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APPLICATIO"�FOR CONSTRUCTtGN PERMIT �, <br /> TO BE COMPLETED IN BLACK INK—pLEASE PRINT �'..�� <br /> �� <br /> j HL-ATINGSY,;ILM: JGl1S JLLL-CiRIC J _ _ �I <br /> BUILDING DEPAHTWENT . _-.__ _ <br /> - - - --- <br /> - -- -------_ <br /> 59-8810 ----- - <br /> i I�LI� c ru. ��o7�� �' Ba N Ile y& Ia MECHANICAL <br /> ri � ' COMBINATION _ __ _ PLUMBING SIGN <br /> rny�vwrn -----------� - <br /> VoL'i 5 �.mnnuna:::� --------- <br /> , ___- -- <br /> 1�-'X �J�d� m�n��r <br /> ,�NANr — --- -- _---� �1-a:�o� <br /> AINI 40UIIf 5 -' -... . -. -.-.. - . . <br /> '__ -' __�-_____ <br /> __._- '_ _"____" <br /> ���`� ��1�a0 3303 Cd 5i�'o �'�1.5 ���v�f} �, �„�N� — <br /> �fiC/11fEC700UE5KNL11 MAILA[IDfIL.,S - �,��,-�-- --- ---- -----�-_ <br /> :�I+ IYIONk <br /> G[NfOnI.CONIf1nCTOH I.InII Af�irtifti5 —"--"—cltY ��--'- -"----- <br /> I ��� 1n I /„L/1� MONI it�If UGIN:E I <br /> ���� �+'< �st��K��P f. _�`t� le `IFlGa � <br /> MEG�uNi,e�ccxJtancroi� unn nuria.cs � --.- - .. - -� <br /> i.nv -....-- -- - ---- �- -- <br /> 11�s_K��- Cc o, � ��s���--�'�tl_�e `�s!_,�� _ �,Z , ,���,� � m/� ,,��r�.�/�<<:,�,�;--- <br /> PlUM01NGl;pl111r1�on Mui.noonr,s ��- �_��1_I�!1.�Iv�� l�� <br /> ��f'� 711• 111[�b� �IAICIiC(N51:1 <br /> _____.-_'_-_.___._.__._ <br /> LONfp�\Ct 1`111C[Ui WppN ... .----"---'--'" <br /> OCSCRIOE WOqK ANU SOUAfiC(OOtAGE INVOLVLD - -- <br /> CONIACiPpp9JHpNDP1�UNLNO- /��� _ % � <br /> j 1 <br /> — �d� r� IZIGCc�1-(��5 ���K��r�1ec�s o�OG � <br /> r - - -�--�_=���_3�1L -- �' . ��1- <br /> vnarosrouseoreuiioir�c --- � HERE�Y CLRTIFY THAT I HAVE READ ANU G7CAMINED iH15 <br /> O��L� APPLICATION AND KNOW THE SAME TO BE TFUE AND CORRECT.ALL <br /> PROVISIONS OF I.AWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> IEGALDESCflIPTIONOLPqpPEBiV�5H01VNBLLOWpqp7ipCH fWOfAP1E5� WORK WILL BE COMPLETED WITH WHETHEF SPEGFIED HEREIN OR <br /> ��1 - ma:K ��� ____ __ NOT. THE GflANTING OF A PERMIT DO[S NOT PRESUME TO GIVE <br /> AUTHOf�ITY TO VIOLA7E OR CANCEL THE PROVISIONS OF ANY <br /> --- _____.________ __ OTHEiR STATB OH LOCAL LAW REGULATING CONST�iUCTION OR TH[ <br /> � -�- - PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV TVIE <br /> _____ OWN[R OF 1HIS PROPERTY 7p pERFORM iH[ WORK POF WHICH <br /> v�ncuTnxioNuran[n ,� ------------� - APPLICATION IS MAD[ AND •I COMPLV WI1H fHE STATE <br /> ' CONiRACTORS LAVJ 1827 RCW AND 29G200 WAC <br /> _— —_________- ^ <br /> ro�ismucnoH�nnNieNocn.wnnus aieri�orrzNuunrn � �- <br /> PROJECTADDRESS --------- ---- - X--l��!'�C� -�v`^'� � V ^ 7 � <br /> �.�„�,��'(r�'i / G � ----- - �,;��--- <br /> --- -- <br /> , „—„��,.,�� :. „�.,.