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APPLICATION FOR C�NSTRUCTION PERMIT "'' <br /> evere[t <br /> ,�E�,a,ro� e <br /> �.t�oF <br /> everett <br /> BUILDING DEPARTMENT <br /> 259-Bd10 TO BE COMPLETED IN INK—PLEASE PRINT <br /> � DEMOLIIiON � COMBINATION �,BUILDING MECHANICAL PLUMBING SIGN <br /> OWNE ]/-' MA'1A0�,�/11EJ5/5/ ry ��j�j�O �)CIIV/J�J�y./ IiP (�� Plbll� <br /> JFv�NI//� ��7M7/ S j//"�- N�W/4!I/ QJU/� w�GN��^��� <br /> �A IOEC10 O�E^��NC�B �� MI.ItA00BE55 Cllv Ii> PNONE <br /> l/�/T�/�,f�J /�Y,�3 '' lil •F�rT�Z/5f� �f'�-/.225 <br /> GLNER� LONiF�CIOIi MAIlA00RE5$ CIIY II1+ p110NF IICEN EI <br /> ��!�f /, yr�y��rtiF f��i/ ��oir 5�7� /�fc�� <br /> ucc�un� �cauna +c un�� ones cirv zia vHorvc uc[xse. <br /> �� i ,p <br /> ,<l� �q��s�./'—l� <br /> p YG/ c rrtn����YRilAOJ� ��CItV ZIV PNONC IICCNSE� - <br /> 1� <br /> /� <br /> ClA55C�WORN <br /> �KEW ADOITION ALTERATION REPAIR � DEMOLITION WOODSTOVE'FRPL INSERT BUILDING RELOCATION <br /> tE1PNiIMPlIOVENENi0RIN1[P/I011PE1A0�[tON'y 9 CONIAQP[(150NlNOVNON[NO <br /> r.orvrnncraniceor'wan.: /arfYJy rY/�-"`'"�^• //j YcY <br /> DES��i'BEN'ORNI.NpSIXIMff IAGEiNlOIVED <br /> vnovoseousc�rew�- " " / s J I HEREBY CERfIFV THAT I HAVE READ AND E%AMINED THIS <br /> APPLICATION ANO KNOW THE SAME TO BE TRpE AND CORRECT.ALL <br /> i[cuoeuniviroi�ovaRon[n*r�s�owua6iowoannecMvo�.�acoarts PROVISIONSOFLAWSANDOROINANCESGOVERNINGTMISTVPECF <br /> WOHK WILL BE COh1PLETED WITH WHETHER SPECIFIED HEREIN OR <br /> im o�a�__or NOT. THE GRANTING OF A PERMIT DOES NOt PRESUME TO GIVE <br /> q AUTHORITY TO VIOLATE OR CANCEL TNE PROVISIONS OF ANY <br /> (/h� /_(���l� �({�,�i OTHER STATE Ofl LOCAL V.W REGULATING CONSTqUCT10N OR THE <br /> 9 �� PERFOflMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> O�VNER OF THIS PROPERTY TO PERFORM THE WOflK FOR WHICH <br /> APPIICATICN �S MADE AND I COIdPLV WITM TNE STATE <br /> CO!JTRACTORS LAW f027 qCW AND 296200 WAC. <br /> scnmm�corccaraacionoa�unronrzcomcvi on�e <br /> X /� � <br /> veaecr r.00ness ��9 �G A ✓,Q -- � � <br /> ` . L��, ... J� pG�liC N C vO�S'JESSIiCt,Sl NO�NOOOSMESSNAM£ <br /> TT' / <br /> PLUMBING MEC ICAL <br /> NO. TYPE OF FI%TURE OH ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATEfl GLOSEI�TJILET� _���__ AL-�l�MN�LG UNR�H P. <br /> BATHTL� ' � FORCED�IRSVSTEMS-�.TU. hi E.A. <br /> —�JO�— —— <br /> LAVATORV�WASMBASIN) 7 UNITHEATERS-B.TU. IA <br /> SHOWER p ' _� CLOTHESDRYEAS �— <br /> � KITCHEN SINK B OISP - VENTILN ION FAN ' <br />' �— <br /> DISHWASHER p •- R�NGE HOOD � <br /> IAUNDRV'RAV Vr'ATER NEATEq _L_ j <br /> CLOTHESWASHER WOODSTOVE � <br /> - URINAL METALFIREPLACEBCHIMN�Y _� i <br /> DRINKING FOUNTAIN FIflEPLACE INSEAT <br /> FLOOR DRAIN - HEAT PUTAP <br /> BACKFLOW PREVENTERS GAS PIPWG ' <br /> ROOPDRAINS-RAINLEADERS 30 '- � E%HAUSTFAN --� <br /> � SINN(SERVICE--BAR,ETC.) <br /> S118 TOTAL 5 ,30 I SUB TOTAL S /./p ; ' <br /> PERIAIT i ' PERMIT S <br /> TOTAL FEE S /.J O ; � TOTAL FEE S %yU ' <br /> rnarvisE�o K� nc�ns�ioacx� sio�s��one+/ vur�e.e<nriuuoEn rcE .lZ�•M aECEmrHo <br /> �i� S 90 av,�� � YsP �a � 38 5'LY <br /> usez e w*necn v�unrsrte FEES VALUATI N FEE <br /> �J <br /> J( VES � NO ouaDiNG �(o��� <br /> hifOfCONSi.LLIOWABIf fYG CON��'^�Wl IXa•'ne�� M1OWpnl:lin.u���5 ��U <br /> - f�' � - /�� �-� PLUMBIN6 /30 ��U <br /> OU <br /> p¢PKWDG NOUYei��..� BnSEMENt M[CHRNICAL <br /> y —"r-"7"`,';r vEs Nn � (�� �yO ��" <br /> CLNL'N1CVV'.VY Rfl SPq11NLEP�5/PE00 M[IGHiI'MIL/.iION �T��E�('�' -�I^V� p 1� <br /> . VES n NO JD/ STATE�WLDING SURCHApOE 6 �� <br /> FEI.SONIORSPO�IXLFPS — �— <br /> � SiAiEENEflGVSURCHARGE <br /> nrv�k�iroHncrev v r�secrncveonr CITYOFEVEflETT aueuewoaKS �J ` no <br /> �f� LOCALSRLES <br /> TAX COOE IS 3105 TOTAL a1 7 � 7D <br /> �3�o�sF t <br /> i�rF c,,�r, <br />