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r;�•'� i <br /> APPLIC1aif10N FOR CONSTRI��:T10N <br /> PERMIT <br /> fhB fYB�Q�B9� <br /> CIiY OF �•��'��`�� <br /> everett e <br /> BUILOING DEPARTMENT <br /> 259-BB10 TO BE COMPLETED IN INK- PLEASE PRINT <br /> im„—rn uui�mmi.,s �.u� nr riuna�. <br /> _�LIETCo -------/7o/S /S'�'/}�4 N,�. _ _ SRftnR _ �/8�3T _ 763 'c�?1 � <br /> �EN�NI MAII�I100F55 Cllv !IP PIIONE <br /> MGM�iEC�OR0ES10NEP M�Il�OURE[5 Glr IIP FIIOHE <br /> O[NEPIlLON1O�CtOP M�II�DORESS CIIY Z�� ���ONE UCENSE• <br /> 4FGN�NIG�IGONIneL�O� MAII��ORE55 CItY 2�� PIIONE IICENSE• <br /> _ _—."--_- .__ _ .. ______._______—___'_________. <br /> PWMPINOLONIfUG�OR MAIL�ObfiF55 Giv )IP PIIONE �IGENlE• <br /> �¢ ► I PLv.v w /va-��—P,---- -SyO�"''"'�� - 9`�J`��- --�if�4d>> �RrrP��H <br /> aessorrronK - - - � - ---- - - - - - <br /> ❑ NEW ❑ ADDITION ❑ �LTERATION ❑ REPAIR ❑ UEMOLI110N ❑ WOODSTOVE/fRPL INSEIIT ❑ OUILDINO RELOCqiION <br /> IEHANI IMPNOVEMFHt OR INIE111011 PEMODEL ONLY f.OHUCI PI1140H Mlfl PIIpNE NO <br /> CONIP�CI PIUGE Of WORK <br /> OE'JCRIBEWONR�NDBOU�REfOOGOEINVOIVED -- --- --�--"-- —�------ ---- -- -- <br /> �UM����- <br /> rnoroseo us[or eunoiHa I HEREBY CEATIFY TIIAT 1 H4VE 17EAD AND E%AMINED THIS APPLICATION ANU <br /> KNOW THE SAME TO BE T riUE AND CORRECT,ALl PROVISIONS OF LAW9 AND <br /> ifo��OEecRirnoeorrnol�Entvi&�owNOE�owon�tlAW�founLonE9� - ORDINANCES�OVERNWCTNISTYPEOFWORHWILLBECOMPLETEDWITH <br /> WHET:IERSPGCIFl[DIIF.R[�NORNOT.THE(iPANTIN00FAP[RMITDOESNOT <br /> PiiESUME TO f IyE AUi HOAI IY Tp VIOLATE OR CANCEL TME PROVISIONS OF <br /> �oi__ eiocK o� - ---- ANVOiHE�i51ATEORLOCALLAWREGULATINGCONSTRUCTIONOfiTHEPER- <br /> FORMANCE Of CONSI{7UCilON iHA1 I AM AU7110RIZED BY iHE OWNER OF <br /> 71115 PqOPER1V 70 PERFORM THE WORK FOR WHICH APPLICATION IS MAOE <br /> -- ---- AND I COMPLY WITH 7HF StATE CONTRACTORS LAW 18.27 RCW RND <br /> 2DG 200 WAC � /� � <br /> SINNt11n1 p1 CON101CInpp11q1111�NiVfO�CENf OUE � <br /> __— _ _ .. ___ <br /> e I <br /> - - _. __ . X,�,v4...C��u---�Q����Gsc�.��•. i <br /> �OJECf�ODRE93 �� �� 11'1•IIC �FUIYpUSWfF5111,�NSENO�NI111U3WE44N�ME � i <br /> �OGq / /? �" # Z <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF FIIITURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATEF CLOSET(TOILEn _ �Z U (� NC-A/HNDLG UNITS- H P I <br /> __.--___ _ _.._ .__ . . . . . __ . _ . __ -._- ___.--_ _- <br /> � BATHTUB I� LJ � fORCfDnin :v51EMS- B7U MEA <br /> _ _ _ _. __..___. _ . .. _.. __-_ <br /> a LAVATO�iVIWASHBASIN) ' Z(� C(�j UNIt11PotFR5 -PtU M __ _ _ <br /> 9HOWER �-- - CLOTIICSDRVERS ___ _ .___._. _ __ _ — I <br /> KITCHENSINN6D19R . _ �(� VENiIINIONfAN _ __ <br /> DISHWA9HER _...gv. I7nN(i[Hnpp _ __ I <br /> LAUNDRVTRAV _��- x WAIERNF.NFfI . _ J�� _ _ I <br /> CLOTNES WASHER WOOD StOVE <br /> URINAL MEIAI.fIREPLnCE d C111MNFV , <br /> .__'— _ . . _ .. . . ._ —___ — <br /> DRINNINO FOUNTAIN �IREPL�CE INSERT i <br /> '--___ '__ __-__ __"'_ - .-_ __ _-_— <br /> FLOORDRAIN �iE�tPUMP � i <br /> —. _-.-_— -'—_ _. ___-_ _. .. . . . . _ _-.. -_.- .— . <br /> BACKfLOW PNEVENTER9 GnS PIPIN[i ' <br /> _- _ .__--._.. .__— — I <br /> ROOF DRAINS-RAINLEADEqS ExH4U5T f�N <br /> SINK(SEFVICE-BAR,ETC.) <br /> _ _.._ - __- _-_ __._ __-_—__ — <br /> .- _ _-_._. ._--___ ..___.. —_ _— _- � <br /> _ _ _ ________ _ I <br /> SUBTOTAL S._ ___�.1.5 �_.. __� � � � � �� _SUO70TAL S �� lj�_ . <br /> __ -. — __ .. . <br /> PERMIT S PENhili S �_ <br /> _ _-- _. _. _—.. .-- ___. . __ . ._.____.--__ . __ <br /> TOTAL FEE S TOTAL fEE S ( , <br /> f1pN19EfB�CM RE�OSEIO�CM SIpE5fIPACN PLAMCBELKMUMBEII fEE 11[C[IP1M0. <br /> U4E10NE �o�enee----- v�ceHtsnc FEEB VALUATION FEE <br /> n YE9 ❑ NO — <br /> -.. _ __..__ __. <br /> BUILDINO <br /> IYPEOiCAH91 OCCUP�NCY0110UP NOOfOWElLIN0U111�5 __- ._ __..__. _ . _ . _"___ _ <br /> �«�.a��,.���.� ���Ma�No - — -5�5 co <br /> SVEOFBlD6 NOOf810R1E3 BSMI OCClOnO � <br /> ❑r MECHANICIIL . _�L� [,Q_ <br /> flN _._.__' —___"..._. ..—_ _ _-- _— <br /> ___._--- _ unaiaTiMitaioN-__— OTHEA <br /> fi11F5nqINNlER9PEW�REU ❑YE8 ❑NO <br /> __.. —__ _ ._. - -_ . S1AffBUILDINOSURCIIARG[ <br /> STAtE ENEf1GV SURCIIf.fU7F <br /> .__ _ _ _. __ . .. _- ___.__. ._ . . _ __ '____' _'__'_.- __ <br /> m�ru� �nr.�u��i. n4 �v�nNS�nvn P� . <br /> PUPLIC WORNS 1 , �1 <br /> TOTAL w <br />