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� <br /> � APPLICATIC-'I FOR CONSTRUCT'7N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT rr <br /> BUILDING DEPARTMENT HE/U ING SYSTEM: IJ G�S U ELGCif�iC U _ ___ __-� <br /> 259-8810 <br /> I I DEMOLITION I I COMBINATION I I BUILDING '+GMECHANICAL I I PLUMBING I I SIGN <br /> oww�n rnnnnooness �-- aiv- ---- -�n�----- rnour ------ -----� <br /> Go�vyY SqutavS� � <br /> P�.rt�'�+�r[S 2'731 ulccrwaE. p.iE ENt�'� 98+Lo � 388- 840� <br /> ------ - - - -- -- — _ --------. —_. <br /> 1ENANi M�ILA�DRE55 CiIY ]iP PnpNP <br /> ���OLETC@�rj E'VE¢�ST ��ITUAt. �bl.✓¢SZ• <br /> nncrarecronoFs�cN�n e+ro�nooness rnv nr mwve � <br /> f,EHENAICONTRAQOR IAnIL4�ORf.55 CIIY 21P PIIONE SInIFLICFNSE� <br /> ___ Pw.rQ�FPoq9cF _ <br /> rn[amNicnicouinncion uni�nonness cirv �m m�rn�e smte�rer+ser <br /> PlaTR�oT F�c�. 2oo4_a qb„We Lr. E. "C��oeHe. 98424 ^. -n�92�-z2q.�� <br /> P_ac-�.cTe-� _ <br /> riuur+iriocor+rnncion Mnnnnon�ss cnr nr ruouc srnirirruce. <br /> ca�inn trniceorvronk - � <br /> � �t9co • — I - <br /> OESCRtBE WORK qN�$IXIpRE�001qGC�NVOIVEU CoiltACT PERSON AH[I PI IONE 1!0 <br /> E cTE�o EX�ST�r-�4 "SFiF.�" SPo.c..E _ <br /> F�a.£ St�ct�.�1��.Us�s -10 Na.� cGi�.i a�i '�'r�-.•��s �-�r�an�E. C2oc�� �J2to - 2zgp <br /> �'R ^N-' "JSO ^aO• FT. -C'QJ-J� � HEREBY CERPFY THAT I HAVE READ AND EXAMINF.D THIS <br /> rnnroseo use or nmiou�o � � APPLICAtION AND KNOW THE SAME TO DE IAUE AND CORdECt.ALL <br /> [Zf�Z-Rs,aL J�u.._�r��.Eyt.. PROVISIONS OP LAWS AND ORDINANCES GOVERNING THIS TYPE OP <br /> LEGALUESCRIPIIONOFPNOPEPiv�SNOVMOEIOWOFAnACNiWOCAPIE51 WORK WILL BE COMPLEIED WI7H WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRAN7ING OP A PERMIT DOE5 NOl" PRESUME TO GIVf- <br /> iot e�ocK or — ----- qUTHORITV TO VIOLATE OR CANCEL 1"HE PROVISICNS OF ANY <br /> OTHER STATF OR LOCAL LAW REGULA7ING CONSTRUCTION OR THE <br /> PEFFOR6IANCE OP COtJSTRUCTiON. THAT I AM AUTHORIZED BV THE <br /> OWNER OP THIS PROPERTY TO PEFPORM TNF WORK FOR WHICH <br /> APPLICA717N IS MAOE AND I COMPLV WITFI THE STATE <br /> PARCEI i�%1.0 NUM�EA coNrnncto�s�nw�e.z�acw nNu 2sr,.zoo wnc. <br /> CONSTOUCTIONLO�q LEN�ER.GDDOESS,IELEPHONENUA1�Eli <br /> L7�� .F�--�1 Gaz� 8� ! S-9 S <br /> PROJECTADDRESS / � ^� �' sc imr ` n.rz <br /> *� �— C.OI..�+.a�C �–'c . enrnusnn,sni.rnsi.ie� . -' <br /> PLUMBING MECNANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � !u'C-NHNDIG UNITS-H.P. I <br /> BATHiUB ; FORCED AIR SYSTEMS-B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) �— UNIT NEN�ERS-9.T.U. M ; <br /> SHOWER � CLOTHES DRYERS � <br /> KITCHEN SINK&DISP i VENTILAiION FA1J <br /> DISHWASHER RANGE HOOD <br /> LAUN[1RY TRAY � WATEF HEATER <br /> CLOTHES WASHER � WOOD S70V[ <br /> �-- <br /> URINAL ; METALf-IRtPLAGE�WOOD BURNING) � <br /> DRINKING FOUNTAIN � FIREPIACE INSERT ; <br /> —�-— —� <br /> FLOOR DRAIN HEAT PUMP � <br /> BACKFLOW PREVENTERS ; GAS PIPING ; <br /> ROOF DfiAINS-RAMLEADERS �— EXHAUST FAN -�� <br /> SINK�SEFVICE-BAR,ETC.) � ' ; <br /> � <br /> — ' <br /> - � � <br /> -- -- ---� ----�-- -- ----- - <br /> - �--- <br /> -- - —�- <br /> — - � � <br /> SUD TOTAL $ i SUB TOTAL $ <br /> PERMIT $ —�— PEflMIT $ i <br /> TOTALFEE $ TOTALFEE $ <br /> FOR OFFICE USE ONLY: <br /> FHONISET��CK RE�RSElOACN SIDES[T04CK PLNICNFGC 1J,A�� ,y fGF� REGEIPiNO. <br /> j// <br /> C� <br /> � useza�e tornneA vncnursne ' FEES VALUATION FEE <br /> � Il VES Il NO A��ILUING � � <br /> ' trrf ov coes�. r+o.or stomes m�mm�nc, un�u man�i�in,ns - - -- ,-'.� �� --',— <br /> r,nnm pLUMBING ' <br /> i <br /> 517EOF0LD0. FIRESPAINY.LEPSRE00 BASEMFHt MECI�IANICAL � <br /> i <br /> f I YES I 1 NO -- � <br /> o.curnwcv�ono rweninnn+neoo r�eicr�ruMimnnrv �bDI1:ONALPLANCHECK ��C-�+; <br /> s , /� ', <br /> _ O1HEF7 ��jr1�7_ L1// ;_ <br /> B[�;ON - _ �r _-". _-�,r_� <br /> 51 N E OUILORJG�SU11CI IAR(3f: i <br /> ir+tn�eav r�ni�seranoveom CITYOFEVERETT PUBLICWORKS � ; <br /> !hM LOCAL SALES <br /> on�� g/'Z . ) TAX CODE IS 3105 torn� / j � � ' <br /> � <br />