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� APPLICATIQ 1 FOR CONSTRUCT )N PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT � <br /> BUILDINGDEPARTMENT HEATINGSVSTEM: i_JGAS OELECTRIC O <br /> 259�8810 <br /> �. � DEMOLITION I 1 COMBINATION I 1 BUILDING i]MECHANICAL i l PLUMBING f i SIGN <br /> ��wwn u�n�ooirc5s cm rn �+�wc <br /> � � /? l t'r,. ,2rn �>z�7 C=U �i�z�,C = S%" `�3S`/ <br /> rEr�+wr ru�a�oon�s's un tm cwvc � <br /> �� /A� /_�tiS��.45F��� <br /> •nc�rz�aanocs�r.ven u�nww+�ss cm zm '+�a¢ <br /> �_"l�' <br /> r.irrzau<arnF�u:� n wa�ooncss cm nv vrdc sr�*EiwcrrsEr <br /> MfC���NLKI".[»�R�L�On MAI�ppPESB f.T ZIP WI]NE 61�R1�C[NSt� <br /> P:;M9M6CWiPltiql M14�Cp1E53 C�LY dP iNOME 6i�tELCENSE� <br /> CWTAAG v'�[E Of WaPx <br /> r� (\ <br /> ) <br /> DESCFR MOnR 6 i��CfO�1.bEM1RVCD�-? , / �(.<- CONI�CiMRipIiWOMIJNEIq �A ' 'I <br /> �7 �� �/ / � _ _ U I/�///S(1��J _ <br /> . �iL./-" dL�K'7iO.US / Ck�.0 E. � <br /> _� <br /> I MEREBY CERTIFY THAi I HAVE fiEAD AND E%AMINE� THIS <br /> PipFO5F0USEOf&0.UM6 APPLICATION AN�NNOW THE SFME TO 6E TRUE AND:ORRECT ALL <br />� PROVISIONS OF LAWS AND ORD�NANCES GOVERNING THIS TVPE OF <br /> �auo[un�vipnp�rrqrean;sMowHeciavonuiuv*rrocor[s� WORK WILL BE COMPLETED WITH WHETMER SPECIFIED HEREIN OR <br /> kOT. THE GRANTING Oi A PERMIT OGES NOT PRESUME ip GIVE <br /> ��� �� � AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> 7(�� Z ���,_f� _- _ OTNER STATE OF LOCAL LAW flEGULATING WNSTfiUCT10N OR iHE <br /> �/ PEI7FORMANCE OF CONSTRUCTION.THAT I AM AUTNORIZED BY THE <br /> OWNER OF THIS PROPERTY Tp pERFORM THE WORN FOF WHICH <br /> Pexnr,uioxwBw APPLILATION IS MADE AND I CGMPIV WITM THE STATE <br /> CONTFACTORS LAW 18T RCW AN�296200 WAC <br /> CONSINVCi1JNlO�NIINCP.�00FE55.1RE�MOYENUMBFR ^� /r / <br /> % �/ f.L'c� �� �4- f� <br /> PPOJEf.'T 11DDRE55 ��� �'O� <br /> ,��jC�,t LNL��--i .�. __ <br /> PLUMBING MECHANICAL 4 <br /> NO. TYPE OP FI%TIIRE OP ITEM FEE N0. TYPE OF EOUIPMF.NT FEE <br /> WATER CLOSET�TOILET� A�A NNOLG UNITS—N P. <br /> BAiHTII(1 FOiiGE0AIR5V5TEM5—B.T.U. M EA. <br /> LAVFTORV(WASHBASIN� I�NITHEATERS-07U. M <br /> SMOIYEN CLOTHESDRVEFS <br /> NITCMEN SINK 8 DISP VENTIlAT1041'AN <br /> DI�NWASHER RANGE HOO� <br /> LAUNDRV TRAY WAT[R HeA?-R <br /> GLOTHLS L'1r15HER WOOD STOVE <br /> U�In�AI METAL f IREPLPCE�WOOD BURNING) <br /> URINKING FOU6TAM fIREPIACE INSERT <br /> FLOOIi�RNN HEAT P�!t° <br /> OACkFLOW PREVENiEAS GAS PIPW(, <br /> RUOF OHAINS—RAINLEALFRS E%HAUST FAN <br /> SINK�5'flVICE—O�R.ETC.) <br /> SUB TOTAL E Sl1B TOTAL § <br /> PERM�i S PERMIT S <br /> TOTAL FEE $ TOTALFEE S <br /> FOR OFFICE USE ONLY: �Id�I 9X <br /> i0.'W15LiMCV PE�FS[IP�CK STESEi9�LN PWiC4ELNVL'MIiEP If[ NELFiP NO / <br /> �,��,�� ��s�� ia� � �ovs� <br /> �usr. iounce veuetsrtE FEES VAWRTON FEE/ <br /> _ C� YES .lFO BuaDING _�gt/ '�. <br /> iYRlYC0451 HJU1'SiOqIES rtfe���'• ]dLV.f�IKu\.�6 — I <br /> Z Z rwuen+� 3 v., <br /> �- .� ti'� <br /> SV[�N&W I�RESeHIKKlCR5RE09 BA�S�"SNi MECNRNICId <br /> `J�v . I. �Y5'> �CVES i�. NO <br /> OCNPANOtOAp fIflFUARNfllOD �I[bNiUYIUlIW AODIiIONALPUqLNEGX <br /> �a'i' T.l� orHea <br /> aE.� _ : <br /> ���J��,� 51ATE BUILDINO SURCHARGE _;1 <br /> nuacer w.ns�vew� oer �ITYOFEVERETT au�ucw0aK5 <br /> .^�23�93 LOCAL S4LE5 <br /> i�re TAXCOOE153105 rore� — <br /> � ' . <br />� _ <br />