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` APPLICATIf �1 FOR CONSTRUCT )N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE .^eiINT <br /> I <br /> __ _ _ _ _ <br /> �-_ _ -__ _ _ _ - _ � <br /> HEATING SYSTEM�GAS J ELECTRIC J __ <br /> BUILDING DEPARTMENT — — <br /> 259 8810 <br />� DEMOL.ITION COMBINATION BUILDING xNiECHAr�ICAL PLUMBING_ SIGN <br /> OWrill� MnILnnDREss Cirv �"�� 7�n PRONI <br />� �N �a��� ��Z( i?,7� Pc �,�, �n�FcL �Sc��2 �5Z-37��1 <br /> ip�pry} lAAIL RO�N[SS CIiV SIP PHONF <br /> I AqCMITECiOp�E51GNER MMIADDRESS CITY 1iP PNONE <br /> IGFNER�I f.ONTR11CtOR MAiI�DORE55 CITV T�P P��ONF STAi[IICENSC� <br /> MECM�NiCUf.ONTRACif1R MAiIADDPE55 Cllv IIP PI�ONC ST�tEIiG[NSE• <br /> E�,C�sr�L�LC+C� I�l i � MAx�niE viE.� Dk. E�bt£���c;i.ts23✓�'-� E�,EY�,S iZ/K7 <br /> riu�aoiNccoNTr+ncron rani�nooness r.irv rm i^�o��r srnreu:ense. <br />� c�iaJnyrra�c^�wonK <br /> �(�J�.� <br /> pFSCRipE WORN�N�SOU�RE FOOTAGE INVOIVFf CONTPCI PERS(N ANO PHONE NO `r� �S�� `//(/ <br /> JC��r � T <br /> �N/-�CL �/95 �'�L'� �+�` �7Ac� -- <br />� ��� i HE(iEBV CERTIFV THAT I HAVE READ AND E%AMINED THIS <br /> Paoroseouse ov euaoiNu APPLICATION AND KNOW THE SAME TO BE TAUE AND CORRECT. ALL <br />� ��l/�iL�A L PROVISIONS OF LAWS AIJD ORDINANCES GOVERNING THIS TVPE OF <br /> IEf.RlDESCRIPIIDNOFPRO".R'vIS��OWNBEIOWOR�TIACHTWOCOPIE51 WORKWILLBECOMPLETEDWITHWHETHERSPECIFIEDHEREINOR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> iot---- o��cK — or - pUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br />� OTHER STATE OR LOCO.L LAW REGULATING CONSTRUCTION OR THE <br /> — -- PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> OWNER OF TH!S PROPERTY TO PERFORM THE WORK FOR WHICH <br /> r _____ APPLICATION IS MADE AND I COMPLY WITN THE STATE <br /> veaee�r�r i n r+uueen CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br />� CONSTRUGiIONIO�NIENUFAA0DRE55.7ElEPHONEINMPER / //� /f��_ �i� <br />�� Z�s.cr,�F��,,�a r�tA'���r� � --� '�� ''�- --�� i _ <br /> PROJECT ADDRESS `�"'� �� � � <br /> I I <br /> a, �����:..— <br /> PLUMBING MECHANICAL Ii <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUlPMENT FEE , <br />� WATER CLOSET�TOILET� _ A�C—A�HNDLG UNITS—HP. I <br /> I BATHTUB FORCED MR SVSTEMS—B.T.U. IL�J _ I <br /> LAVATORVIWASHBASIN) i UNITHEATERS—B.TU. M � i <br /> I SHOWER CLOTHES DRVERS ' ' <br /> KI7CHEN SINH 8 DISP ; VENTIIATION FAN _ , <br />��I __ DISHWASHER RANGF HOOD ' <br /> LAUNDRY TRAV WATER IIEATER <br />�� CLOTHES WASHER WOOD STOVE <br /> I I�RINAL METAL FIREPLACE IWOOD BURNINGI _ <br /> DRINKING FOUNTAIN FIi1EPLACE INSCRT _ <br /> FLOOR�FiA1N HEAT PUMP <br /> BACKFLOW PREVENTERS ^ GA�PIPING <br /> ROOF DR�INS—RAWIEADERS E%HAUST FAN <br /> SINK�SERVICE—BAR.ETC.) � <br /> � <br /> T <br /> I SUB TOTAL $ SUB TOTAL $ <br /> PERMIT $ PERMIT $ <br />,I _ —_—_—_______._.__ — ?OTAIFEE $ �� ' <br /> TOTAL FEE $ <br /> FOR OFFICE USE ONLY: <br /> ... _—_ ---�� r�r.cemrruo <br /> _._.____.—__._. rcE <br /> vnoHr se roncm m�n si-i+nrK sioe SErencn rinN nrtcn�+unior� <br /> !/!� ? • <br /> use zor+e i oi�r+e n v�cu+t srte FEES VALUATION FEE _ <br /> - � YES h� �ui�niNc ' <br /> IYPEO(CON9 NOOFSTOHiEti or�umno x��nmvti',�w�ou'� — — <br /> ------�--- <br /> '•'^' PLUM�MG _ <br /> SREOiBIDG fIf1E5PRINNlER5RE0� BRS[MFN7 MGCHANICAL <br /> YES � NO ---- --- ; <br /> ADDITIONAL PLAN CHECN � <br /> (N:CIIP4NCVlORD FlFE�UPMRfOO MEif��tliMitAliUN — � <br /> i <br /> IP .— — __ — _ OTNER __ — �_ ----�— <br /> fiE�50N <br /> StAIG�UILDVIG SUNCHpRGE <br /> winKcnv aiwNsnarnoveon. CITYOFEVERETT rutn�^wonKs <br />� �oca�saies - <br />� ��,E TAX COUE IS 3105 TOT^� <br /> � <br />