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� APPLICATIa.: FOR CONSTRUCTi.JN PERMIT I <br /> � TO BE COMPLETED IN BLACK INK-PLEASE PRINT �' <br /> � � <br /> � HEATINO SVSTEM: U�AS ❑ELECTRIC ❑ <br /> `� BUILDINO DEPARTMENT <br /> 259-8810 <br /> � CI DEMOLITION i i COMBINATION i I BUILDINQ I I MECHANICAL I I PLUMBIN(i l I SIQN <br /> i p / MAILAODRE69 CITY 21P P1qNE <br /> � �1I/✓r/ S� C�41✓ y7/�. ' �/c.r �t/ 'l 2 S Z' `�l 7 U'L <br /> h�(� MAR110DRE59 CIfY ZIP PMONE <br /> � <br /> '� 11RCNITECTORDEBIONER IMIL�DDRESS CITV IIP PHONF. <br /> OENEPALCONTMCTOR MAILADDNES9 CITY 21P PHONE Bi�TELILEN9E/ <br /> MECWWIC�LC TBACTOR M�RMDHESS GTY ZIP PIKKIE SiQEIICENSE/ <br /> A�.w•Wn�.,.���- �� 3lio - N4!/ .trc .F-�r Sfzoi 7cs•5-�f, ,v�.�/,�! !os �ra I <br /> pIUMlMOCONTpACtOR MMLADORE55 CITY 21P PIIONE BTATELICENSE� iI <br /> �' <br /> CLA6!OF WORk <br /> I' NEW I I ADDITION I I ALTERATION I I REPAIR I I DEMOLITION I I WOODSTOVE/FRPL INSERT I I BUIL�INQ flELOCATION <br /> I, n-� C.oNUCT PEnSON ANo rIqNE rro <br /> �I CONTMC7 Pf110E OF WORN ���� � . <br /> �� pE�WOIIII AN�BOUARE FOOTA6E INVOLVED <br /> I-t+s�ru« �•,s Fa,.•�,1��� <br /> '' naroe[oueEOFwaora i HEREBY CERTIFV THAT 1 HAVE READ AND EXAMINED THIB <br /> �� � `i APPLICATION AND KNOW THE 3AME TO BE 1RUE AND CORRECT.ALL <br /> uoKo[ecn�rrqaacrarenr (SMOWNBELOWOR�fiACNfWRCOF�EB) PROVISIONSOFUWSANDORDINANCEBOOVERNINOTHISTVPEOF <br /> WORK WILL BE COMPLETED WI711 WHETHER SPECIFIED HEREIN OR <br /> �� �or xacK oF NOT. THE ORANTINa OF A PERMIT GOES NOT PRE9�IME TO OIVE <br /> !� AUTHOHITV TO VIOLATE OH CANCEL THF PROViSI0N3 OF ANV <br /> j j OTHER STATE OH LOCAL LAW REGULATINO CONSI�RUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORI2ED BY THE <br /> �7 OWNER OF THIS PROPEHTV TO PERFORM THE WORK FOR WMICH <br /> APPLICATION 13 MADE AND I COMPLV WITH THE STATE <br /> �� CONTRACTORS UW 1827 RCW AND 298.200 WAC. <br /> � moxcieoonEes ! / X I«"'"'—�/ �� ��� �� <br /> ��u� wic <br /> �' � 7� � ✓ G✓I cnrwsr+[u�wEMaExo il <br /> � Kyy�p MECMANICAL <br /> I ND. T11M OF Fl7ITU11!OII REM FEE N0. TIPE OF EWIPMENT PEE <br /> WA7EH CLOSET(TOILET) � A/C—NHNDLO UNITS—H.P. � <br /> BATHTUB ' FOFiCEO AIR SYSTEMS—B.T.U. M E.A. ' <br /> i UVATORV(WASH BA31N) � UNIT HEATERS—B.T.U. M � <br /> � gHpyyEq � CLOTHESDRVERS � <br /> � KITCHEN SINK 8 OISP ; VENTIUTIUN fAN T_ <br /> � OISHWABHER � RANOE HOOD � <br /> � LAUNORV TMV ; WATER HEATER ' <br /> If CLOTHEB WASNER � WOOD BTOVE � <br /> " �qry� � METAL fIREPUCE 8 CHIMNEY � <br /> (� DRINKINO FOUNTAIN � FIREPLACE INSERT � <br /> �j FLOOR DRAIN � HEAT PUMP � <br /> r� BACKFLOW PHEVENTERS ; OAB PIPINa ' <br /> !; ROOF DRAINS—MINLEADERS � El(HAUST FAN � <br /> �� SINK(BERVICE—BAH.ETC.) ' ' <br /> s ' <br /> � � � <br /> i� ' ' <br /> ; <br /> , � <br /> , � <br /> , <br /> SUB TOTAL S ; SUB TOTAL f ' " <br /> '�I � PERMIT { � PERMIT S � � <br /> •� TOTAL FEE S ' TOTAL FEE S ' � <br /> j FOR OFFICE U8E ONLY: <br /> i� FIIOHTlEI�ACK REMBETBACK BiDEGET&1GN PIANCNEGNNUMBER fEE pECEIPTNO. <br /> � <br /> .i utczare �otu�e� v�currsire FEEB VALUATION FEE <br /> BWtoINa � <br /> ' IY1EOiCONfl.AILUNIWF t1'VFOfCONS1.ACTW�I oavrurtr iaaow[wxouxin i <br /> � �� � PLUMBINO i <br /> , /II[pfllp0. NOOi8TO111E8 BA6CMEN7 MECNANICAL <br /> � <br /> ' OCCUMNCY LOAD FINE BVRNRLERB REdO HEIONT LIMIil17qN ADDITIONAL PLAN CNECK j <br /> � <br /> � 1 <br /> � _ $PRINNLEit ' <br /> i <br /> ' IIEABONFON6iRMMtLER9 --�— <br /> � STA7E BUILDIN(7 5URCHAHOE i <br /> i MNfE�y PlANBMPROVEDBY CITY Of EMERETT pUBIIC WOHNS j <br /> �ocu s��a <br /> TA)I CODE IS�106 roT�� ; <br /> �....... ,.,,,,, . . - , _ -•�.... ..� <br />