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APPLICATIC ! FOR CONSTRUCT' )N PERMIT � <br /> TO BE COMPLETED IN BLACK INK-PLEASE PRINT er�n <br /> �_., <br /> BUILDING DLPARTPdENT i HEAT WG SVS7EM. J GAS J�LECTHIC J <br /> , ----------- <br /> ___ <br /> - ------ <br /> 259-88�0 - --- --- -- <br /> DEMOLITION COMBINATION BUILDING UIECHANI��AL PLUMBING SIGN <br /> -- ---- — --— - - -- -- <br /> CYiryPn �A;a� nt'ppES� �, . . __ '_ '_ -__._. <br /> D�• P��ONF <br /> ���T_In�s�s�.J�l� -u���b' ��1C��L_ _�J r GJ� _-��'� 3�- Z 3 Zo <br /> i[NANi I.IAII FVUHf 19 f,I1V !�4' PHOF( � <br /> .._ . ._ ._ _____ <br /> nqCrutCCLORf�[SiGNCF IAALLF�pNFSS f.i�v Ili' ���ONE <br /> G[NERAI CONTqACTOF MFR AD[1RESS CIlY ZiP PMONE SfAtE�IGFNSE• <br /> A��f rC�UN�U�GON�R�C,T R M�II�ODRE55 � _' Q - ),� .."","—/ - I,� ---� 1"� ---' --- <br /> 7`�.� . l � � fW�L.f� Ll /1��Cf�� (�J,n�. srnreiicv�sr.. <br /> �/ +�t-ia1�' �ul[h: � 7_ . _7`�` Q • �`8�' �i �7i//t��t G <br /> PiuMBWGCON1RACiOP IInpDRfSS i� IiF YARLICFNSE• � <br /> -_. .—_. -_._-___ ._._....__ <br /> C::1liqACtpli'Cf.OPW(1NN � � � � <br /> Z a c_____ <br /> ^f SCFIEIE YlORM P U 1;pUAR Pp(iTPGF INVIXVE] --- -- ----- --- ---... -- . -----�-- <br /> ��� /�� � ,iiqi/.Ci Pf PyOry nqli PralrO_ Lq <br /> �C��`J�_S?_!S'�_�OfCG� �l L/�. -- <br /> �(c.�+-,- . ��c�t/� /�'(k2,�,��- <br /> 1 HERE6V CEFTIFY TI1AT I HAVE HEAD AND E%AMINED THI:i <br /> rnovosco use oF em�oiNc APPLICATION AND NNOW THE SAME TO BE TRUE AND CORRECT. ALi_ <br /> ___ PROVISIONS OF LAWS AND ORDINANCFS GOVERNING THIS TVPE 01= <br /> i1G4�DE5CRIPT10NOfPROPER(Y�SMCWNOELOWOf1ATTRCHiWOCOPIES� WORK WILL BE COMPLETED WITH WHETFIER SPECIFIED HEREIN OR <br /> �;��- H�ocK or __ . __ NOT. THE GHANTING OF A PERMIT DCIES I+�T PRESUME TO GN[ <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF AIJY <br /> _ _ CiHEH STATE OR IOCAL LAW REGULATING CONSTRUCTION OR THE <br /> - �- PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV TH[ <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> rn�acF�raxior+un+een '-��-- �� APPIICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONiRA ORS LAW 1 7 CW AND 2 6.200 WAC. <br /> ____- ' �, <br /> CnN51RUCilON I OAN LEN�ER ADORESS.iELLPHONE NUTAf3FR <br /> - ------- �e_ _ _� -- $� ��� <br /> PROJECT ADDRESS � -.-,�-, - - „„�— - <br /> nc2 5lC. n .�, -- ---------- -- - - <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE N0. TVPE OF E�UIPMENi FEE <br /> WATER C!OS[T�TOILET) � AC-A-HNDLG UNITS-H P. ; <br /> ---_._-_ __.__.-__-- ___..______._�__ ____ _____________._______. - _ <br /> _ BATHTUE� ____ FORCED AIR SVSiEIdS- �T.0 h1 EA. <br /> ._—___-___ _ _-_________ ____.. <br /> . LAVATORV(WASH�ASW) ' UNIT HEATERS-B.T.U. M <br /> SHOWER CLOTHES DRVERS <br /> _ KITCHEN SINK 8 DISP VENTILATION FAN <br /> _ DISHWASHER RANGE HOOD ---� <br /> LAUNDRYTRAY WATER HEATER <br /> _ CLOTHES WASHER WOOD STOVE <br /> _ UFINAL M1fETAL PIFEPLACE(WOOD BURNING) � <br /> DRIhKING FOUNTAW FIREPLACE INSERT �� <br /> FLOOR DRAIN HEAT PUMP � <br /> BACKFLCW PREVENTERS r GAS PIPING � -� <br /> ROOF DRAINS-RAINLEAOERS --r EXHAUST FAN <br /> SINK(SERVICE-BAfi,F�G) -�-- <br /> - --T_ - �-__ . <br /> , <br /> . . _ ____ _—� <br /> — _ _______ ._,__ __. <br /> SUF3 TOTAL $ ; SUB TOTAL S ; <br /> ____-___._--_________ . ___ _ _._ <br /> PERM�T ¢ � PERMI7 5 � <br /> _._ _ __.______ _. ____..___ __._ _____ -__ .-_._ ___-___.__-- __._______ <br /> .. TOTAL FEE $ �"�--- , TOiAL FFF --5 �-- -�- - <br /> FOR OFFICE USE ONLY: <br /> _ _ - -- - -- - <br /> ����Nt:eiEt�LH �� PfMtillpA(n h�!)[ Sf_IB�CH 1'IA!lfNfChN/ll]ld[1CR 11I 11FqIPlHO <br /> --" — � /.�,� <br /> ,.�,i :.or+e ioi enen vacnNi srte FEES VALUATION FEE <br /> �c. �.o,.u,�, NO nunOWc � .. <br /> _ YES <br /> ',:IOfCON51 NOOFStOPIES a.C.inu uiMr.uus ... - . - .-. --.-----� -___ _.'__ ___ ... <br /> cxno�. <br /> PLUlAE31NG � <br /> __'—__ -___ - -_—Y_.. <br /> ',VFOFOIOG. fIRESPRiNNLERSREOD BASEAIENi MECHANICAL <br /> ' i. YES i��. NO - .----- --.-- <br /> �� UI'ANf,y�0�0 flRE�VRIA RE00 HEIGHT LIMiIATiON ADDITIONAL PLAN CHECK <br /> _____ <br /> — __ .__ <br /> ..__ _ _.. ...-_._ __ . __. _ O1NLR � <br /> �:�nr;uH . _. .__.__ _ <br /> i_ <br /> Si�Tli BUII�ING SURCHARGF. <br /> . '-_.—__ —'_'___ _ ._ ._".._... l . .__._ _-_-_ '______- _ __'_'..._- � _ . <br /> -,���inv rinri;arr��nvrnnr � CITYOFEVERETT i=ueucwur�r.°; <br /> LOCAL SALES �— <br /> ���� TAX CODE IS 3105 Torn� <br />