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APPLICATI�.d FOR CONSTRUC7 .JN PERMIT � <br /> TO BE COMPLET� 71N BLACK INK—PLEASE PRINT <br /> T��� Au:_� �� 39y( -CX�o - O 2� -�OOC� <br /> BU�LDINGDEPARTMENT HEATINGSYSTEM: rGAS ❑EI.ECTRIC O <br /> 259-BB10 <br /> • DEMOLITION ' COMBINATON • BUILDING •MECHANICAL SPLUMBING SIGN <br /> �pL'� IC31� .fiON�Jl�ON �}�IJ3 1`ilWl FlZ.la1�11F�FTf P��E 25L-5`Iz� _ <br /> TEN/J1T MA4AODPE55 Clry IIP FWJFE <br /> ✓ <br /> �PCNIiEGTORO[SqNEII 4MMOPE55 CItY IIP PIqNE <br /> J W t1`�/ <br /> GEHERALC 1FAGL011 M�0.AOUPE55 ;trw_ IIP 3�d ']f�IPr S1AiELILHSE• <br /> �il ��r,IS1iZAAGflO�� 3Y7� 13'f�' /Z✓ nJE� �Yf�vJJ�� � �3J1� LE•%✓iTt�,Y/�ldPr <br /> MECNANiC0.0 RI�CIOA M�4�DDPE55 CItV IIP F11:NE SI�iElCENSE• <br /> lAnJl(�t/Ov/N /J��/ �'LclR(.r/�� <br /> PWMBINGLpI1R�CiOP M�R/�U�flE55� GiY. 21F %qNE Si�IEIICENSC• <br /> nnnuNsv�l�'/ r'��ti`�-(��-+�� �o flJnp��1Yil�� <br /> ��„��� . <br /> � � NEW ,�.ADDITION ' ALTERATION REPAIR �OEMOLITION I WOODSTOVEFRPLINSERT BUILOINGRELOCATION <br /> CONIALI PERSON ANO V�10NE Iq <br /> J �/ q� <br /> LpI1RALiPPICEOF WIX�R ti ��3' rn �� ^� ��Y��`r <br /> OESCPIBE WJRN�N�SOUAFE iW GG[�NV0.YE0 <br /> !19(J_ hAT'F� ( I� SF� Cs/1771�Cf'4 � IZr7 $1` <br /> rnoros[ouscareun�ivc ' I HEflEBY CERTIFY THAT I HAVE READ AND EXAMINEU iH15 <br /> ��� Rn"P�1��M '� �h��-.hGG ��G�• APPLICATION AND KNOW TME SAME TO BE TRUE AND CORPECT A�L <br /> �¢en�oeunirrnwaveorenrvR�oN++o[irnvoa�*ucerauncowcs PROVISIONSOFLAWSANDOR�INANCESGOVERNINGTHISNPEOF <br /> WOFK WILL BE COA1PlETED WITH WHETHEfl SPECIFIED MEREIN OR <br /> ior 29 i�5aiocv or f° O/ GY�O NOT.THE GRANTING OF A PERId1T DOES NOT PRESJME TO GrvE <br /> AUTHORIIY TO VIOLATE OR CANCEL iME PflOVI510N5 OF ANV <br /> OTMER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR TME <br /> PERFORMANCE OF CONSTflUCiION.TMAT 1 AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTV i0 PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COh1PLV WITM THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> x� (�J�'✓%l, 1-9-�z <br /> c�¢reooaess �eK.�noT— nur <br /> 9{0� r-owl�� Av� � e � A --�a;R«n,<�.��.� <br /> PLUMBINC MECHANICAL <br /> NO. TYPE OF Fl%TUNE OR REM FEE NO. TYPE OF EOUIPMENT PEE <br /> J WATERCIOSETQOILET) - AC—hNN�LGUNITS—H.P. <br /> BATHTUB FORCED Alfi SYSTEMS—B.T.U. M E.A. <br /> LAVATORV�WASHBASIN� h � "- UNITHEATEFS—B.T.U, M <br /> SNOWER — CIOTHESDRVERS <br /> KIiCHEN SINK 8 DISP VENTILATION FAN <br /> DISHWASHER tiANGE MOOD <br /> LAUNDPV TRAV WATER HEATER <br /> CLOTHES WASMEP WO00 STOVE <br /> URINAL ME?AL FIREPLACE 8 CMIMNEY <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOWPREVENTERS � GASPIPING <br /> NOOF DRAINS—RAINLEADERS / EXHAUST FAN <br /> SINH(SERVICE—BAR,ETC.) E A1S O ' S //✓b' <br /> S�(r'f� U,VL' <br /> �— <br /> SUBTOTAL 4 � — SUBTOTAL S — <br /> PEHMIT S PERA71i S <br /> TOTALFEE S TOTALFEE 5 J ' / <br /> FOR OFFICE USE ONLY: � ��,.11 ' �DLP � � �: /� 7 f ' <br /> iVq11l5(iOACM NEARSEIMCK J SNESEiBALN PIANP�EGM1NVMO[B / iC AECCi1'iN0 <br /> � � / gsm/3 '' �3.lsv 11� 3// <br /> us¢z��� io*euer. v�u�+rSrtE FEES YALUATION FEE <br /> O111L01NG Q'�O�j <br /> 1rRpCOMISkIONIBI[ 61'lMCONSI�C�WI RL6� tlaMRlN4wn <br /> � , � PWMBING O — <br /> SiSEOFBLW NOOFSiOniFS B.�SEYENi MECNRNIC�L <br /> I Sr lwoN f <br /> OCcuvuSv�w.D �mEsvrva�cqseEOD ME�cN�uurteiror{ pDDIT10NALPUNCHECK <br /> �JQ / <br /> Np �CJ SPRINNIER <br /> PE�SCN NSfXM✓.tFPS —1— <br /> STRTEBUILD�NGSURCHARGE ( � <br /> wuxe er ruvs evvnwmer CITY OF EVEflETT Pl19LIL WORNS --!- <br /> LOC�LS�LES <br /> �I�hL TIIX CODE IS 3105 *�T�� 3 ; <br />