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�• � APPLICATIO�t FOR CONSTRUCTIAN PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINI �rr. r <br /> BUILDIN(3 DEPARTMENT � HEnnNG SYSTEM: U Gns �(ELECrAIC U __� <br /> 259-8810 - <br /> �. ❑ DEMOLITION I 1 COMBINATION �j BUILDIhG I 1 MECHANICAL I 1 PLIIMBING [7 SICiN <br /> uu�nooness cnv zin r��oe�E <br /> �ro�,�k lC„� — Aa,,,e„e,� <br /> � ttN�Ni p u�a�ooness cirr nr r�roue ' <br /> . �RCNITECTOADE9qNER M�ILAOOf1EAS CI1Y ZIP PIpNE �— � <br /> �es��N (�.cNs<<I�. �G t�c 13oCe Mu ��t � 9�sa�s '�15-65�i <br /> UFNEHQCONiR�CTOH M�IL��DRESS CIIV IIP PIqNE Si�iELICENSEI � � <br /> , „ 'll�i - II(� 5-r `.'il,J Ev 2P-H 9S(ZO� ���8-0�5� ARMNAC�K i�ar� <br /> ME HANICQ OpN7q� T011 M�R�UD11 / CIIY 21P PIIDNF. SUtE LICENSE� <br /> M � rYt�f�4.hJ ��/�$C ' <br /> PLUMBINOCONiP�CTOR IA�IL�OOf1ES9 CttY ZIP PIqNE S1�TElICENSE� � <br /> � <br /> CONTR�CfPRIGEOFMmIM � � ' � <br /> �sa,�rn . <br /> OESCPIBE Y/OIIN�ND^uOURiE i00U0E INVOLVEO CONUCI PEI150N RNO PIqNE NO y � <br /> _ t-� A w o� I�i'EQ�`_S�_!1� <br /> 3y8-o'7�3 ' <br /> � I HEREBV CEHTIFV THAT I HAVE READ AND ERAMINED THIS � <br /> rnorosEo use ov surtortro �I� ' I_ APPUCATION AND KNOW THE SAME TO BE TRUE AND COPRECT.ALL � <br /> ��^��I�°- ��'�'��I,y �b1.Q_.__ FpOVI510NS OF LAWS AND OHDINANCES 60VERNIN4 THI;TVPE OF � <br /> LEWILOESCBIPfqNOFPROPERTY�SNONMBEI.OW011AIT�C117WOC�IX�'�IES� .��pI WORK WILL BE COMPLETED WITH WHEiHER SPECIFIED HEREIN OR ' <br /> �or� aiceK -- oF ,�.uVu�2lriiLo/�7.l— NJT. THE �RANTIN6 OF A PERMIT OOES NOT PRESUME TO OIVE <br /> AUTHORIiV TO VIOLATE OR CANCEL THE PiiOVISIONS OF ANV <br /> OTHER STATE OR LOCAI.LAW REOULATIN6 CONSiRUCTION OH THE ' <br /> PERFORMANCE OF CONSTRUCTION.TNAT I AM AUTHORIZED BV THE . . <br /> OWNER OF iHIS PROPERTV TO PERFORM THE WOHK FOR WHICH � � <br /> - APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> P�RCEL TAX ID.NUMBEII CONiRACTORS LAW iB.27 RCW AND 296.200 WAC. � <br /> � — <br /> CON9TRUCTIONLOANLENDEP.�ODRESS,7ELEPHONENiIMACfi ryryl�_�yC.�` ,/ � <br /> ,�ASBA ti1Jc .3�m �L�',�ir�� � Jr-�7,3� 97 �. <br /> PROJECT ADORE99 N p.�E <br /> r O LII MNX11951�LLN5f MI . <br /> PLUMBINO MECHANICAL � � <br /> N0. TYPE OF FU(TURE OR ITEM FEE NO. TYPE OP EOUIPMENT fEE ' � <br /> WATER CLOSET(TOILET) NC—AIHNDLO UNIiS—H.P. , � - <br /> BATHiUB ' FORCED Alq SVSTEMS—B.T.U. M E.A. � <br /> LAVATORV(WASH BASIN) � UNIT HEATERS—B.T.U. M ; � .. <br /> SHOWER � CLOTHES DRVERS � <br /> KITCHEN SINK 8 DISP i VENiILATION FAN y ' <br /> DISHWASHEH � � <br /> RANGEHOOD T— <br /> UUNURY TRAY ; WA7ER HEATER ' � � <br /> CLOtHES WASHER � WOOD STOVE ; . .. <br /> URINAL ' ME7AL FIREPUICE(WOOD BURNINO) � � . <br /> � DRINKINO FOUNTAIN i FIREPLACE INSERT � ' �� �� <br /> FLOOR DRAIN —~— <br /> __ HEATPUMP �— <br /> BACKFLOW PREVENTERS i 6AS PIPINO ' �- <br /> ROOF DRAINS—qA1NLEADERS —�— E%HAUST FAN � � <br /> SINK(SERVICE—BAfl,ETC.) � <br /> , � <br /> � — �-. �_ <br /> � SUB TOTAL � ; SUB TOTAL S ' , <br /> PEiiMl7 y PERMIT S � � <br /> TOTAL FEE S ' TOTAL FEE Z � <br /> FOR OFFICE USE ONLY: �(v� C� <br /> FIIONiBETBACI{ REA.BETBACI( SIDE6E�B�CR PL�NCNECKNUMBE iEE RECEIPiNO. -��',','� <br /> �O� ZO ' t � '�<l��a. '/^O. /� /OS 3 I� <br /> usFy�E IOT�IIEA V�C�Nt61fE FEES VALUAiION FEE I <br /> /c� _ �-+ f-I VES f�I NO BUILDINA R O0 ���J ; �0 �i <br /> 1,RaCONst.-- — No of srOn�Es orcunxcr xo atnHi��xaunn 3./ ' `.�,,..'� <br /> ' � A/ Z __I PtUMBINO �� � �[j �.:� <br /> �— r— <br /> 81ZEOFRI FlIIESPRINKLERSREOD P>SGMENT � <br /> i�,o s°� +aAn � �S � � ves �„H MECHANIC�I _ IO� O � oo . " ;.;i <br /> OCGUPANCYIOAD LIRE A�11N REOD IIEqNiLIMQItAiION � i �� ����I <br /> ADUIT IONAL PIAN CHECK <br /> "�� �`� , OTHEA � �p J <br /> RE�SON — <br /> STAIEBWl01NO5URCHAR�E ; "J <br /> J <br /> mreeeev PUNSArr'r+o�oer CITYOFEVERETT rueucwonhs .'�(� � ��;� <br /> ���" LOCAL SALES <br /> oae� Z� y � TAK CODE IS 3105 rou� � � J� <br /> �..r�r <br />