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APPLICATI4"'",,1 FOR CONSTRUC7':�N PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT � <br /> ��.«.. <br /> BUILDING DEPARTMENT HEATING SYSTEM: �GAS ❑ELECTRIC ❑ � <br /> 259-8610 <br /> DEMOlITION COMBINATION BUILDING �MECHANICAL y(pLUMBING SIGN <br /> O ER MAIL ADD E55 GTV ZIP PNONE <br /> �` ` �S <br /> ` l 'e� � � � <br /> �p T � MAILAD�RESS CITY ZIP (�/1 PMON <br /> HI EGTO DESIGNER ,(y MAILADD�' ' O��i1 �l � �k'I'L /�T �i/� —/JCO .� '���� <br /> � /� CITY IIP PHONE <br /> 1 i�� .vn�tll,�/�lL'.�t�I J�-/`C �co I rT A�n.r A� �^ !n /� � � n�,T C��S � <br /> G NERALCONTRACi R MAILAD�FESS ���ty �� Z�p !;'� —� SiATELIC�SEk <br /> PHONE <br /> _ ��n-(k��C.��m,a�:,.�.�' Pc�(��a c',,�� . -�-�.,,.s,� ��.3-9�'rc'� L.fq--13s9 <br /> MECMANI ALCONiR�Mp��qDORE�S CI V �IIP P NE STqTELICENSEN <br /> PLUMBING WNTRA'TOR MAIL pDDRE55 CI1V 21P PHONE a7ATE LICEHS[I <br /> 1 <br /> ��ss_L�R_t_C— Lumn,dK� !Nl r lrii A,�— �� C ClJGtvt��� �I�1 ��P ¢Z�'7 �lSPj'��?,�lSQ <br /> �NEW ADDITION : ALTFRATION REPAIR . DEMOLITION � � WOODSTOVE/FRPL INSERT � BUILDING RELOCATION <br /> CON7ACT PEfl50N AND PHONE NO. <br /> CONTRA�T PRICE OF WORK <br /> D^ESCRIBEWORKFNb50 AREFppTAGEINV(�VED _ <br /> � P OPp$EppgEOF I��AT/NU �`.II'I /P!1 I�L��{'� I <br /> I HEREBY CERTIFY THAT I HAVE READ AIJD EXAMINED THIS <br /> � 1 L C�'S' �ry�����'� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> �ecnioescaiatioNo FOPENTV(SHOWNBELOWORATTALHFOURCOPIES) PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> . �ot B��K oF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> . NOT. THE GRANTING OF A PEqM1T DOES NOT PRESUME TO GIVE <br /> . AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTY TO PERfORM THE WORK FOR WHICH <br /> APPUCA710N IS MADE AND I COMPLY WITH THE STATL <br /> CONT TORS LA iB.27 RCW AND 296200 WAC. <br /> X ' � .s/, �— <br /> PROJECTA��RE55 S�GNe�unr y n��F <br /> Z � � �.._ <br /> bivflUAryit�i�.tM1iFNO <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FI%TURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSE?�TOILET) A'C—A�HNDLG UNITS—H.P. ' <br /> BATHTUB ; r FORCED AIR SYSTEMS—B.T.U. M E.A. —� <br /> LAVATORY�WASH BASIN) � UNIT HEATERS—B.T.U. M � <br /> SHOWER CLOTHES DRYERS <br /> Z KITCHEN SINK 8 DISP ( ; VENTILATION FAN — <br /> OISF�WASHER � RANGE HOOD —T— <br /> ^L LAUNDRY TRAY ; WATER HEATER � <br /> _� CLOTHES WASHER � WOOD STOVE � <br /> URINAL ' METAL FIREPLACF&CHIMNEY � <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN ^r� HEAT PUMP , <br /> BACKFLOW PREVENTERS GAS PIPING <br /> Z ROOF ORAINS—RAIKLEADERS � EXHAUST FAN ' <br /> SINK(SERVICE—BAR,ETC.) � � <br /> J ' � <br /> � - _ �" — � <br /> ' � � <br /> � <br /> � <br /> SUB TOTAL $ ^, — SUB TOTAL 5 � <br /> PERMIT $ � PERMIT $ ";r,y� <br /> TOTAL FEE S -'"u— <br /> ' TOTALFEE $ � <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBAGK REAP SETBACK SIOE SETBAGK PLAN CNECN NOMBER FEE REGEIPT N0. <br /> � !� <br /> USEZONE LOTAREA VAGANTSITE FEES VALUATION FEE <br /> BUILOING � <br /> 7YPEOFCOHiS.ALLOWABLE iYPEOiCONST.ACIORL ocNo�Ntr ND.ppNfluHGUNrts <br /> caoue � FLUMBING i <br /> SIZEOFB�DG. NO,OFSTORIES BASEMENT MECHANICAL � <br /> OCCUPANCY LOAD FIRE SPRNKLERS FEO'0 HEIGNT LIMITqiION ADDITIONAL PLAN CHECK. � <br /> SPqINNLER ; <br /> REASON FOR SPRINKLERS � <br /> -�T� <br /> STATE BUILDING SURCHARGE <br /> MTpKEBY PLANS�PPROVEDBV CIiYOPEVERETT PUBLICWOflKS <br /> LOGAL SALES <br /> TAX CODE IS 3105 TOTAL <br />