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�� � Ii <br /> � �'' APPLICATIGnI FOR CONSTRUC7 .ON PERMIT � <br /> TO BE COMPLETED IN BLACK !NK—PLEASE PRINT <br /> L ._ _ _-- -- ._ _ — __ <br /> HEATING SYSTEM U GAS J ELECTRIC 'iJ ___ . _I <br /> BUILDING DEPARTMENT � --�-�----�-� - �- <br /> �59 8810 ,,��"" <br /> DEMOUTION COMBINATION BUILDING �'�mECHANICAL PLUMBING _ SIGN <br /> I�\•'�lll I.IpIAIII]IiI:S ITY - y~ 1'1(1NF <br /> N�� ����-�?���sL -����� �n-�,-lt-I ��C�i�I ��;:(' I �,�.��`,T--l1 �'�, — � <br /> �� 111�ANi 4AIL�DUI1E55 LIIY lIC 1HONE <br /> Q � ��GNRECIORDESKNER M��I�DORE55 CIiV IIP FNONF <br /> ��� GrgtP�LCONiRACTOR �AML�O�Rf55 CIiY ZIP PIIONF Si,1(C LICEHSE� <br /> R�I:CNRlICQC�n��CTOfI MN��D�R[55 � CIiV P1bNE SUTfIIC[NSE� <br /> ��� `7l�UF l'XAM��> 1'CRnhle� AI�P_ (� (�F�� il� � �-��_�. �p �Si��J�`�.��— <br /> � i��.ur�eiNccor�rry�c*on� r.u�:�ooaess cirv m� r��a+c s�e�uiccH� r <br /> ��e _ -�J -- <br /> f1AS50f WORN Y <br /> p M NEW ADDITION r`AITERATION REPAIR DEMOLITION WOODSTOVE�FRPL INSERT BUILDING PELOGATION <br /> '0 O /y^� coN(1 i renso�+eraorno�+r No <br /> p p' c[INLR�CT PPiCE OF W011h �` �- �-�' ' __l�� l-�_.� \�-�-�� - <br /> M �(SC/RIOE WORN�NO SOUME fOO�GE 1NV V[P� � <br /> y �r�M NOT (�.�/�Yr1:�An/IC � WA�Ne/� 7h P \ <br /> '�'��� rnoros[ouseoreuavinc I HEREBV CERTIFV THAT I HAVE READ AND E%AMINED THIS <br /> � -� y APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> � ��CZ y.u(� J LC �� <br /> ieeuoescnir*���or[nrvis�wvmnetowoa�i ncHrounc �es� PROVISIONS OF LAWS AND ORDINANCES GOVFqNING THIS TVPE OF <br /> � -- �_n.` ' YlORK WILL BE COMPLETED WIiH WHETHER SPECIFIED HEPEIN OR <br /> �ot A�a• a' NOT. THC GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> � � / L,O ( S '=Y-� I j} AUTHORITV TO VIOLATE OR CANCEL iHE PROVISIONS OF ANV <br /> . • � ��,R T; ' . ` �-f� � OTHER SiATF OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> -}� ' 1 � ['� PERFOFM�NCE OF CONSTRUCTION.THAT I AM AUTHOR12ED BV THE <br /> 16O/�� 2 (, /v0 ` /G� ��ti'`<<� SL.�."�M_ ��P���F�HISISRMADETA DPECOMPLVHEWIT�HKTHOERSTATE <br /> CONTRACTpHS LAW 18[7 W ANO 29620D WAC <br /> � / n <br /> '�'j -- --- M` ! . __ _ -. <�C �l..,.c.X �/ '�i� C i�� <br /> � rcna�ecr nonnes, �+ ..-'"��°. ' � �."„� <br /> �] �C� E ����_.', A;�P ��L�K� � – ���J,��;�.�- —� ------ <br /> i ' PLUMBINO ECHANICAI � <br /> I C NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> �; WATER CLOSET(TOILETI � A C -A HNDLG UNITS H P � <br /> —�— -_. _. ____-______-_._____.�___ . _-__. -___�-.. <br /> 1 � BATNTUB ' _ FORCED AIR SVSTEMS�_I3 T U.__M E A. _ <br /> � LAVATORV(WASH BASIN) - --r UNIT HEATERS-B?.U. M <br /> � SHOWEP CLOTHESORVERS <br /> ��' ` <br /> i ��' _ VENTILATION FAN _ <br /> HITCHEN SINN 8 DISP ._ <br /> DISHWASHER ) RFNGE HOOD <br /> � LAUNDRV TRAV WATEfi HEATER <;r7 <br /> � _ -/___. _ �-_�- <br /> � I ,�� CLOTHES WASHEP -- WOOD STOVE <br /> ��1 URINAL METAL FIREPLACE 8 CHIMNEV <br /> DRINNING FOUNTAIN FlREPLACE INSERT I <br /> T <br /> FLOOR DRAIN H[�T PUMP <br /> ' '�' BACKFLOW PREVENTERS � GAS PIPING � <br /> _ _--__ __-�_- I <br /> ROOF DFiAINS-RAINLEADFRS E%H�UST f"AN <br /> SINK(SERVIGE-BAR,E7Q) � <br /> _—r____ - I <br /> �_ '_ _ — - - - -- __ —-__'T__. i <br /> �►' - _ - - _ _- -_�"'_- I <br /> � SUP 70TAL b _� ��- SUB TOTAL 5 _�v ; _ II <br /> -�- � PERMIT $ � II <br /> PERMIT 5 _- __. �__----__ ___. __ . . _ __-_ _�_:-__._ <br /> �1� TOTAL FEE E V - TOTAL FEE S y S I <br /> FOR OFFICE USE ONLY: <br /> _ _._.._ __—_ ----- <br /> rNOHiSfrnnrM i�lAnsrtORcx S�nEtiUpni.r Y�nHC��If.kNun�lu�� �It nlcunruo <br /> � � � �7 <br /> use�iart�- - �ai nau ver.�m sm -- � FEES VALUATION FEE <br /> HUiI UING <br /> iv��O�CONfS AIIOWABIE ��PI Oi LOqSt�CIIIAI rcrm�x�� en i� �.. .. . -- -- � - � �� <br /> vcav I'I UIdCING � 'o� <br /> 54EOLBL00 NOOFSTORIES flASFMENI �,���;��pNICAL � <br /> _ � _ <br /> [KLUF�NfVL0�0 RfiESGi1NNLFRSHEOD I�EIOH111MilAuoh <br /> n11PI1ION�LPLANCHICK �/ � i`��' <br /> _'_'__ ::PRIHkLfA �� <br /> P[�SONfOPSPRINNlE�S � - - � � I <br /> s1All PUIIUINGSlII1CIlAl1,1 �I <br /> _ . .._ __ _. _ ... _ . .._.. _._.�-_ , <br /> nrtn�Fnv- - �-��--- -dinr�snFruuvii��rv CITYOFEVERETT r�uniicW.�nkti � <br /> LOCAL SALES • <br /> TAX COOEIS 3105 rorn� ;�� � ' <br />