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P". <br /> APPLIC�ION FOIR CONSTR�TION <br /> PERMIT <br /> M�Ev�rymn everett k <br /> GTY OF � I <br /> everett <br /> BUILDING DEPARTMENT <br /> 258-8810 TO BE COMPLETED IN INK— PLEASE PRINT <br /> �HEq MAIL�U�PE55 CIIY ZIP PMONE <br /> 1� : c I � 3�{z3 S �,�rP �v�r� 98zo3 353 S7r7 <br /> TEN�NT ���M�IUDORE55 CIIY 21P PNONE <br /> MCMITECTORDES�ONER MAiUD�11E5S C�Iv ZiP PIIONE <br /> OENERKCONIReC10R MML�OORESS CIIV ZIP FNOHE IICENSE• <br /> ME�YUNIGKCONiP�G10R M�IL�OO�ESS d1V EIP PIIONC 4CEN8E• <br /> •L Y OCO tML10N M�IL��OPfSS CItY IIP 1`IIOIIE LICENlE• <br /> � <br /> 1 Q/�1S OF WORR <br /> ❑ NEW ❑ ADDITION ❑ AlTER11t10N ❑ AEPAIR ❑ UEMOLITION ❑ WOODSiOVE/FRPL INSERT ❑ BUILDING RELOC�TION � <br /> ANNIT IMMWEMEMT OR IMERqR REMODEI ONIY LONI�GT VEB80N�ND PNONE NO <br /> I <br /> pp�iMCT M11C[OI W011K � <br /> I A��NOY.LI�IWE��, . 1 <br /> o�s o�w��oir�o IHEREBYCERTIFVTHATIMAVEREADANDE%AMINEDTMI9�PpLICA710NAN0 I <br /> G'iClJ KNOW THE S�ME TO BE TRUE AND COAF7ECT.ALL PROV1910N90F LNNB AND <br /> LJr/G_ OROINANCES 40VEPNINO THIS iVPE OF WORK WILL BE CAMPLEIED MAiH <br /> �[p11�p(lGp�PIqHUFPROPERTYUHOWNBEIOHONIITUG1�fDURGOPIE51 yyHETHERSPECIFiEDNEREINORNOT.THE6PANTINOOFAPERMiTDOE9N0T � <br /> PRESUME TO GIVE AUTHORITV TO VIOLATE OR C�NCEL THE PROVI&ONB OF � <br /> �pr e�oc� or ANVOTNERSTATEORLOCALUWREDUL�TINGCANSTPUCiIONORiMEPER <br /> FORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED 8Y THE OWNER OF <br /> THIS PROPERTV TO PERFORM THE WORK FOR WNICH APPLIC�iION 19 MI1DE <br /> — AND I COMPLV WITH THE STATE CONTR�CTORS LAW 18.27 RCW AND <br /> 296200 WAC. <br /> &ONATUREOFLON�PAp�OROPAUINORIZED�OENi DATE <br /> X Mn� o�V ��'cme ��3�� 9 <br /> J� 3y13 gL..oCe R�� IpCLiC�NTSCiTVBU51NE39LiCENSENO�NOBU91NE59N�ME <br /> 'L�V e.('e , <br /> �LyM\INO MECMIINIC11l <br /> Np, TYK OF FlIfTUlIE 0111TEM FEE NO. TYPE OF EOUIPMENT f[! <br /> WATER CL09ET ITOILE7) A/C—MHNDlO UNITS—H.P. <br /> d1THN8 FORCED RIP SYSTEMS—flT.U. M EA <br /> UVATORY�VJA9H BA91M UNIT HEATERS—B.T.U. M . <br /> s��R CLOTHE3 DRVERS <br /> KITCHEN 91NK 6 D13P. VENTILATION FAN j <br /> DIBMWASHER RANOE HOOD <br /> LAUNDRYTR�V WATER HEATER <br /> CLOTHE9 WA9MER WOOD STOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEY <br /> DRINKINO FOUNTAIN FIREPLACE INSEfiT <br /> FLOOH DRAIN HF.AT PUMP '; <br /> BIICKFLOW PRFVENTERS 6RS PIPING � <br /> I <br /> pOpF DRAIN9—AAINLEADER3 EXHAUS7 FAN <br /> SINK ISEMICE—BAfL ETC.1 j <br /> SU8707AL E SUBTOTAI f <br /> PERMIT E PERMIT E _ <br /> TOTAL FEE E TOTAL FEE S <br /> iRONTBET&1CK RE�OSEIB�GK SIOESEIB�GM PL��ICHECRl.UMBER FEE 11ECEIRNO. <br /> UBEZONE lO1�RE� �AG�NLSIIE FEES YALUATION FEE <br /> ❑YES [1 NO <br /> euaoiNc <br /> 1YpEpFfqN9i. OLGUP�NGYGROUP NOOfUWELUN0UNIIS <br /> ,a�pwexfiecrw� PLUMBING <br /> MZEO�BLDO. NUAIS10RiE5 BSMc oCCto�o MECHANICAI <br /> ❑Y <br /> ❑N <br /> tlE16NILVAllAllqN OiHER <br /> FIPEB�pINRlER5RE0U'9ED ❑YE9 ❑ No STATE BUILDING SURCHqRGE <br /> �' STATE ENERGY SURCHARGE <br /> ,vpuWtioMeGcer rl.�Hs��rn.9r PUBLICWORKS <br /> TOTAL <br /> i,T <br /> ?T,.� . ._ .. .. . ' <br />