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,•:. <br /> APPLICATIOI� FOR Gt�NSTRUCTIvN PERMIT ���� <br /> TO BE COMPLETED IN BLACK INK-PLEASE PRINT <br /> f�l[ATING SYSTEIA: U GAS lJ ELECTRIC U _ � _1 <br /> BUILDING DEPARTMENT <br /> 259�8810 <br /> y �� I '� DEMOLITION I i COMBINATIUN � BUILDING ' i MECHANICAL i I PLUMdING i I SIGN <br /> � owrrtn M�iinnun[cs cnr �r�r r�ar+e � <br /> A � �'lI-� l�o�i,,r�; co.��.o. L'scX 37�7 M�5 �i=-7c Sc-/+�rYF ���� 9 �2�/ 3�fz-sd'�P <br /> qyry+y 1FN�NL MAR�DUf1F55 f,I1Y lIP PiIONE --- <br /> Hc�^ �--�OL�/NC C,O <br /> Fjz� �OCIIITECIORU[SM.NER N�0.�ODRE55 CRV Z�P PNON( <br /> h°e �°� r :��� , . ,. ,• ._ i• rt:�ta — <br /> u[r+enuca+rnu.���n MetieoonEss cnv Z�i' r�ror+e sarc��cer+sE� <br /> y --- <br /> � ���� Z�p PIqNE SIQELICENSEI <br /> N[u�µ�ckccxnrecton M�R�DD(1E55 <br /> �d Cnr ]Ir rrqNE 51�1EliCFNs[r <br /> Q �"� PlUM01NOLONIMCIOR MMl�U011E55 <br /> ��8 - -- <br /> 'n��yy� � C 55 Of 1KN1N <br /> �y� �NEW I I ADDITION I I ALTERATION I I REPAIR ' I DEMOLITION I I WOODSTOVFJFRP�,INSERT I I BUILDING RELOCATION <br /> caaecr rEnwr�u�o�nor+e�ro <br /> H �dNq-,� i� ����7/�02,5�"l <br /> cartn�cr pnicE ar vronK <br /> ��y H ncscnye won��r+o saune rooiere ir+vaveo— �6 6 -3 S 6 3 <br /> c' �� (� l t� i ��� � C� - -- - - <br /> �� rnb�oseouseorttminnm I HEREBY CERiIFY THAT I HAVE REA� AND EXAMINED THIS <br /> O y �ti / APPLICATION�ND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> vanioeunmiauorrnorenrvis�awNaeiowonnn�eNrouncar..-i PROVISIONSOFLANSANDOROWANCESOOVERNINGTHISTYPEOF <br /> WORK WILL BE COb�PI.EiEO W!�H WHETHER SPECIFIED HEREIN OR <br /> ior eioc� w . NOT. THE GRAN�i ING OF A PERMIT OOES NOT PRESUME i0 GIVE <br /> AUTHORITY 10 VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STAiE OR LOCAL LAW REGULATING CONSTRUC110N OR iHE <br /> PERFONMANCE O�CONSTRUCTIGN.THAT I AM AUTHORIZED BY THF <br />� �. . ; OWNER OF THIS PROPERTV TO PERFORM THE WORY, FOR WHICH <br />�'��I� �. ' APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> I � I. CONTRACTORS�AW 1P27 RCW ANO 2962G0 WAC. <br />�; � <br /> a� • � . :' ` �. — /� /'��' �( / .'r/f��'� <br /> .,��� X � <br /> sn'.rui�ne n��t <br /> PPQIECT�DDREr5.5I /`^ /�� G �/,' ,- ____ — <br /> ���3 (/V. C�/T-S/N� �C/� ��� • � _ CI1vpV5nHRl?INSf�u <br /> .Xn. <br /> /// PLUMBIN� MECI IANICAL <br /> ( ��� -NO. TYPE OP FIXTURE CR ITEM FEE N0. - 1YPE OF EOUIPMENi FEE ' <br /> � WA1ER CLOSET(TOILET) NC-A/HN�LG UNITS-�H.P <br /> BATHTUB ' __ FOflCEO AIR SVSTEMS-�.T.U. M E.A. � <br /> � IAVAiOHV(WASH BASIN) —r UNIT HEAiERS-B.T.U. M � <br /> �� _ SHOWER _ _ CLOTHES DRYERS � - <br /> KITCHEN SINK 6 Dl;r' VENTILATION FAN �_� <br /> . DISHW�SHER _ RANGE H000 _ <br /> LAUNDRV TRAV ' WATER NEATEIi � <br /> CLOThES WASHER —� W�D SiOVF_ _T <br /> � METAL FIREPLACE 8 CHIMNEY : <br /> �� UF�NAL — � <br /> DRINKING FOUNTAIN FIfiEPLACE INSEFT � <br /> T <br /> HEAT PUMP ' <br /> � FLOOR DRAIN � — r — � <br /> I '� _ BAi:KFLOW PREVENTERS ♦ i GAS PIPING _ � <br /> � I�I ROOF ORAINS—RAINLEADERS � EXHAUSi FAN <br /> �� SINN(SERVICE—BAF,ETC.) � � <br /> ---r— -- i <br /> I '.�_ ___ i_—_— — - i — <br /> `.�� — -- —--� _ <br /> � <br /> � SUBTOIAL S ' <br /> _ SUBTOTAL E __�_ _ — pERM1T S I <br /> `t_! TO�ALI Ff_[ E TOTAI FEL S _—l— <br /> FOR OFFICE USE ONLY: 1��'3' �- ;- = - <br /> ---- ruqcurcnr�uunfn r�-e ncr.emir+o <br /> rnorurs�txncn nF�nsr��,�cn sm[s[iev:k <br /> i ` �. <br /> usezc�rt �arenee WC�4ISi1E FEES VALUATION fEF _� <br /> OUIl01NG % � "' �`'' <br /> —____ _._._ ___._____ —'__ —_—_�— <br /> IVI'[OfCONiS�ILOW�flIE 1YVFqCM151 IWI orGq�N� �domu�NCIM��t � <br /> V 2 PWME7W0 <br /> ii•�/_ - R — ----- — �— <br /> � <br /> s¢eaeiai. voors;omes nascMCNi n�cci�ntiicni. , <br /> 1pj� So,sT. i jl� -- --- -- — � - <br /> AUDI710NA1�l�N CNECN �� � S=" <br /> OCLUVINCV10�I1 FlOESPRNXIEfi`.11E00 11EIOHIlM11��110N _ � <br /> � � !�(J _______ SPIIINKLEf1 � <br /> � "__"_—_- _1_ <br /> IIE�SONfOASPRRIXLERS <br /> S1Alf Ol11lDING SURC��/���0[� U ; ��' <br /> muKeer vucsnrPaoyt�ui� CITY�OFEVERETI PUBUCwonks � <br /> � LOCALSALES <br /> ` � TAX COOE IS 3105 TaTA� / � � _C c� <br />