� •„ ---- <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITCM FEE NO. TVPE OF EOUIPMFNT <br /> _ WATER CLOSE-T�TOILET) FEE__ <br /> - ---- -____________ � A�C--A'HNDLGUNRS-HP. � <br /> BATHiU[3 . _._..._ .._'___ . . , <br /> ____- __-_--____.-._- .._-.-.__ .-___ ___ <br /> _ __.__ ____ ; FORCED NR SYSTEMS-U.T.U. M LA. � <br /> LAVAIORYIWASNBASIN� �- --�-- ��--��--"- --- <br /> -.__-__'�-__-____ <br /> �- -----------__ � UNII�HEATERS-(1.T.U. M � <br /> SHOWER . _-- _ ___.___'_.-._ ___ _._ ._._.-.______- ' <br /> -- -.-___ ' CLOTHES DRYEfiS ---—�-T- <br /> KITCHEN SINK R DISP - _....-�----�---- -----' ---�-------�- -- <br /> VEN7ILATION FAN -----� 1 <br /> _---____.—._'._—.-__ _._ � , <br /> DISHWASHER � � -"--'-- � <br /> __ <br /> . ______'._-__. ____________'__.._____T <br /> -- ----__ RANGG HOQD <br /> _ _LAUNDRY TRAY -- ---�---'�--- ----�W�iER HCN�EH "-�-------- - . <br /> CLOTHES WASHER r---�-�'-- - --- <br /> URINAL �—'--- -__..___W�OD STOVE � <br /> ._._ Mfl7AL 19REPLACE�WOOD BURNING) <br /> _ DRINKING FOUNTAIN_ __ FIREPIACE INSEH7 <br /> _ FLOOR DRAIN ---------;--- --- -Ii�AI PUPAP -------�---- -----�-- <br /> �ACKFLOW PREVENTERS � --- ----�--- -�--- ---�--- ------ <br /> — _._ GAS Pi�INr, � <br /> ROOF DRAINS-RAINLH�DERS -�—T - � ERHAUST F�N --�- <br /> _ SINK(SERVICE-BAR.ETC.) — --- ------- ---- _ <br /> -----_ � <br /> ------�--- ----- � <br /> , ----._--- ------ —�- <br /> J __.___ 1 <br /> �— - � <br /> __�r__ <br /> _ SUB TOTAL $ __ ' SUO TOTAL 5 I <br /> _—_ ' , <br /> PERMIT a -r-.__ _.-- -�---------------- �- ' - <br /> _—.-_-__ --._-_ ' PL-FlMIT $ � <br /> __________�_._ ___ __ __.___ _ <br /> TOTAL F[E 5 . ._-_.__. __._-__-__ ___.__r_ . <br /> TOTAL F[E $ <br /> FOR OFFICE USE ONLY: <br /> FIIONiSETO4CN R[4NSpf0�f.N __""-- tilf)f.i[11141:H �__--�— I�l4N!'�1 CNlllll.lfl 111 I� <br /> ] � � ' l rn r. � u l <br /> USE ZONG � l01 ANU --'------- - � •�/"` <br /> vncnNtsrtE FEES � VALUATION FEE <br /> __ ' ' YES � ! NO oun ouuc I <br /> ���'f01LPH51 NOOF,L'iORi[S ixiu��v� xni+vx:uix�,n��>, ' ' <br /> .-__-__-.-_-__'___"_'_ _ <br /> '_ __-__'_____ ___ __.___ <br /> ,. GRryll' � i I <br /> PlUM81NG <br /> SREOFOIDG �II1ftiPNHNLFRSNEnD Ilq5fA1[11i --�---- ----- ----�-- I <br /> '� I YES ; i NO M[CHANICAI__ <br /> cecureqcviono Fmc eMnro�u MEIGHI�IMIi�110N ADDRIONALPIANCHECK <br /> _ i <br /> PE�SON ---— O�HEH � <br /> ___—___ __�__ <br /> SiAiE f1U11 UING 6UHf,NARGC � <br /> n�uKcov---- rinNsnrrWuvruuv CITYOFEVERETT ruoi.icwonks <br /> �M LOCAL SALES <br /> _�-- � _-- 'I_-TAX CODE IS 31OS TOTAL ---_-'—"_'_ _____ '_____�_ I <br /> i ., , -�/�. , � <br /> ��--- <br />