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APPLICa.(ION FOR CONSTRI..:TION <br /> PERMIT <br /> the EwtimU, <br /> CITY OF <br /> rvrM•II <br /> everett e <br /> BUILDING 0EPAI7TM[.NT <br /> 2598810 TO BE COMPLETED IN INK—PLEASE PRINT <br /> MNER MAT ADDRESS OIY <br /> ZIP NON[ <br /> �y CQ_usiRu�l101V p.0 . y,?y76(�F.t11`t1lt�,[L7fl-9vQS <br /> IENANT wIL ADDPE84 pfr r <br /> ARCHITECT OR DESIGNER Lit ADDRESS OTY IIP PHONE <br /> OENERAICO Mi TOR - MAIL ADDRESS -- - -CITY ZIP NONE LICENSE. -- <br /> �gleMV OWStRttCT1 <br /> NEON RICA CMIReCTOR wII ADMf88 --------C11Y !IP-----NON[ ,N„'ILTNSE�,,.`A <br /> F�lA18LS _I��t!?t6��t/G_._!'11�- !n� AedU ^ , s'. JYY R/RL �v <br /> M UMMMO CONTRACTOR MAIL ADDIIEB! C. ��- ZIP 87y r� <br /> br RIUNL IKIMSE <br /> aAee OFWpIK — -- - -----'-- <br /> ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODStOVE/FRPL INSERT ❑ SUILDINGBELOCATION <br /> TENANT IMPIIDVEMEM OR INTERIOR RE MY CONTACT PERSON AHD NONE NO <br /> CONTRACT NICE OF WMR <br /> DDISSSCRIBE(�INOOAKKLLAND SQUARE FOOTAGE INVOIVED <br /> PIIDPdfiDuSE OF IUB INo <br /> 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND <br /> �(//m KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVISIONS OF LAWS AND <br /> L1 LOCKRIPT NO PROPfRNISNOWII BELOW OR eIteLHFMRCOMfSI ORDINANCES GOVERNING THIS TYPE OFWURKWILL BE COMPLETED WITH <br /> WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OFA PERMIT DOES NOT <br /> LOT__ III OF PRESUME 70 GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PER- <br /> FORMANCE OF CONSTRUCTION THAT I AM AUTHORIZED BY THE OWNER OF <br /> THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATIOR IS MADE <br /> -- AND 1 COMPLY WITH THE STATE CONTRACTORS LAW 1827 RCW AND <br /> 258200 WAC <br /> MONAIURE O CONTRACTOR M AUUORRED''AGENT DATE /�/ `] <br /> vnnnnAFnNI11 _ !Nr�Cl��2A.W[I11._ l, z—g? <br /> IPPICANI Y ME SI ICENSE NO AND BUSINESS NAME <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) A/C—AEHNDLG UNITS—HP. <br /> BATHTUB FORCED AIR SYSTEMS—BTU MEA <br /> LAVATORY(WASH BASIN _ UNIT HEATERS—BT.U. M _ <br /> I SHOWER CLOTHES DRYERS <br /> I KITCHEN SINK S DISP, VENTILATION FAN <br /> 4 DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL METAL FIREPLACE B CHIMNEY _ <br /> DRINKING FOUNTAIN FIREPLACE INSERT _ <br /> FLOOR DRAIN HEAT PUMP _ <br /> BACKFLOW PREVENTERS __ OAS PIPING _ — <br /> ROOF DRAINS—RAINLEADERS EXHAUST_F_A_N___ _ <br /> SINK(SERVICE—BAR.ETC I <br /> BUB TOTAL E SUB IOTA[ J.Fc-=,P <br /> PERMIT E PERMIT TOTAL FEE S TOTAL FEE FROM SEYMCA REAASEtBM:K SIDESEIBAOK PIAN CREDIT NUMBER FEF M <br /> �A ! <br /> USE LONE IO AREA ISIIE FEES VALUATION FEE <br /> D YES IT NO <br /> POPEOFCMST OCCUPeNCYGROUP NOOFDWEILINGU.RIS BUILDING <br /> ALLOWABLE/ACTUAL <br /> PLUMBING <br /> SIZE Of BLDG HQ OF STORR6 OMT bac_lm <br /> U r MECHANICAL <br /> Il N <br /> HEONTIIMIATON OTHER <br /> FIRE SPRMKLERSREOOIREO OYES ONO <br /> STATE BUILDING SURCHARGE <br /> STATE ENERGY SURCHARGE <br /> APMICATNIN ACC BY BARS APPH BY <br /> PUBLIC WORKS <br /> TOTAL � <br /> �I <br />