIV[0 <br /> �[ouseaer �olH 1 �/J �— � IIILFEBVCEfiTIFVTHATIHAVERE�0AN0E%AMINEDTHIS�PPLICATIONAND <br /> S,/ (JN�j �fY•� �'L��l ���L�-� � �'V=y�_ NNOWTHESAMETOBETFUEANOCORRECT.ALLPROVISION90FlMN9AND <br /> �Eo�uDElGN�P1�ONOfPHOFERTV15110WNBElOW nenecurouncorlcs OR�INaNCESGOVERNING1H157VPEOFWORNWILLBECOMPLETEDWIM <br /> WHEIHERSPECIFlEDHEREINORNOT.THEGR�NTINOOF�PEPMITDOESNOT ; <br /> �pr� etocKSL= or �L�'1T 1--�V«L� ANYOTHERSGEEORLOOAL AW EIGULnTNGCO STRUCTIONORTME�R 1�� <br /> FORMANCE OF C9NSTRUGTION THAT I AM AUTHON�ZED BV THE OWNER OF <br /> --------- AND PNCOMPLVTW T IRTIOIE STATE CONTRACTrOR3�lAWL1827�NRCW A D <br /> 296 200 WAC. � <br /> — SIGN�IUPEOVCONIN�CIONONAlIi110NRE0�GENi OUE ��0� �j/��� I <br /> X ��,�� °��l ,' <br /> PIIOhCf�ODAE35 �� �PPLIf.�HiSCIiV015M[SSIICENS ANOBUSINCSSN�ME � <br /> � I ,��� � ' r-i� � � � <br /> .k <br /> KUM��N4 � MECHIINICAL <br /> Np, TYPE OF FIXTURE OR ITEM FEE NO. T'PE OF EOUIPMENT FEE <br /> WATERCLOSETITOILET) _ __ A1C_A/HNOLGUNITS-H.P. <br /> B�THTUB _ _ FnRCED AIR SVS'EMS-OT.U. M EA <br /> UVATOPV(W�SH BASINI � _ _UNIT HEATERS-OT.U_M ___ <br /> SMOWER _ _ CLOTHES ORVFI75 __ _ -- <br /> KITCHENSINK6DISP. _ _ __ VENTIIATIONFAN <br /> OISHWA9HER _ _ __ RANGF.NOOD_".___'_'__ _ — <br /> UUNORVTH�Y --' __ __ _ WATERMEATER ' _'_'_ ___ _ — <br /> CLOTHES WASNER WOOD STOVE _ <br /> UR�NAL _ _ METAL FIREPLACE d CHIMNEY _ <br /> '-____'_-- <br /> DRINNINO FOUNTAIN FIREPLACE INSFfiT — <br /> . __' _""__-__ _ _ <br /> ' _ _ -' __- _ ..-_'__-- - <br /> -"-------"'�- HEAT PUMP <br /> FIOOR DRAIN /� . . .....-�----�--�- - — <br /> -__.___ _ _--___-_ _"." <br /> (� _ ______- <br /> BACKFLOW PRECENTERS __ _ ______ __ GAS PIPING _______— — <br /> ROOFDRAINS-FAINLEADERS __ _ _ E%HPUSTI'AN_ _ <br /> SINKISERVICE-BAR,ETCI _ _ - - -- - <br /> SUB TOTAL E ___ SUB TOTAL s <br /> PERMIT g -_-- _ _. _ _PERMIT s _ <br /> TOTAL FEE E TOTAL FEE _ 5 <br /> fRONTSETB�C1t NE�RSEiB�CN SID[5[1B�GN PI�INCNECNHOMBEN <br /> FEC PECEIVfNO, <br /> �oteaee v�c�r+isrtc FEES VALUATION FEE <br /> USE20NE i�YES Il NO - <br /> — BUILDING — <br /> TVPEOFCANffi. OGGUP�NLYORDUP NDOFDW[LLINOUNIiS -— - <br /> a�ow�B�EII,CTw� p�UMBING - <br /> 9�ZEOFBLD.i NOorsronies- eSMi. a�«•� �,�ECHANICFI _ _ _ -- �' <br /> UV <br /> I l N <br /> IIEIGII1lIMITATION OTHER _ -- <br /> _ — t <br /> FIRE SPRINHLERS RCOUIRED ❑YES O ND STATE BUILOING SURCHARGE __ _ <br /> �---_— �. — I <br /> STATE ENERGY�URCHAliGE __ <br /> ♦vM¢+noH�cc er �LRISAPPR BY pUBLIC WORKS <br /> TOTAL ` <br /> � <br />