Laserfiche WebLink
..� _ <br /> APPLICATII .�1 FOR CONSTRUCZ �N PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT ��r��s <br /> BUILDING DEPARTMENT HEATING SYSTEM: T�t,AS �ELECTRIC U 1 <br /> 259•8810 <br /> ✓ DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> OWNE5 M�il�DDRE55 � <br /> Noizafi E�r��tr L , o,Us ['�«� Cu��c-fr [.Jm�h �'oP"r`,a �_ �a�/ 3 9e��,� <br /> TEN�NT M�IL�DnDRESS �yJ / CITY \ 71P PHpNE <br /> _y��U(lr M /!Y ,'""1-1 i Y/O�J'� <br /> �RCHiTEC70HOE51GNEA M�II�ODRESS LRV 21P PNpHE <br /> _- Qw/,r� <br /> �GENERAL CONTR�CTOR M�II AODRE55 dTY 21P PnONE STQE LICENSE• <br /> ��tJ l�K'S. <br /> MECH�NICQ CONTRACTOq M�II AD�NE55 CITY IIY PHONE STQE LICENSE t <br /> PLUMBING CONiR�CTOR MML�OONE55 QTY 21P PNONE STQE I ICENSE t <br /> �[d P,� n�SU� �C��199 f3/� C.'�Jc=��'j`/-/' GIa9C'/� <br /> CLASS OF WdIK <br /> NEW (i/ADDITION ALTEHATION PEPAIR DEMOLITION WOOOSTOVE�FRPL INSERT BUILDING RELOCATION <br /> �-`` a„ CONT�Ci PEl150N�ND PHONE NO <br /> f.O�tIAAGTPPICE OF WORk '�(/, ��� �Rn�� ��y- 3 I I <br /> �ESCRIBEWORItdNDSW�REFOOT�GEINVOIVEU /LLS SHE�T �Lk <br /> � �` w�RK iN :1emE !:'�X�SI l�, �`� �; - -wwtta <br /> .> x r1 <br /> vaoroseous aem�owc � i NEREBV CERTIFV ?HAT I HAVE READ AND EXAMINED THIS <br /> 1 E� ROO E!✓ Sf1ELTb APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> LEWl0E5CRIPTqNpFPpOPERiV�SNOWNBELOWJR�t MFIXIRCOPIESI PROVISIONSOFLAWSANUORDINANCESGOVERNINGTHISTVPEOF <br /> iot � i� (�v�� eiocK S�> oF j E ' WOfiK \NILL BE COMPLETED WITH WHETHER SPECIfIED HEREIN OR <br /> � NOT. THE GRANTING OF A PERMIT UOES NOT PRES�IMF TO GIVE <br /> 4��u� g �} ��1`��.,.y /1 AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> � (�.�a'�AK) a<<4'i f 1,��0 �Q� fL � n OTHER StATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> n � 1 PEflFORMANCE OF CONSTRUCTION.THAT I AM AIITHORIZFD BV THE <br /> � /�yQ�,,..�y � f� lj,O16(n ����Q �� ��td)✓ OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> ��'— APPLICATION IS MADE ANU I COMPLV WITH THE STATE <br /> k �4 f �„ P���,,�T' �U�,�,�� CONTR^TORS LAW�827 RCW AND 296200 WAC. <br /> / � <br /> x � ' � � l/l_�( �1�, , <br /> PRq1ECTADORE55 n sir.v nmt 7 �'/� _C,�� <br /> .-7`�Z�n- C�Q1�12 ��'� L C�L ----_— o.�� -_ <br /> ,�+r ��,.a�s��,== ��,,,5, �o <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF FU(TURE OR ITEM FEE N0. TVPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � A�C—A%HNDLG UNITS—HP �— <br /> BATHTUB FORCED AIR SVSTEMS—B.'.U. M E.A. <br /> LAVATORV(WASH BASIN) UNIT HEATFRS—B.T.U. M <br /> � SHOWER � �- CLOTHES ORVERS "�(t 5t T-- --� <br /> KITCHEN SINK d DISP VENTILATION FAN w � <br /> DISHWASHER RANGE HOOD <br /> LAUNDRV TRAV WATER HEATER � �N � <br /> CLOTHES WASHER � WCGJSTOVE ; <br /> URINAL METAI.FIREPLACE 8 CHIMNEV � <br /> DRINKING FOUNTAIN � FIREPLACE INSERT � <br /> FLOOR DRAIN � HEAT PUMP , <br /> BACKFLOW PREVENTERS � GAS PIPING � <br /> ROOF ORA�NS—RAINLEADERS EXHAU£i FAN <br /> 'Z SINN(SERVICE—BAR,ETC.) <br /> � <br /> SIIB 70TA1 S SUB TOTAL S r� <br /> PERMIT $ PERMIT E <br /> TOTAL FEE S TOTAL FEE y --'�— <br /> FOR OFFICE USE ONLV: �(� c��; <br /> FRONT SET� , qEAP SET� ' SIOE SE79��Jc P��ry��O��� F'E� L�; RE�Pi�.��� <br /> S `( <br /> Iuse zor+e � LOT�NE� VAC�NT SITE FEES VALUATION FEE _ <br /> � BUIL�ING �<� / r �'r J 60 �//� <br /> iYVF Of LONIS�LLOW�BIF (YVF Of COH51�C111A1 octur�Mr xo w ow��ioxe uxns - —_�7�f- <br /> i � � ��a� ' PWMBING • � > <br /> a <br /> SIZEOFBIDG NOOFSiOPIES BASEMENT MECHANIC/1L � <br /> S � J ��J <br />� OCCUP�NCYl04U FIPESPPNMLERSREO'fl HEIQHTLIMrtqilOy ADDITIONALPLANCMECK <br /> A hl/A Z�8 � � <br />�` SPRINKLER r <br />� RE�SONFORSPqIN1aER5 � <br /> STATF BUILDING SURCHAFGE i�G <br /> INUMEBV PUNS�PPROVEDAV CITYOFEVERETT PUBLICWORKS . <br /> LOCAL SALES <br /> � �, /�Z TAX CODE IS 3105 TOTAL �r ��/l, <br /> / <br />�.r. <br />