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ocr���tl <br />'' �^=�' APPLICATiOrr FOF� CONSTRUCT�:�N P�RMIT' � <br />� " - <br /> ,^E , ^ TO BE COMPLETED SN INK—PLEASE PRiNT <br /> GTY OI" } __ <br />� eVeYe l� HEATING SYSTEM• ❑GAS ��.J ELECTRIC J_._.--- --- ------ � <br /> BUILDING UEPARTMENT <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING MECHANICAL o+c 'PLUMBI�G SIGN <br /> OWfRR M�ILAO[18E55 QTY Z�° � . �•�J�,. �II`,� <br /> ; . -C� '1 ,� �.�. �� cf 4 , � � r_�-,� � � � ., ,_;; � _ �—� , <br /> 1LP ] GITv 11P PIqNE <br /> suaenoness - C <br /> � � ro � ✓� G-f�A�V 6 � ��� 7�5� l� � _ u.-c� � �Z'7� — <br /> I�RCNIiEGTOROE A NILLAOORE`i6 <br /> GITV ZIP PHONE <br /> 10 C - <br /> y ']����ry., .� 'M,Z�IP�q( �y PNONE LIC[NSE• <br /> - t t MA M�PE55 G �-/ C�LTJ7" W�'�( <br /> y � z �_ � . <br /> -•� c����l u.a z�'e-u�y <br /> K, (p CITY � 21P PHONE LILENSE� <br /> H A I.IELNrIYILALLONTAACiOR MhLLPD� ' <br /> O G O <br /> � N H <br /> � VlUM9NGGONTiiRCTOR MAILADDR[55 GILY 21P PNONE I�CENSE� <br /> 2 <br /> N <br /> Q M LUSSOFWORN - <br /> � � R � �: NEW I �� ADDITION ALTERATION REPAIR �. DEMOLITION ._�� WOODSTOVE/FRPL INSERT �,��. BUILDING RELOCATIO J <br /> GONTACTPENSONANDPHONENO. <br /> M�2' G�T. )� <br /> 7 H I9 �pNTRACTPWCEOGWORN _ � / <br /> i <br /> � H y DESLNIBE WOBK 6ND SOU�RE FOOtAGE�NYOLVEO <br /> 8 y ^ I <br /> O C N ' ' ; 7 `'� � <br /> � q � v seous-oFo iy� i 1 HEREBY CERTIFV THAT I HAVE READ AND E%AMINED THIS <br /> �q h�� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORREGT.ALL <br /> y PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVFE OF <br /> � p V. LEGALOE RIPTIONOFPl10PEflNISHOWN0EL01YONATIACMFWNCOPiES1 y,�ORK WILL DE COMPLETED WI7H WHETHER SPECIFIED HEREIN OR <br /> �oT e�x,c oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHOf,�ty TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATF OR LOCAL LAW FEGULATING CONSTRUCTION OR THE <br /> PERFOFMA4CE OF CONSTRUCTION.THAT I AM AUTHORRED BY THE <br /> OWNER OF TF!IS PROPERTY 70 PERFORM THE WORK FOFi WNICH <br /> APPLICATiON IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296200 WAC. /O/�'+/�L) <br /> SiGNATUPEOPCCNTPRGTORORA'JiHOBiZEOAGCNi DAiE LJ <br /> X � �� <br /> � <br /> PR6/ECTA�D�[55 A ppP�IL�NiSCIiY0U5R+C55lILENSENO.At106USME - <br /> h � �` C� O L <br /> PLUMBING MECHANICAL <br /> i� � NO. TYPE OF FIXTURE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> �� WATERCLOSLT(TOILET) _ A'C—A'HNDLGUNITS—H.P. <br /> OATHTU� FORCEDAIflS`.'STEMS—B.T.U. M E.A. <br /> i IAVATOflY IWASH OASIN) UNIT HEATERS—B.T.U. M <br /> � CLOTHESDRVERS <br /> I I ,�i K TOCHEN SINK 8 DISP i VENTILATION FAN I <br /> ��► RANGE NOOD , <br /> DISHWASHEfl WATER HEATER <br /> LAUNDRVTRAV � � <br /> CLOTHES WASHEfl � iNOOD STOVE ' <br /> � � �' , URINAI ' METAL FIREPLACE 8 CNIMNEV ' <br /> ��� �� DFINKING FOUNTAM FIREPLACE INSERT � <br /> FLOGR DFAIN I1EAT PUMP ' <br /> BP.CKFLOW PREVENTERS i GAS PIPING �� <br /> ��1=1 FOOF�RAINS—RAINLEADERS ; ExHAUST FAN <br /> , SINK(SEflVICE—BAR,ETC.) � � <br /> i � <br /> ' �*�w1�� ' � � 1, <br /> ' SUB TOTAL $ SUB TOTAL 3 - - <br /> I � PERMIT $ PERtdIT $ <br /> � TOTALFEE $ TOTALfEE S _ <br /> �I �IA� - 'i�:�'�I <br /> �� FOR OFFICE USE ONLY: � ' <br /> FRONTSEt9�CN RERqSEtBACN SIDESETBACN PLANCNECNNpA1BER F[E <br /> n[cEmtNa. f � � <br /> •,,'.i:� ;� <br /> usezoNe LOT�PEA veCartSnE FEES VALUATION FEE ; ' :� . <br /> J �_i : <br /> BUILDING � CO �1 ��C�� � '��'b.� . <br /> - _':_ ,�.�. � <br /> iYPEOi[ON15.ALLOWRflLF iYf'EOfCONSt.AtiUAI OCL�ICY MORUrturt�GuxitS — _,.,�.i'�I� — <br /> v` �r V _ �� PLUMBINQ 1 ,_„ <br /> SREOF9�DG. � � NOAFSTO�IES B/SEMENT MECHANICAL �� <br /> � r�`� <br /> ,��D �� � <br /> OCLUPANCYIOAD FlRESPRNNlER5RE0'D MEIGNTLIMITRION <br /> ADDIiIONAI PUN CHECK <br /> S � <br /> - � � OTHEfl � �) � <br /> PERSONFORSPRINKLENS <br /> STATE BUILDING SURCHARGE i <br /> �Hu�eer P�S. %Y CITY OF EV�RETT PUBLIC WORHS � <br /> �/ LOCALSALES �,,_?; ,��� <br /> .� TAX COOE IS 3105 rorn� �_� ; <br />