2717 COLBY AVE 2016-01-01 MF Import

APPLICATION FOR CONSTRUCT.�N PERMIT � TO BE COMPLETED IN BLACK INK—PLEASE PRINT ��J __ BUILDING DEPARTMENT hEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ 259-8810 X DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN OWNER MMLADpRE,a CIN ZIP PHONE LarB Gt7�4t'f�et� �lo r� itaG 2731 u1Ur M� �111�- 3�j-62o�> Ti1MMt� M�IL AODRESo GTY IIP PHONE �— !�r 4 Ccr.WiY Sc9ukP� ��5 �4�a1 u�rr�.�o� E� �, �?DI 3PB-f'� �PLHRELTOROESIGNER MAILAODRE55 CITY ZIP PHONE GENER�LCONTPACiOR MAIL�O�RE55 LITY ZIP PHONE .iTATELICENSE• SG P.� T�'fi"'�2JL(If�__�fl MECH�NICALCONTA�CTOR M�ILADDRESS LITY ZIV PM06'E 5TIITELICENS'_� PLUMBING CONTR�CiOH MAIL qDDRE55 CITY ZIP PMONE S1FTE LIGENS'c 1 LLASS OF WORK _ ! ! NEW ! i ADDITION I I ALTERATION AEPAIR x DEMOLITION WOODSTOVF�FRPL INSERT . BUILDING RELOCATION CONTACT PERSON AN�PHONE NO CONTRACT PRIGE OF WORK �u�p � i'�......� �in ��,�Y r/O'!lJ "..W (lRN DESCRIBE WORK AND SOU�RE FOOTRGE INVOlVEO — PFOPOSEOUSEOFBUILOING i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL LEWL DESCRIPTIONOF VROPERTV�SNOWN BELOW OPATTAC4 FOUR COPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILI BE COMPLETED WITH WHETHEF SPEf,IFIED HEFEIN OR �oT�_ e�ocK �� or NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVIS�ONS OF ANV — OTHER STATE OR LOCAL L4W REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONS'RUCTION.THAT I AM AUTHORIZEU BY THE OWNER OF THIS PROPERiY TO PERFORM THE WORK FOR WHICH APPLICA710N IS MADE AND I COh1PLY 1NITH THE STATE U CONTRACTORS LAW 18.27 RCW ANC 296.200 WAC. PHOJECT ADDRES si nn[u@[ � � �'M� 3L I�Q2 _ I' ''�. A4 CJ�L27L1� o�rc � � u*�eus.w[ssuccrvst ra PLUMBIN(i MECHANICRL NO. TYPE OF flXTURE OR ITEM FEE NO. TYPE OP EOUIPMENT FEE WATER CLOSET(TOILET) NC—NHNDLG UNITS—H.P. ; BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M ; � SHOWER CLOTHES DRYERS KITCHEN SINK 8 DISP ; VENTILATION FAN DISHWASHER � RANGE HOOD LAUNDRVTRAY ; WATERHEATER � CLOTHES WASHER i 6JOOD STOVE URINAL METAL FIREPLACE 8 CHIMNEY � DRINKING FOUNTAIN � FIREPLACE INSERT ' FLOOR DRAIN � HEAT PUMP �— BACKFLOW PREVENTERS � GAS PIPING � ROOF DRAINS—RAINLEADEFS � E%HAUST FAN ; SINK(SERVICE—BAR,ETC.) � � T I 1 SUB TOTAL $ ' SUB TOTAL $ _ PERMIT 5 PERMIT $ ; TOTAL FEE $ �f.�TAL FEE 5 � FOP. OFFlCE USE ONLY: FRONTSETB�GK qEAASETBACN SIOESETDACH P�ANCNECNNUMBER FEE RECEIPTNO. � � y USE7.ONE LpTAREA VACRNTSITE FEES VALUATION FEE BUILDINu � i TYPEOFCONiSALLOWABLE iYPEOfCONSi.l.GitlAl OCtUwrcr 1mpVMLLrv,�Nrts � �a0°P PWMBING � SREOFBLOG. NOAFSTORIES OASEMENT MECHANICAL � OCQIP�NCVLOAD FIRESPRNNLERSPEO'D HEIGNTUMITATION ADDITIONALPLANCHECK ! �PRINNLER RE�SON FOR SPRINKLERS --T— SiAiE BUILDING Sl1RCHARGE ' INTAKEBY p�,ANSAPPqOVEDBV CITYOFEVERETT PUBLICWORNS � LOCAL SALES —� TAX CODE IS 3105 rorn� ;