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APPLICATIO�ii FOR CONSTRUCT.JN PERMIT eVefe1� <br /> �E���� TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CIiV Oi <br /> eve ret� HEATING SVSTEM: O GAS O ELECTRIC O —� <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING MECHANICAL �PLUMBING SIGN <br /> OVRlER M�ILADDRE55 GLv ZIV PHONE <br /> �FK l���N ��3oZ ,s-i�"g�.�e &�,q 98oiL �rSi-iySi <br /> TEN�NT MAlll100RE55 Gliv 21P PHONE <br /> �RCHITEGT OR DE5IGNER M1111 A�DRESS GTY ZIP PMONB <br /> OENEHAL CONiNl1CTOR MAII�DDPESS CRY IIP PHONE UCENSE� <br /> MEGH�NIL�L GONTR�CTOR M�IL�DURE55 CIiV ZIP PIIONE LILENSE� <br /> PIUMBINaCONTR�CTOR M�IL��ORE65 CITY 21P PN"NIE IICENSE� <br /> �K iN� �o i3o� �.,�tir N✓rk 9go7� y8� -09s�' dMr�,��`ics�T <br /> cuss or wonK <br /> �CNEW � ADOITION ALTEHATION REPAIR DEMOLITION WOODSTOVE/FRPL INSERT �. . BUILDINQ RELOCATION <br /> fONT�CT PE1150N AND P'H"ON��E NO 4nn O7S D <br /> CONTR�CTPNICEOFWORN WO.QUU .�f✓G QKfT� / "� <br /> pESCqIBE W011K�ND SOWRE FOOTM'•:INVOLVEO <br /> anovorseouseoFeuaorca I HERE.BY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> I,7 -4"v'r �CgRTr�•� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.AU. <br /> lEOAL DE6CRIPT�ON Oi PNOPERTY ISNOWN BELOW OR Att�CH FWH C071E51 PROVISIONS OF LAWS AND OROiNANCES GOVERNINO THIS TVPE OF <br /> WORK WILL 6E COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �ot aiocK or NOT. THE 6RANTING OF A PEHMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PHOVISIONS OF ANY <br /> OTIiEfi STATE OR LOCAL LAW REOULATIN6 CONSTRUCTION JR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHOHIZED BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOP WHICH <br /> APPLICATION IS MADE AND I COkPLV WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> SiONATUHE CONTR�CzORORAUTIqRREe0AA�0ENT D�TE �/2,6/91 <br /> �/� r_" <br /> PROJlC��DDRESS X o 13 v 37 LL/TF ��: _ <br /> ,9 �O �,, �As�,o ua. a 1�' � � �P��"�NTSCIiYBUSINES"�IICEN5EN0 ANDBUSINESSN�ME <br /> PLUMlINO MECNANICAL <br /> qp, TYPE OF F4ITURE OR REM FEE NO. TVPE QF EOUIPMENT FEE <br /> WATEH CLOSET(TOILET) / A/C-A/HNDLG UNITS-H.P. <br /> � BATHTUB ' FORCEO AIR S�STEM�B.T.U. M E.A. � <br /> LF.VATORV(WASH BASM) � UNIT HEATERS-B.T.U. M ._T_ <br /> L f'iHOWEH ' CLOTHES DRVE:RS <br /> KITCHEN SINK 6 DISP I VENTILATION F\N <br /> DISHWASHER FlANGE HOOD <br /> IAUNDRVTRAV ; WATER HEATEP'� � <br /> 1.� ClOTHES WASHER � WOOD STOVE _T <br /> URINAL ' METAI FIREPLACE 6 CHIMNEY ' <br /> DR�NKING FOUNTAIN � FIREPLACE INSERT � <br /> FLOOR DRAIN � HEA?PUMP <br /> BACKFLOW PREVENTERS ; GAS PIPING <br /> ROOF CRAINS-RAINLEADERS EXHAUST FAN __ <br /> SINK(SERVICE-BAR,ETC.) I � <br /> � <br /> � ' <br /> � ' <br /> — � ; <br /> � <br /> SUB TOTAL S ; SUB TOTAI S ' _ <br /> PERMIT S PERMIT S � <br /> TOTALFEE E TOTALFFE S <br /> FOR OFFICE USE ONLY: <br /> FRONT SETB�CN RE�R SETBACK SIDE SETB�Ck PI�N CHEC�NUMBER FEE Hf.CEIPT NO <br /> USE IONE lOT�RE� W1C�NT BRE FEES VALUATON FEE <br /> BUILOING ' <br /> tYPf 01 COHfS�IIOW�BIF 7YR 01 GON51�CNAI ocNww[r Ma a vMi�nc uMrts <br /> '""''P PLUMBING <br /> SIZE OF&DO NO OF 6TORIES B�SEMENT MECHANICAL � <br /> i <br /> OLCUP�NCY IO�D FIRE SPRNNLERS REQO NEIONT LIMITATION AD�ITIONAL PUN CHECN � <br /> _ i <br /> i <br /> OTHER _ _�_ <br /> RE�SON FOR SPRINI(LERS � <br /> STATE BUILDINO SU7CHAFGE ' <br /> _._ � <br /> :NTANEBV PLANSAPPROVE�BV CITYOFEVERETT PUBLICWORNS �� <br /> LOCAL SALES <br /> TAK CODE IS 3105 ior�� <br />