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APPLICATI� � FAR CONSTRUCT �N PERMIT �✓� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT � _ HEATING SYSTEM: �GAS J ELECTRIC J . _J <br /> -- ---- ----�---------__..___. <br /> 259-8810 <br /> _DEM�141TIp ��OMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> -{ � <br /> OWNFR l� FT7 noni•vl ---�---- -...----�irv __ � __-_ . _ .r_ ,u ..-- --- --�-�--- --- <br /> ���l�-�7'1-�--�1�l.l.'G:X�1s.��ar-'.-tid:1.Q F-Ir,r1y L/'6_'�1��! __�.1�3�--- - <br /> �T N�NT MMl p00t1E55 /p1V ,� /ziP p p�� q� <br /> �r' .�C��.i��(3'S_l�/�����i�. C-1�f/�-E�i����0.�.�r�= <br /> n��crnrer.ronoesicNea uniunnarss / - -- <br /> ,tnrnnicnranncran nan.nooeEss c�rv -- - r�r r��om sureucer+se� � -- <br /> ',��t�-1_���r�/,�'�>i�'� _��$_�� <br /> 1.'1 GIANIUL f.ONi.UCTOF M�il AUD�FSS CIiY JiP P��ONF STATF IICENSE� � <br /> ���Yri1�-c�i�� ,�-/l�� r.,, Pn �c �. �E=�' �//_�'dl�i�a�33d/Aira2rNr ll.�P� <br /> �iiPdHMOCONiR�L10R MAilp qE55 CiiV ZIP PIIONE SiAiEUGF.N5E1 <br /> t'.ONLRIICT PlIICE OF WOHN (� - — ---. . <br /> - n__�� .._-_ _ _ <br /> D!Sf,Rlqf.WORN ANO SOU�Rf� AG!iNVOLVEO CONIACT PEPSON AND PHONE NI � <br /> - 1,�/ _—�nr. -----__�,'/ii._�f�–����Q� <br /> .�'f�t,yyt,��f�,� , Fr �=�Cr's�--------��L�-�1 — - <br /> `_-�P/I -� //,�� X/5T/h�l ,�f'Y-�/GOJ�� i HEREOV CERTIFV THAT I HAVE READ AND EYAIdINED TFIIS <br /> rnnroseo use oc nwioiNr APPLICATION AND KNOW THE SAME TO BE TRUE ANU COAMCCI nLL <br /> /9,t�/�/l�-/���f/�9f/��� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE Of <br /> i.r�:uoescAirnoNnp� noaenrv�s�owNneiowon�necNtwocoriesi WORK WILI BE COMPLETED WITH WHETHER SPECIFIEO HEREIN OR <br /> NOT. 1HE GRANTING OF A PERMIT DOES NOT PFESUME TO GIV[ <br /> �c�i eL�N - �r — -- -- AUTHURITY TG VIOLATE OR CANCEI. THE PROVISIONS OF ANV <br /> OTHER STATG OR LOCAL LAW REGULATING CONSiRUC1lON OR iH6 <br /> -� --"- PERFOFMANCE OF CONSTRUCTION. THAT I A1A AUTHORIZED B�THE <br /> OWNER OF THIS PROPERTY TO PERFOpM THE WORH FOR WHICH <br /> -- - -- APPLICATION IS MADE AND I COMPLV WIiH THE STATE <br /> rnnr.ei uK�o ruuMaen CONTqACTORS LAW 1827 RCW AND 296200 WAC <br /> ��.ONSiRi i�:iiON I OPN I CNDf R ApDRE35.TELEPNONE NUAIOF fl <br /> �1�`'_7— ,,�, �'� -�.�y4�� - ���– <br /> PROJECT ADDRE55 � ���.��� � u.n �� <br /> i'�f'" - _._�c,-_-_—_. —.. __ _-_- <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> . WAiEH CLOSET�TOILET) � A C-A HNDLG UNITS-�N.P <br /> _- --_ _ _._'_____ - _. .__-___-._--_.__- — Y-.. . <br /> BAIHTUB FORCEDAIRSYSTEMS-B.T.U. M EA. <br /> _ LAVATOFV IWASH BASIN) _ UNIT HEATERS-B7.LL fd <br /> ___ -_ _. - -.- _ ' <br /> SHOW[R CIOTHES DRV[RS �� <br /> -___ _____--_ ____ __._ ._.__ _ _— � <br /> _ _ KIiCHEN SINh 8 DISP ; VENTILATION FAN ; � <br /> DISHWASHER HANGE HOOD —�- <br /> __ LAUNDRVTFAV WqTER HEATER <br /> ___r_- ___ _ _—_ _-. <br /> _ CIOTHES WASHER WOOD STOVE <br /> ._-_. — - __ � <br /> URINAL � METAL FIREPIACE(WOOD BURNING) � <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR�RAIN HEAT PUMP <br /> ___ 6ACKFLOW PR[VENTERS J_ GAS PIPING <br /> ROOFDRAINS-fiAINLEADERS � EXHAUSTFAN <br /> ___ SINK�SERVICE-BAR,ETC.I _ ; __ � <br /> . ._ -- -� ---- - - -T-._. <br /> SUB TOTAL 5 SUB iOTAL 5 � � " <br /> PERMIT $ —r- PERMIT $ - <br /> TOTAL FEE E TO7AL FEF $ - <br /> FOR OFFICE USE ONLY: <br /> IfiUNiSLTH�CK RIA�i511PACN ��� SII)btiFiR4fN PI�IlOICCMNJMPfR �fl HI'C(IPINO <br /> ji a_ <br /> [ <br /> ust r��[ u>�nnrn v�ceNr srtE FEES VALUATION FEE <br /> . � VES f7 NO BUILIIING �� <br /> I.i!�l�ON51 NO O�G�ORIES oc[uo�y�,r no p vw¢uyo Ux.l � � � -- - � <br /> ` --______ ._-__ . _._ _. . <br /> ���'r F•LUM91NG -.. �-'�-"-� -' <br /> Siil OfBLDG PIqESPRINNlERSRW'D B�SEMENT M[CNANICAL /�,� <br /> I�! YES � NO - -- - 6l�_ <br /> � <br /> nt�(UPANCVLOAU FIREM�fIMRE00 HEIGNTUMR�iION FDDI110NALPLANCIIECK � <br /> OTHF9 <br /> i <br /> n��nr;nq . . � <br /> __"___ —._... __ _ __. T <br /> STAtE(�UILDING SURCMARGE <br /> �� .,.rn. �uNsnvraoveoev CITYOFEVERETT ruaiicwo�Ks <br /> LOCALSALES <br /> o,��t TAX COOE IS 3105 TOTAL <br />