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.__, <br /> APPLICATIOIC"FOR CONSTRUCTIC`'�V PERN IT �—i ' - � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT �� <br /> - _ _ - 1 <br /> L_HEATINGSVSTEM: GAS JELEGTRIC J _ __ <br /> BUILDING DEPARTMENT ------ --- ' -- - <br /> 259-g�yg�1�/� � � <br /> � c�� DEMOLITION � COMBINATION XBUILDING MECHANICAL PLUMBING SIGN <br /> ------ _ _ �t --- - -- _ -- -- -- -- <br /> �;wuf.n �nn�nonEs utv t�i• rr.:'vi <br /> A � MiKE 52YlW3NSK ��,���t�?�De1��11k-��� 1������ <br /> C y y iENAN1��7 MMl�DONF.55 -- CIIY �P rNONC <br /> a � 1 <br /> y �� �R�HItK10PDf5�f.NE� MAM1M1pRF55 f.'Iv 10' ��"�N( <br /> K ���]]]n _— . <br /> � (�� Pqtn�t('cN�in^R�CniOR M�R�DORESS G1Y ZiP _ '---�PeONE STATEIIL�'�SE� <br /> � �� i,�i,��uqiC�LLUNIR/�CTOR IA�II�DDf1E55 CiTV liP PHONE Si�TEUCENSE� <br /> O �� i9UAlqMfiCONIRACTOR IA�iIAUDNfSti CIIV ZP' PHONE SUiEIICENS[� <br /> ��g --- — <br /> QJw Qrrryyy ��I�tiSq WORN <br /> � h�� NEW ADDITION ALTERATION REPAIR DEMOLIiIpN WOO�STOVErFRPL INSEFT BUILDING RELOCATION <br /> � y cv�rAscr rrnsaN nNn r��o�+e r+o � <br /> H H ca�*anCrcnicForwonK � 7� � �°�� �I(;� SZy/�✓�/�J'� � 1-__ ����7s j� <br /> gy nrscnme oi�•�an saun[rrquce i v. veo �� <br /> H <br /> �� �a�' ��__�e,�.. ,� �.Ga^°cs�,y_in 1� �Y1,;.. <br /> � � cAovo;c��ominwc � � - i HEREBV CERTIFV THAT 1 HAVE READ AND FXAMINE� THIS <br /> yy SA�LC �1L..y��l�l°N�_ APP�ICATION AND KNOW 7HE SAhIE TO BE TPUE AND CORRECT.ALL <br /> Of/� iece�ocsr,nirtroHovraortnr�sr�owr�eriowonnirecNvounconiesi PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTVPEOF <br /> � WORK WILL BE COMPLETE�WITH WHETHER SPEGFIED HEREIN OR <br /> ior moc:K S9 3 or II�TOF ��A�D ��pT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> hU7HORI7V TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> IMp�te✓erk�yl"_Cb� �i ��JJAL�LON� OTHER STATE OR LOCAL LAW REGULATING CGNSTRUCTION OR THE <br /> n - - PERFORM4NCE OF CONSTRUCTION.THAT I AM AU7HOHIZED BV THE <br /> �����_,�;, �,ow�ne 3_2�� OWNER UF iHIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> 1, )- APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> � CONTRACTORS LAW 1B27 RCW AIJD 295200 WAC <br /> ���__'Sd.9_�LM N eLT� P <br /> �� <br /> �---- � / e� �. � <br /> _�p_� �.�eve�fi.v� ._f�2,F�-9� x , <br /> WR /%:'�� i�7'�1��.�.i'= /�,�wi,/��''�- <br /> Cnao�¢reoonr s —_- _ _-��� __ _ �„�� - -_-- <br /> 7�r �'"'//-9/ ./�G8 �23-9/ <br /> PLUMBINO MECHFNICAL <br /> ( � NO. TVPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> � WATERCLOSET�TOILETI __ ��_ C _AC__AHNDLGUNITS-HF�_ _ <br /> i _�_ BATHTUB J FORCED AIR SVSTEMS-B.T U. M E.A. <br /> � � �_ LAVATOFV�WASH BASINI — _ -r _Q UNIT HEATERS=B.T.U. M — — ; <br /> SHOWGR _y CLOTHES DRYERS <br /> KITCHEN SINK S DISP � VENTILATION FA�I <br /> I �� � Rf�.,�GEHOOD --�- <br /> I DISHWASHER _ . _ - <br /> LAUNDRVTRAV � WATER NGATER <br /> I � CLOTHES WASHER WOODSTOVE __ <br /> I � URINAI Q- METAL FlREPLACE 8 CH�MNEV —' <br /> �� � DRINKINGFOUNiAIN FIREPLACEINSERT i <br /> Q FLOOR DRAIN HEAT PUMP <br /> ' BACNFLOW PREVENTERS _+ GAS PIPING � <br /> --�- <br /> ' �� ROOF DRAINS-RAINLEADERS E%HAUST FAN <br /> -�-_- -_ <br /> �I �1� _ SINK�SFRVICE-OAF,ETC.) _ __ __ -- <br /> -__ _.___- � <br /> _'�_ __-____'_ '_ • <br /> � ,_1=1 -_--- - - - _-___-_ _ '._' _�— <br /> T� <br /> ' SUBTOTA� $ SUBTOTAL f __ _ <br /> __- . _-_ - -- <br /> _ --__ _- —_�-_.. .__.__ ' <br /> PERMIT S PEPMIT S _ <br /> _ � _ _ 70TAL FEE S -_ ___ .._-___ .._-__. __ - ._'- <br /> �� TOTAL FEE 5 <br /> � FOR OFFICE USE ONLY: ���'• �7 _ <br /> __ _ <br /> - r IIONt sFiHn6r nrnn�t�H�rx sp� St iNni x � � nry nl'�pip.qn n i n � , n c i u ' <br /> • � / � �71)� �� ��� J ��— �'� � <br /> �� �_—_ _—— ___-_.____—. ._. _. �. <br /> u.reaie ioienu vncnn�snt FEES VALUATION FEE <br /> �-Z - �---� •-" riun+n_Nc-- - ��112 �t __ � /r� '�O <br /> ��p�pr[oNiSIALLOw�fl1F IrttarCpHsl�clU�l '�„ ' . . �: <br /> �� —'�N — — ��' - - �9 <br /> SVEOfBLD(: NOOFStORikS OaSF�+fN� MCCHANICAI � <br /> i <br /> Iz��3 .e �y.'w', 1 �r, <br /> �/� f`l��K ' 2 � � ' <br /> - A��ITIONALPLANCH(CM � � �7 <br /> OCCUP�Nf.YLOAD fIRESPRNKIERSFWD ��FIG��IIIMiIAtIjN 1� � <br /> nt.�SO��ORSPRINKLERS �U �� / - SPPINNLFR _��� � � � �-� ...�. . � . <br /> i <br /> STR7E13UIlDW( SURGIIAR�F _����_� <br /> _____- _ .. _- . <br /> -1- <br /> �v���eer ruNsevrr�ovrnin CITYOFEVERETT ruenCwor�ns <br /> LOCAL SALES „�� ; � <br /> �/Ql��Z ��, TAK COOE IS 3�05 rora� �� <br /> 7 <br />