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� �^-� ,..., ' <br /> � APPLIC�f10N FOR CONSTR�CTION <br /> PERMIT <br /> 1��Ev�rpmn evrrett <br /> CITY OF <br /> everett � <br /> BUILDING DEPARTMENT <br /> 259-8810 TO BE COMPLETED IN INK— PLEASE PRINT <br /> [p AI�I��OORE55 CI�Y !IP P110NE <br /> K�V IU M14-N�Q.. _ 7�YS Tl�fB���lILL l�L�_� ✓ 3l�.ti-770L1 <br /> IEN�NT M�il�00RE55 p�Y ZiP PHnqE <br /> uq <br /> MCMITECTORpE8i0NEN MMI�DONE55 GRY ZIP PNONE <br /> Nd- <br /> OENE GONTRALiOR M��L�pORE55 GfY 21P 1'NONE IICEN9E• <br /> M�BR�D� �2►�FiE�ti' 22�(-- h�1CKER3c�h�_,Sfe.�- ��/c��' "Lt33-7/2 � Mca����,+o <br /> MECM�NiC11LCONTR/�CTOF M�iL�DONE55 LIIY ZIP fl10NE UCENSE• <br /> SEPtL��s �*e�..rr <br /> 0.UMaNOCONTMGtON M�iL�00RE54 CI1Y ZiP 1'NONE 4CEHSE• <br /> l • . <br /> LLAbS O�WJRK �.�J/ 1(� <br /> ❑ NEW ❑ I1�DITION ❑ AITERAtION 00 REP�IR ❑ DEMOLIiION ❑ WOODSTOVE/F(lf'L INSERT ❑ BUILDING RELOCATION <br /> lElMNT IMPROV[MEHT OR INiFRh�R PEMOJEI OHIY CONIACI PERSON�ND PIIOHE IIO <br /> �OpMTMGi PR10E Oi WOH�Q.QC�(.J <br /> OEOCMlEWORN�HOBOU EfOOTOEINVOLVEO <br /> ' � FtRE YZEPa�a m oR�ceiU�qy c_ciusi <br /> � MOPOlEDU9EOFlU�lMNO IHEREBVCERi1FVTHAiIH�VEREADANDE%AMINEDTHISAPPLIC�TIONAND <br /> � ��uLTI FANIL`� / - LE KNOW?HES�METOBEiRUEANDCARRECT.ALLPROVIS10N30FLMN$AND <br /> lEpµp[DGPIPTqMOFPROPlR ISH uEtOwONeT*/�C OURConE51 ORDINANCES WVERNINO THIS TVPE OF WORK WILI BE COMPLFiED WIiH <br /> ') '�A WHETHER SPECIFIED HEREIN OR NOT.iHEORANTINU OF A PERMIT DOE9 NOT <br /> lpr_� e�otK or' .,[q LL EY t/l �u-� PRESUMF.TO GIVE AUTHORI^'TO VIOLATE OP CANCEI THE PROV1910N90F <br /> ANV OTHER STATE OR LOCAL�AW RE6ULATINO CON9TRUCTION OR iHE PEIF <br /> FORMANCE OF CONSTRUCTION.TMA71 AM AUTNORIZED BV iHE OWNER OF <br /> S E� � T W(J Z 17 E�6 _�4„� THiS PROPERTY TO PERFORM THE WORN FOR WHICH APPLICATON 19 MI1DE <br /> AND 1 COMPLY WITH 7HE STATE CONTRACTOFS LAW 1B27 RCW AND <br /> � 2BB200 WAC. <br /> SbN�IUREOF�ONIP�C�OAORPU1nOq1LE0�AENi D�IE <br /> � �� �/� <br /> ` ������ IC�HTBCITYlU IE9! EN9ENO.�NDBUSINEO N�M <br /> f � 7 i -L 2 E R <br /> M,UM�INO MECXIINICIIL <br /> s Np, NK Of FIXTUIIE OII ITEM FEE NO. 7YPE OF EOUIPMENT FE[ <br /> � <br /> WATER CL03ET ROILEi) NC—NHNDLO UNI7S—H.P. <br /> ) NUNTUB FORCED AIR SYSTEMS—B.T.U. M EA <br /> UVATOHV�INA9HBASIN) UNITHEATERS—B.T.U. M <br /> � SNOWER CLOTHES DPYERS <br /> KITCMEN SINKt DISP. VENTILRiION FRN <br /> DISHWASHER RANOE HOOD <br /> � LAUHDRYTRAY WATEHFIEATER <br /> t <br /> CLOTHES WA9MER WOOD S70VE <br /> I URINAL METAL FIREPLACE6 CHIMNEV <br /> t ORINKINO FOUNTAIN FIREPIACEIN3ERT <br /> r FLOORDRAIN HEATPUMP <br /> L -- <br /> � BACKFLOW PREVENTERS GAS PIPING <br /> k ROOFDRAINS—F7AINLEADERS EXHAUSiFAN <br /> i 9�NK�SERVICE—BARETCI <br /> i <br /> Si1BTOTAL 5 SUBTOTAL S <br /> PERMIT S PERMIT E <br /> TOTALFEE S TOTALFEE S <br /> FROXT BETBACK NFAF SEtBACN SIpE SEIBACN PIAN CH 'lt MUMlEII FEE i IIECEIPf NO <br /> �5 ��.'�� "3 C�, `S 1�� 2.-��s� <br /> UBE20NE �or�neR vec�r+tslrE FEES VALUATION FEE <br /> ❑YES �J�O <br /> BUILDING <br /> TYPEpiCON9i ��� OCCUPANCY4ROUP HOOfOWELLIN0UN115 <br /> �LtOv��BIFi�Cru�l \/�1 R� I /� PLUMBING '_„_ <br /> �S���1 T <br /> uz[ora�oo NOAfStORIE9 esN� occ.io�� MECHANICAL <br /> 18'IY� SI' 3�i ��' �'' <br /> neimrtuMneno�+ OTHEIi <br /> iIREBPRINrcLENSRE01➢PE� ❑rE5 no N� _ STATE BUIl01NG SURCHARG[ <br /> STATE ENERGV SURCHARGE <br /> APPLIC�TION� PUN9�Pp� <br /> PUBLIC WORKS <br /> <� � <br /> � � TOTAL <br /> ,•.,� . _ _ ..r.. .._... „ .. ., .... : . . . . � s._ <br /> �•trY4R� . ��.. ,.� � � �. i. � . , .. . ... � . . <br /> ,�. ... ... ..' . . . . � ",. r�' .. . .... . . .r.• � , r., , .\:.,:.1 � . t:.Y:, ii7 <br />