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APPLICA�'ION FOR CONSTRIi.:T10N <br /> PERMIT <br /> f�e beryreen �•v��rell <br /> GTV OF � <br /> everett <br /> BUILDING DEPARTMENT <br /> 259�eet0 TO BE COMPLETED IN INK— PIEASE PRINT <br /> wm��n / u.0 r.nnai ss �ur zm y runH� <br /> MNfI1�IJY`1_—'�_1__�_!/Q�L/�=7_Uno Ss ��-.J� In�fL�l^(�'1� c'fy�t,4.� rw� l�1G�_r��riHi�-�S_.� 'y�.s^� <br /> _ . . . ... . _... _. . .__ ______ _._____— <br /> ♦HLH�IECTORocS�cNCR — �-� �� -��- ���"��i Mnn[ss- . . Gir- t�r� � rNONt <br /> _________. . ._ ."____ .'_ - �IIV_ _.- .' _ _I'110N[__- -_-"- IICEHS[• <br /> GCNEH�LCONTRACTOR Mu1��fIf.C55 ����• <br /> MEtN�N1ULCONTR�CTOR M�II AOOPCSS C�fY SIP 1'bONE IILENSE• <br /> � t�.�� �� L` -__-_' "_ '_____-_ - _ <br /> PIIMSIHOCONIP�GiOR M�II AOORC55 QiY ZIP �-- --FIION[ - -� ULENSE� �- <br /> pA$S Of MORK � �� <br /> ❑ HEW ❑ A�DITION ❑ ��TERATION ❑ NEVAIR ❑ DEMOLITION ❑ WOODS70VFJFPPL INSERi ❑ BUILDING PELOCRTION <br /> TENMII IMPROJEMEHi OR INTEHIOR REMOOEL ONtY CONI�Li PWSON�Np PIION[NO <br /> CONTIIIiGTPR�CE0IWORM. " "_"_ _"__._-_-__.._..____- --- <br /> p(lG11lE WORN�HD SOU�AE fOOT 6E INVOI.V[0 <br /> i��-�i�t 0(� ! I 'P�I'r i� 4f 1�l �(' • ------ - ---- ---- -------- <br /> n�oPoeFo uSE or emio�M6 I HEREBY CENllFY THAT i HAYE READ AND E%�MINED 7HI5 APPLICATION AND <br /> f _ Q n . . 1, ,^�� KNOWTNESAMETOBETAUEANDCORRECT.ALLPROVISIONBOFLAWSANO <br /> p^"�i'7 �-�"Q'� ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLEiED WITM <br /> �E�.�u RIFTIONOfvNOPERTV�5110WN8ElOWON�TI�LHfO11RCOPlE4 yy��ET1IEHSPLCIFIEDHEREINORNOT.TMEGR�NTINGOFAPERMITDOE9NOT <br /> PPESUME TO GIVE AU7NORITY TO VIOUTE OR C�NCEL THE PROV1910N90f <br /> ior�� etoC��� aF �--� --� - ANV0711ERSTATEORIACALIAWREGULATINGCONSTRUC710NOHTMEPER� <br /> FORMANLE OF CONSif7UCTION.THAT I AM AUTNORI2ED BV TME OWNER OF <br /> 111I5 PROPERIY 10 PEF�FORM 7NL WORK FOP WHICH APPLIGATION IS MADE <br /> ._-._ .