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/��RLICATIC'� FOR CONSTRUCT7N PERMIT (�� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT G�r�s�r <br /> BUILDING DEPARTMENT HEATING SYSTEM: U GAS ❑ELECTRIC f„) _� <br /> 2ss-ee�o <br /> DEMOLITION COMBINATION �'BUILDING MECHANICAL PLUMBING SIGN <br /> OWNER M�IL�DDRE55 GITY ZIP PIqNE <br /> ���nAr�n�a f?o 6�. it4a 4��i 16�� +x� �.,,� <br /> TEN�NT MMl�0�RE5S CII� IIP PHONE <br /> „�.RryCNITELTIRD� ����/�p�pFs7�m��' ITV i PHONE <br /> :��/,y�� vf= ��_ 9�f �f- �3-�t�.-- <br /> —� -i9z <br /> OENER/�L� CONTR�GTOR M�II�DDRES Gi� IIP PHONE 5UTE LICENSE• <br /> `J4LGGcI4/-.� �f�f-' <br /> MECNMlIC�L CONTR CTOR MMl�DOHE55 CITv IIF PHONE STATE IICENSE� <br /> PWMBINOCONTq�CTOR M�IL�DORE55 GTY 11P PHONE SUTEIICENSEI <br /> CUSSOF WOiiN ___ <br /> NEW �. ADDI'ION ALTERATION REPAIR DEMOLITION WOODSTOVEiFRPL INSERT BUILDING RELOCATiCN <br /> �� �� 7J �7� CONUCT PERSON�NO PNONE NO <br /> GONTq�CT PRICE OF WOqN <br /> DESCRIBE WORN�ND SOU�IIE FOOUGE INVOLVED / r. /�' � � 3�3 -SU 7d <br /> \�ltl(�l. <br /> P OSEDUSEOFBUIIDING i HEREBV CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> APP!.ICATION AND KNO6Y THE SAME TO BE TRUE AND COFRECT.ALL <br /> Ea�LDE PIPiqNOFPR PERTY�SHOWNBEIOWORATI�CHFOUqCOPIF51 PROVISIONBOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �o*_ eiocK or N07. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITV TO VIOLATE Ofi CANCEL THE PROVISIONS OF ANV <br /> � OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHOFI2ED BV THE <br /> �,�,_T�_µ�,�,_�. � OWNER OF THIS PROPER7V TO PERFORM THE WOFK FOR WHICH <br /> 1 APPLICATION IS MADE ANU I COMPLV WITH THE STATE <br /> CONTRACTORS LA,W 182J RCW AND 296 200 WAC. <br /> �r.��r.e u. ue.ei eu.� 4 L WM bw�r�r_ <br /> leerr,uc_.fiau�� I1t�1u... 4a.ler� ,r <br /> R�QIEC7�A D�55 � -- <br /> S�GN [ ��� <br /> CpYpU5ME55LSfN5FN0 —�� <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> _ WATER CLOSET(TOILET) NC—AMNDLG UNITS--HP. �— <br /> BATHTUB FORCEDAIFSVSTEMS—B.T.0 M E.A. <br /> LAVATOFV(WASH BASIN� UNIT HEATERS—B.T U. M <br /> SHOWEH CLOTHES DRYERS , — <br /> _ KiTCHEN SINK 8 DISP VENTILATION FAN — <br /> DISHWASHEH RANGE HOOD <br /> LAUNDRVTRAY WATER HEATEH <br /> CIOTHES WASHER WOODSTOVE — <br /> URINAL METALFIREPLACEB CHIMNEV <br /> DRINKING FOUNTAIN i fIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP �— <br /> BACKFLOW PREVENTERS GAS PIPING <br /> FOOF DRAINS—RAINLEADERS E):HAUST FAN <br /> SINK�SERVICE—BAR,ETC.) i --� <br /> __ i — <br /> SUB TOTAL § SU8 TOTAL S <br /> PERMIT y PERMIT S <br /> TOTAL FEE 5 TOTALFEE S <br /> FOR OFFICE USE ONLY: h/� �� <br /> FRONTSET�B1�CN RE�RSETB�CN SIDES'_itlBCn PL�NCNV"ChNUMBEN FEE REGEIPTNO <br /> 2vI _.�� to' 34o�s— y33.x� �Zy.s� <br /> �Musez ioren¢� WC�NiSrtE FEES VALUATION FEE <br /> ~ � _( _ BUILDING / 1� .) -� � �J <br /> 1YaE0-t1YtONiS�n�*V�BIE TYRO�COH51�[IU�� occuwx. xnn^wuuaurns --- . �IT�j_ - <br /> Jl' NIZ �– � H�Z a � PWMBING <br /> SRE OF BLDG�i,�O NO Of STOPIES 0�15EMENT MECHANICRL <br /> � 5 �'. NO <br /> OCCUP�NCY LO�O FIqE SPRNNlER�S N/E00 HEIGHi i IMIT�110N ADDITIONAL PUN CIIECN N��1 O/1� � _. <br /> �py Z� .� 7✓`� ' c� Ci�i i <br /> �p�� � �� SPRINKLER ; <br /> RE�SON FOR SPRINNLERS __ � <br /> �.y��ry �V,I- _�/ � <br /> �+ry+Nr�+w�.i SIATEBWLDINGSUFCH4RGF. 1/ ��� <br /> —L <br /> INT�NEBY Pl�NS�PPROV DBY CITYOFEVERETT PUBLICWORNS <br /> i�� n <br /> � 9• LOCAL SALES � � "�%= <br /> � TAIfCODEIS3105 ror�� ,,��-; _ <br /> � <�J <br />