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APPLICATIC"`1 FaR CONSTRUCT'lN PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT �i:• <br /> BUILDING DEPARTMENT L F�EA71Nr,SYSTEId: /J GAS J ELECTRIC J _ ___---------� <br /> 259-8810 <br /> DEMOLITION COMBINATION a'BUILDING /MECHANICAL "�LUMBING SIGN <br /> ow!�rr{ ,/ -- uni�nonn[ss —_—_--- orv .iv rHo�ie <br /> �,(1 ( I'E�QGi� 7o�i.6T ._ � /L/lY� l�� r..�e - °Ihac. SflCl � (�/.��— YSYi! <br /> TFN4N1 ` AIAII ADI1Nf 5: GiV jIP PIIONE <br /> / 0��/�r`'�" ���n � <br /> �RCIIILE'T Ofl DE$IGNER MAII RODNESS CIiV jP p��pNS <br /> GfNERALCONiqACiOR MAiL�ODRE55 pTV 7P PI�CNF SiQELiCENSE� <br /> cc,' r�y r ,,,cr :�lc�i y,;rrf ¢�.� �rl�e l i5�� z-I `f�i—��syy u�� r��<< lvsyvn <br /> MFCN CALf.pNTPACiOR M41�,RL�9E55 C�TV IIP PHONE �r—SiATEL�CENSE• <br /> _��v /-��'� t- �;3 -6 s 6 7 <br /> PW iNS'j,FONTqqLLCR A1RILqODRE S GiV ZIP PNONE ST�TEIICENSE� <br /> ��en /'-vnlh4.��-F�v�h _ _ ��b--2.i 3S� <br /> C(N�iRACi PRICE OF WORK <br /> OESCRIBE WOR1'AND SOURRE F00[ROE INVO VFD CONf�s t P[9s ON ANO P1�ONE NO <br /> � lZCal�—L i.7f/f� '�/C�/'�/�u _ <br /> � S L �/l/C1 � <br /> / <br /> i HEREBV CERT�FV THAT I HAVE READ AND [XAMINED THIS <br /> rnoaoseu��seov emioiNc � . AP?LICATION AND kNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> 5/���� �� OL'�.� ' PROVISIONS OF IAWS AND ORDINANCES GOVEfiNING THIS TVPE OF <br /> iecni/o(e(scniataNOFraorenTvisirowNeeiowoenrtncN*wocovies� WORK WILL BE COMPI.ETED WITH WHE7HER SPECIFIED HEREIN OR <br /> ior—�— ewcK�1�-- or NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ���Q�. v T ,' �l AUTHOFITV TO VIOLATE OR CANCEL THE PqOVIS10NS OF ANV <br /> ��^ /�tLJ-S � U OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFOR�IANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> 1�..�'Z S�.p� � OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> �1-- APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> '�gRCELT�XIC NI/MBER' <br /> '> c � CO TORS L W 1827 RCW AND 296200 WAC. <br /> —1 � <br /> CONSiFUCTIONLO�NIEN E �DDPESS.TE/EPNONEN111.IPER ��� <br /> y_6-y� <br /> PROJECT AD E sc�v� �ni "" --- -i���� <br /> ��� urvousatPsu�e.��i vn <br /> PLUI+IBING MECHANICAL <br /> N0. TYPE OF FIXTURE ON ITEM FEE N0. TYPE OF EOUIFMENT FEE <br /> � WATER CLOSET(TOILET) �) A�C—A�HYDLG UNITS-!LP. , <br /> BATHTUB FOPCED AIR S�STC�dS—B.T.U. M E.A. <br /> LAVATORV(WASH BASIN� O UNIT HEATER'.�—B��.U. M <br /> �- <br /> SHOWER CLOiHES DRVERS <br /> KITCHEN SINK 8 DISP VENTILATION FAN <br /> GISHWASHER RANGE HOOD <br /> LAUNDRYTRAY WATER HEATER <br /> � CLOTHES WASHER _ �� WOOD STOVE <br /> �L ,URINAL METAL FIREPLACE(WOOD BURNING) <br /> DRINKING FOUNTAIN � FIREPLACE INSERT <br /> FLOOR DPAIN � HFAT PUMP <br /> BACKFLOW PREVENTERti ; GAS PIPING <br /> ROOF DRAINS—RAINLEADERS T EXIIAUST FAN <br /> - SINK(SERVICE—BAR.ETC.) ' <br /> —T — <br /> ��� � �.�L_._ <br /> _ __ SUBTOTAL $ SUBTOTAL $ <br /> PERMIT $ PERMIT $ <br /> TOTALFE[ f TOTALFEE $ <br /> FOR OFFICE USE ONLY: ' G (p <br /> IR011i5(1dACK IIEMSFItlRCN / Slp[SELOAL% PIANCHFC NIIIAHEP GEE -l1 RFCEIPINO <br /> �r � 2 l `!" /.3 <br /> � <br /> usE jc�r+E�� �oi aaEa � vncnNr srtE FEES VALUATION FEE <br /> � � VES � NO BuitOiNc y/ <br /> IYfe Of fON51 VO Jf SLONI[5 irr,in�rcr xc rn t�xt rw�.�..•s -- � -'---"--- --��-�� �. 1� <br /> �'/J I Lq.3 � PL1IMBIIJG 7� � � <br /> _'_ /� <br /> SIZE�ID RRFSPRINKIfRSHE00 BASEMENT � — <br /> 12 �f t VES Vry0 MECHANICAI ��O � / <br /> _�S�GAn — <br /> OCCUPApCVIVAp FlIILALARMREOD HEIGMiIIMItAL�pNJ A�DI?IONALPLANCIIECK ��-- <br /> �(1 ✓ ` __ , _-__ <br /> C�CJ O7HER �,(�� ip �nc� <br /> �F�S�N —__��! <br /> S7ATE BUILDING SURCHARGE - H : �=J <br /> -_ .__ .__ . .. .._" '--_- ___ — <br /> nua�ec.r ���Hsnrri��l���m CITYOFEVERETT PUBLICWORNS • � � ��` � <br /> LOCAL SALES <br /> r�.rr 9 TAX COUE IS 3105 TOTAL <br />