- ----� -�� -- AND I COMPLY Wllll TH[ STFTE CONTRACTORS LAW 1B?7 PCW ANO <br /> 29G 200 WAC <br /> SIGIIAIUNLOICONIH�CIUNlrNAl11110N111.IlAf.INI U�IL <br /> ----- -- X ��yn. Q -Cv�j�_A�L �� - ��-�� <br /> FlqJECT IDDPESS ��PI IUN15CI1Y UiISML55lICCNSE NOII�D BIISME55 H�ME <br /> V <br /> �►WM61 0 MECN�NICAL <br /> �p, TYPE OF FIlITU11E OF ITEM FEE NO. TYPE OF EOUIPM[NT FEE <br /> WATERCLOSET(TOILET) __ _ ___ _ _ _ WC_ AMNDI.GUNITS -HP__ _ __ _____ <br /> .._._ -_ - _. ___ ___ <br /> BATMTUB PORCED AIR SYSTEMS-HTL. M EA ___ __ <br /> LAVATORVIW�+HBASINI -�--_ - "_--- '_ ___ 'UNITHEATERS-.BTU _M '__ ___ _ <br /> 4HOWF.R __ CLOTHESORYERS __ _ <br /> KITCHENSINK{DISR __ _,__ VENTILATIONFAN . ____ _ <br /> _ _ — -' . .. . _ <br /> DI$HWASMER RANGE HOOD __ _ <br /> __._ _ _.-- _'- ' ' .- <br /> ____ _ ._ _ _. . . __— <br /> WATER MEAiER ���i <br /> _ LAUNDRVTPAV -. . --- - ��� WOODSTOVC - .. .�� � �� ��—�� -��-- J �, , <br /> CLOTHES WASNER . .. � . .-. .-- - --- � - --- <br /> _. __- _ __ ___._ -_._ _ <br /> URINAL _ METAL FIREPI.Rf.E 8 CIIIMNEY _ <br /> ___ _ _ _'__ _. -.. <br /> ___. __.._ ___.__'."__'_ '_ ___— -__ <br /> __-'- <br /> DRINKING FOUNTFIN FIREPLACE INSEB _____ <br /> FLOORDR�IN -�-- ---- -� __ __ -HEATPUMP��-_______ �._..._ — <br /> __ _ -.. _ <br /> BACKFLOW PfiEVENTERS GAS PIPING _ — <br /> __-' <br /> ..___ . .__.___ _ - <br /> FOOP ORAINS-RAINLE40EF5 __ EXIIAUST FAI. <br /> -.__ _. _. . " <br /> SINKISERVIf,E-BAfi.ETC) . -�--- -.--� -.. .-- -- ----- - <br /> — . _____-_._._ ___.. ____ ._-__._- - <br /> - --'---—-- - - - . . . - - . SUB TOTAL S <br /> SUBTf1TAl 5 . . . ._ __-__.-__--__-� -____ — <br /> _ . ... __._ __ _ <br /> — -� -��- -" PERMIT E <br /> PERMIT _b . _ .. ___- .. .__ __ '_—_.______- _ <br /> _'_._._..'_ -__ _. <br /> TOTAL FEL S TOTAL FEE 5 <br /> FRONTSETB�GK HE�RSETB�CN SID[5[IOACH PL�HLHECItMUMBEfl FEE NECflPTNO. <br /> uSEzouE iot�ec� V�C�NTSiIE FEES VALUA'fION FEE <br /> Il YES I1 NO <br /> . .____._-____ __-__ BUII.DING <br /> ____ _ <br /> _ _ _ _ ._._' -_____ <br /> TYPEOFCONST. OCGUPANLYGRDUP NOOfOW[���uGUNrtS -- - -----� � -- � -- - <br /> eLLow�e�b�clu�t PLUMBING <br /> _. .' _'____- <br /> _.____.-_ --____-__- _ — <br /> —_ ___ --'__.-.__._'_. _ . <br /> 52EOi8106 XOOFSIORIEF BSI.IL OCLIO�D -- - - — � =� <br /> �y IdECHANICAL <br /> ❑n <br /> NbG11111M11AT10N OTHER <br /> __-___.._. .__ _... <br /> RRE51'AINMlERSPEWIN[D UY[d (iN0 _ _ __ ______ . _ $7qTLBUIL�11NG5URCHA�7GE <br /> y1q7E LNEHGY SURCHARGF <br /> eovuUTioNnGc er rue9�rrn nr � PUBLIC WOfiKS� � - ��-�'- ---�-- ' _ 1 <br /> TOTAL �� -� �� <br />