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i �� , <br /> APPLICATION FOR CONSTRvCT10N <br /> PERMIT <br /> fns Ero�prnen rvrrell <br /> GTV OF <br /> everett F; <br /> BUILDING DEPARTMENT <br /> 259-eetu TO BE COMPLETED IN INK- PLEASE PRINT <br /> ONMEP Mnll �UIIPftiS ❑M1 l�P PIION[ <br /> ���v�^1 NL�M-2 ----3tL�,s/z�-'- <br /> __ _ -- _ _ <br /> 1 H�NI �a��l.�O11111F5 f.iiY !�P PIIONE <br /> UAUEJ U����' AP i5. "1$h.� 'i i rri_(,�I� 1��l� _[�lL_ _ CVcr�C�;_c��� <br /> �T.NIfEC10�DE51sN[R M�q WU�C59 I;ItV 11P PIIONF. <br /> OENEA�ICONin�C10R MAI��UORC59 CIIY plv �IIOIIC IiGENSE• <br /> �AL ��)�.iol�ti;t:��� i .� ���/jv� 7//'//� _56Ar,-tf iu,_A _1��1n7 7Si'J02`i �•2�� <br /> 1AE6 HIC�LCONIP�CIOB AU�IAU��[55 CI�Y ]IP FIIONE LIGEN9E• <br /> AU INOGONIP�LIUR MtII�OD�CSS � � CIIV � 21P PIIONF LICENSE• <br /> —�___.—__.'— ' __ . __ __. . __. . ._ ..... . _. _•___ . _ _'.__--__ — <br /> CU590f NVPF �/ <br /> ❑ NEW ❑ ADDI710N ❑ pLjEfiNION �lf� REPAIR ❑ 0[MOl11lON ❑ WOOOSIOVIS?RPl.INSl:fll _❑ OUIl01N0 RELOC4TION _ <br /> TEM�MfIMPPWEMCHfOqINiCOi0t1(1CMOOELONIY� _ � /(I[ /Il r�l�( COHIAC�/PJj IIYON�NpP1�JNENO <br /> contaettrnit_orwonn _____. _ _ . � c"'<^`' __ /�2�nr� L• �- A�SC)1�1 <br /> p[p�RllEWORN�NOSOWREf001�0[INVOIVC� �_-----_—��� � __.. <br /> ('c�r.,i3�,,1�, f2ei'n�Rs --�-J�� JOZ� <br /> MqVplED USE Of BU�LD�NO I HEf7E8v CERTIFV THAT I HAVE f7EAD AND E%AMINED THIS APPLICATION AND <br /> q�+�1�Z-,1�L'N( NNOW THE SAME TO BE TPUE AND CORRECT ALL PROVISIONS OF LAW9 AND <br /> LEMLOE6CN�PIIONpP f'ER�YISH0IVNBEIOWORAUG11fOU�CORES ORDINANCESGOVERNINOIHISTYPEOFWORKWILLBECOMPLETEDW�iH <br /> WIIETHER SPECIFIED NEREIN OR NOi.THE GRANTIN(i OFAPERMITOOES NOT <br /> Pf7E5UME 70�IVF.AUTHORITY TO VIOLATE OR CANCEL THE PROV1810NS OF <br /> iot BiucK. or — ANVOTHERSTAIECRLOCALLAWRE6ULATINOCONSTRUCTIONORTHEPEF• <br /> FORMANCE OF CON51 RUCTION.THAT 1 AM AUTHOPIZEO BV THE OWNER OF <br /> iHIS PROPEIiTY TO PEtiFORM THE WORK FOR WHICH�PPLICATION IS MADE <br /> AND I COMPLv WI1H inF STATE CON1iiACTOfiS LAW 1827 ACW AND <br /> 296 200 W4C. <br /> — SICIIpURCO�Cnrv'OnCInl�nnnp1110NIF0��iFN1 DAiE ,����/ rx <br /> 0 <br /> i X � ]� <br /> ------ - ��nC/f.rL) .� /�c t4-� <br /> pwo.lEct�ooaess nvruc�MSGIVPUSitiBSi NSEN lDB�91NE55N�ME -� <br /> '�� s ��lM`�(�c2- E{IC.L �(L <br /> KyM��pp MECH�NICAL <br /> NO. T'PE Of FiKiU11E OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WA�ER CLOSET(TOILEp NC—NNNOLG UNIiS—N.P. <br /> BIITMTUB FORGED AIR SYSTEMS—B.t.0 M EA <br /> LAWTOFV(WASH BA91N1 UNIT HEAiE�iS—B7.U. M <br /> BHOWER — — -- CLOiNES DRVERS _ — <br /> NITCHEN SINKB DISP. _ _ 3 VENiILATION FAN_ ____ <br /> — ______—_—.' <br /> DISHWASHEP � RANGE�1000 <br /> _ ___ ___-- -- . _ _____ .._-_ ._ -__-._ ._ -_ -- <br /> UUNDRY7R�Y WAIERHENEn _ <br /> CLOTNEB WASHER �'�'OOD SiOVE _ <br /> URIN�L � METnL FIREPLACE M1 CIIIIdNEV <br /> — —'_' _ _ .. . . .___'. ____ _ ' — ' <br /> ORINKINOFOIINTAIN fIREPLACEINSERI _ __ _ <br /> __ ' __—.___ _.' _'__ .. .. . _ - — <br /> FLOOPORAIN HEAIPUMP _ _ _ _ <br /> BACNFLOW PREVENTERS GAS PIPING _. _ <br /> ___ -- .—-.___. <br /> ROOFORAINS—RAINLEA�ERS ____ _ _ _E%NAU57 FAN <br /> SINK(SERVICE—BAR.ETCI ____ ___ ______.-�������---- - - — <br /> SUBTOTAL S SUBTOTAL 5 <br /> PE(iMIT S _ _____ PERMIT E <br /> TOTAL FEE S IOIAL fEE S <br /> FPON13EiBI�GN PERRSEIB<CR SI�CSf.1p4Ce PIAHCHECNHUMBF.II FEE PECEIPfNO. <br /> usEzoNe iornnen v�e�v�sire FEES VALUATION FEE <br /> I1 YCS Il NO <br /> BUILDING <br /> iYPEOfCOHSI. OGGU��NLYG110UP NOOfUW[LLINCUNIIS . -_—--- ------- --- <br /> ♦��pWABIF/�CtUAL PLUM�ING <br /> _� ___ --_—_— ._— _ __'. . . . . ._ _.._.__ .._ _—"__._- _—_ __'.__— _ <br /> 912EOfPID6 NOOf510111L5 tlSMI OCCIORi) <br /> �i y MECII�NICAL <br /> n r� _. ._. _ . . .. ___ '__—___ '__' _ <br /> ___.._____ '— ___—'__ _'. -- i¢iid�iliMnnnnii..__.- OIIIER <br /> nne sannn�cnsn[ou�neo u rE9 u No ___ _ S1nTE t7UILDING SURCNARGE <br /> STATE[NERGY SURCHAfiGE <br /> �PP�ICALIONRCGBV PL�HSRf'PRAY <br /> rueuc wonres <br /> TOTAL <br />