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APPLICATIQ�� FO►R CAN�YRUCT' �N PERMIT ;,��/,���► , <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT ���T � <br /> BUILDING DEPARTMENT H�T�NG SYSTEM: J GAS J ELEC7RIC ❑ I <br /> 259-6810 <br /> Ci DEMOLITION i7 COMBINATiON ❑ BUILDING i7 MECHANICAL C�PLUMBING SIGN <br /> ��t���� �I�c�,���,��(ra�� Co�Uy �Uc_ �v �IS�-��?P� �� ; � . <br /> �� ') - '�5:�� <br /> T[HN:i :lA1AD'�RE:S rrtv 2�o FM�.-fi1E <br /> 7� l 1� <br /> �ncHrtECT oFsua�n v�awoness cm vr vNor+E <br /> ►�°�t� � <br /> cEr+enuca�ra�ctoa ws.�oopEss crtv zw wror+E st�rEucEHse. <br /> yTC t'� �1 I �'� � <br /> l'I� �.'�'GH�NiCAILONTRAGTpH /AAILMDqESS CM ZIP PNONE STFTEIILEN5E1 <br /> m�x �'�. �� . �. <br /> ayy �'lUM9MGGONTPAGTOA 1.IFLLA[NJflESS CIiY ZV P110NE STATELIGEHSE� <br /> N a�' <br /> H Z H GON CT PPICE O N <br /> � H� ��'�� � <br /> � H� �ESGRREWpRKANDSOUAHEFOpTAGEMVOlVEO LOt1T�CiPEP50NJWpPHOHETq. <br /> VI H <br /> � o r� ��l��fl �1 nG �� /� <br /> �3 G <br /> � ~�y �J ' i HEREBV CERTIFV THAT I NAVE pEAD AND EXAMINED THIS � <br /> 1�-i r p -�erosFeu� nc APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL � <br /> pn.q� C � PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE Of <br /> Z H ��.��.�oeseaianorvorrao=wrv�s�+a�metwwonett�eN*uocor�[si WOPK WILL 8E COMPLETED WITH WHETHER SPECIFIED HEREIN OR , <br /> a y� NOT. THE GRANTING OF A PEilA11T DOES tJOT PRESIIME TO GIVE <br /> r H H "� °L�� � AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS Of ANV <br /> `7 f/�H OiNER STATE OR LOCAL LAW REGULATING CONSTRUGTipIJ OR THE <br /> n d� PEFFORMANCE OF CONSiRUCT10N.THAT I AM AUTNORIZED BY THE <br /> Q C r OWNER OF THIS PROPERTV TO PEPFORM THE WORK FOR WHICH <br /> �' t�� APPLICATION IS MADE AND i COMPLY WITM THE STATE <br /> z y y •����CELTA%10.NVIdBER CONiRACTOPS LAW iB27 RCW AND 296.200 WAC. <br /> �-3 O[/r <br /> � -^GtRULIiONLWHI[NDEH.MDR[SS,iELEPMpiEN114BEq � ^ <br /> � � <br /> x �j,1'T� ! ����r��; Yi:'- � ' _ .�> �� _ <br /> � p� � _'- wi[ <br /> PROJ ��5 C i � .I� l � I �� <br /> PLUMBING MECNANICAL <br /> NO. TYPE OF Fl%TUHE OH ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> �� <br /> WATEF CLOSET ITOILET� A'C--AHNDLG UNITS—H.P. <br /> I � j �ATHTUB _ FOIiCEDAiRSYS?EMS—B.T.U. Id E.A. <br /> I LAVATORV IWASH BASIN) _ UNIT HEATERS—H.T ll. M <br /> SHOWER CLOTH[SDFVEPS <br /> '�r KITCHEN SINK 8 OISP _ VENT4AilON FAN <br /> �+� DISHWASNER RANGE HOOD <br /> LAUNDflYTRAV WA1ER HE�TER <br /> ,,,,� CLOTHES WASHER � WOOD STOVE � <br /> I !' URINAL MGTAL FIRGPLACE IWOOD BURNINCa� � <br />� .,...` — <br /> DRINKING fOUNTAIN FIREPLAC[INS[RT <br /> — _�_ — <br /> FLGOR DRAIN HEAT PUMP � <br /> "'� � B4CKPLOW PqEVENTERS ; � GAS PIPING <br /> �� � ROCF ORAINS—RAINLEA�EpS � EXHAUST fAN <br /> SINK(SERVICE—BAR.ETC.� <br /> �� <br /> !'�� SUB TOTAL E SUB TOTAL 5 <br /> '� PERMIT 5 PERMIT $ <br /> TOTAL FEE S TOTAL FEE S <br /> FOR OFFICE USE ONLY: <br /> raor�rs!t��ncv nenesrri�ner sioEseioneK rinr�cuer.✓r�uine�e rc� n[cciPrno <br /> / C'� <br /> usezor+e �oteRee vncartsrte FEES VALUATION FEE <br /> I �� VE3 L-1 NO ouaoiNa <br /> ryp(pt[Urysl. fi00F5TOA�E9 ncrur�.xr.r xodmvi�.iw�un^r <br /> . r,nnw� p�U�AF3ING <br /> 512EOFBLDG. FlflESPPINY.LERSPEOD 945EMEM MEGHANICAL <br /> r i ves n No -- ; <br /> OCCUPANCVLOAo FIR[�URMF[Ov HGiGMiLn.irtniloN ADDITIONALPLANCHECH i <br /> � <br /> OiIiEH � <br /> PGSON -- <br /> S1nTF CIUILDING SURGHnRG[ <br /> n,rnvenv auNsnrraovconv CITYOFEVERETT �uoucwor+ns � <br /> LOCALSAIES <br /> bRi[ TAX CODE IS 3105 TOTAL �� <br />