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xr� <br />;� t� <br />ay <br />,axx <br />C., H <br />9 Hx fn <br />H ZH <br />K n <br />oxo <br />�J !�-I � <br />CA H <br />z <br />� H �G <br />H^ L���] O <br />Y, V � <br />zyy� <br />r t-+ y <br />gy <br />H <br />C'] C7 f� <br />� e� r <br />� <br />H O Cyi� <br />i <br />r_� <br />fhB E'erorcen <br />CITY OF <br />everett <br />BUILDING DEPARTMENT <br />259-8870 <br />� <br />APPLi1.dTION �OF3 CONSTR�l�°TiON <br />PERMIT <br />TO BE COMPLETED IN INK — PLEASE PRINT <br />- ? /�.�` V%. <br />� <br />No,v� - <br />APCMRECTQA�ESIGNER MFILApDRE55 C4Y ZIP F��ONE <br />a� <br />VLUTABINGLON1NnC10H fdAIL4D�RE55 CITY ZIP �MpNE LIGENSE� <br />�(/i5nmu.r P�iJJ J� �/3 f�vicm¢: •i�� �7u.�u�:[� �.� l�138 �G�/5�/J1C//lkH <br />C1A550FV/ORN �� <br />❑ NEW ❑ ADDITION ❑ ALTERATION � REPAIR ❑ DEMOLITION ❑ VfOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br />iLNANI IMPROVEMENT O� RrtE WOP AEId00EL OtiLY CON/t/ACT P[FS�N AN� PNONE NO // <br />CONiPFCTPNICE0FIYORK ��G CC%% ta . _ li � � • .�'—(/Yq'�`• ��� � � <br />TCI7PN„��Ti�i7U � <br />e <br />LOi BLOCrc 0� <br />vROJEG1A00��E55 ��� � � � <br />?� ��1 -c_! �7� `J� <br />PLU�ABING <br />NO. TYPE OF FIXTURE OR ITEM ` FEE <br />WATERCLOSETITCILEn <br />— — _ ._..__..___'—_.__._ _._ _ <br />BATHTUB _ " _ _ _ "' _ ' . _ <br />LAVATORY �WASH BASIN� <br />SHOWER <br />I KITCHEN SINK 8 DISP. <br />DRINKING FOUNTAIN <br />FIOOR DRAIN <br />_RAINLEA�ERS <br />.— BAR.ETCI <br />ALLOWAOIE/ACTt1Pl <br />nnr-ucnnnn.v.:Cu: __. - <br />SUB TOTAL <br />❑ YES [. <br />FEE <br />1Y <br />f; N <br />5 <br />I HEREBY CERTIFY TMAT I HAVE READ AND E%A�dI N ED TH15 APPLICATION ANO <br />KNON'T.HESC,METOBETRUEANDCORRECT.ALLPROVISIONSOFLAWSAND <br />ORDINANCES GOVERNIkG THIS TVPE OF WORK WILL 6E COIdPLETED WITH <br />VIHEiH ER SPEGFlED HEREiN OR NOT. THE GRANTING OF A PER1d1T DOES NOT <br />PFESU�.�� TO GIVE AUTHORITYTO VIOLATE OR CANCEL THE PROVISIONS OF <br />ANVOTHk N STFTEOR LOCAL LFINPEGULATINGCONSTRUCTION Ofl THE PEF� <br />FORt.tANCE OF CONSTRUGTION. THAT I Ald AUTHOPIZE� BY THE OWNER OF <br />THI$ PPOP.'ATV TO PERPOqId TNE WORK FOR W HICH APPLIC4TION IS IdADE <br />AND I C0�.1PLV WITH THE STATE CONTRAC10R5 LFW 1827 RCW AND <br />29G 200 �YAC. ❑ p <br />^icb�.:.� nrCo'�rpeGto:�nr,.:imroaitFUZG[.i o4tE �Q��-J �/ <br />X� <br />)`l � (7Q- i "a,s,-' <br />awi �/^pc F �'JE'�SCNU. 1D�VSiNE55Nn1.- — <br />MECHANICAL <br />NO. TYPEOFEOUIPMENT <br />-C — A�1IMDLG UNRS — H.P <br />� FORCED AIR SYSTEMS— B.T.0 . �d EA <br />_ UNITHEATERS—BT.U. .d <br />GLOTHESORYERS <br />VENTI�ATION FAN <br />_ _ _' — — <br />_J RANGEHOOD ___ <br />_ � _ WATER HEATER _ _ <br />' WOODSTOVE <br />� fdETAL FIREPLALE 8 CHIld VEV <br />�� PIPEPIACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />� E%HAUSTFAN <br />_ -- <br />SUBTOTAL S <br />VERMIT___ _ 5 <br />w�nniouc FEES <br />YES fl q0 <br />--___. . �UILDING <br />�OOGOW[LIINGUrvi15 _._ ___.—.— _.._._ . . _ <br />PLUMBING <br />�cc �ao —_____ — _—.— _ <br />MECHANICAL <br />�EiG�rtuui*nTiorv OTHER <br />_ ___ - STATE BUILDING SURCHARGE <br />STATEENERGVSURCHARG[ <br />PUBLIC WORKS <br />TOTAL <br />VALUATION <br />5 <br />