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Ai�PLICATIQ�' FOR CONSTRUC'T'-1N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> yo9i 3 <br /> HEATING SYSTEM: ❑G4S Q ELE:fHIC ❑ <br /> BU�LDING DEPARTMENT <br /> zss-se�o . . - q,,,��/;�.� ��z��;� �� 39�5� <br /> DEMOLITION i I COMBINATION I:l BI�ILDING i I MECHANICAL �LUMBING I I SIGN <br /> o�+en y�tHran,.GL3.,ly n��a nooncss CITV ZIP PHONE <br /> r�,�,�r� ,�4'3 5', .-5 0 0<,c L;�,a.Fc�� [v'''Vr�,z�7`f 9'sao� .�54-35 35 <br /> 1EN4Ni AVJlA00RE�5 CITV 21P PHONE <br /> nfiCHREGTO00ESIGNER MAILAUDRESS CITY ZIP PHONE <br /> G[IlFR�LCONiMLTO� ,/� MNLAOORESS CITY 21P PHONE STf,TEUCE115E." <br /> _/y�N.�JG/�/_�lI (".,.�57, L�+_'�Caa"�+7'� ?'� % ' �I%� _ <br /> McCN4NICALCON10AGiOR I.I�ILAODf1EF5 CITY ZIP PHONE STATELICENSE� <br /> PWMBMf.CONTf1�CTOf1 lAAILAOORE55 CIN 21P PNONE STATEUGENSE._ 1�✓ <br /> �/�. L.e���,� 'r'G�n P,o.,30,� 5 2_> �9�a,�vs�;Il� 9�17C L.]3-1'/�•G Y S_ <br /> c�nssorwonK i " <br /> ' ' NEW ADDITION I I �LTFRATION � I REPldR fJ DEMOLITION L I WOODSTOVFJFRPL INSERT f I BUILDING RELOCATION <br /> CONTACT PERSON AND PNONE NO. <br /> CONiN�LT PRIGF OF WOPK <br /> OESCPIOE WOfiK AND SOU�RE FOOIDGE INVOLVED <br /> rnoroseousEorouao.Nc , . I NEREBY CERTIFY THAT I HAVE READ AND E%AMINEO THIS <br /> �� � � APpLICATION AND KNOW THE SAME TO OE TRUE AND CORRECT.ALL <br /> L[G4l DESCRIPTIONOF PROPERTV(SH01.N BELOW O(1�TTpCH FOUR COPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OFl <br /> ior BLJCN ___ pF NOT. THE GRANTINO OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PflOVIS10NS OF ANY <br /> OTHER STATE OR IOCAI LAW REGULATIN6 CONSTRUCTION OR THE <br /> P[HFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORI2ED BY THE <br /> - ' �OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> — APPLICATION IS MADE AND I COMPLY WITH THE ST.4TE <br /> CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> i-c" C, . � —„ ��� � x �ll c,o���--.., ���/.-�-._� G� -- ��- `J3 <br /> , <br /> �-naecrnooness sb�+"/ E / � s °^'� I <br /> � <br /> cirveuswEssiwcusEra' <br /> PLUMBING MECHANICAL ', <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. ' TVPE OF EOUIPMENT FEE I <br /> WATER CLOSET(TOILET) F° A/C—A/HNDLG UNI7S—H.P. �_ , <br /> BATHTUF3 � FORCED AIR SYSTEMS—B.T.U. M E.A. ; �. <br /> � LAVATORV(WASH AASIN) � ' F � ' UNIT HEATERS--B.T.U. M ' i <br /> SHOWER ��'° CLOTHESDRYERS � i <br /> HITCHEN L�NK 8 DISP ; VENTILATION FAN y- <br /> DISHWASHER � ' RANGE HOOD �— �, <br /> LAUNDRV TRAY � � � WATER HEATER ' <br /> CLOTHES WASHER WOODSTOVE � <br /> —,-- <br /> URINAL ' METAL FIREPLACE&CHIMNEY � <br /> DRINKING FOUNTAIN i FIREPLACE IPISERT i <br /> — T <br /> FLOOR DRAIN � � HEAT PUMP � <br /> BACKFLOW PREVENTEP.S i GAS PIPING �_ <br /> ROOF DRAINS—RAINLEA�ERS � EXHAUST FAN <br /> SINK(S[RVICE—BAN,ETC.) ; ' <br /> — ' � — <br /> — � � <br /> -- � <br /> � � <br /> —i— <br /> i � <br /> SUD TOTAL $ " ';00 SUB TOTAL $ ' <br /> PERMIT $ , )�� PERMIT S � <br /> TOTAL FEE $ ti " TOTAL FEE S <br /> FOR OFFICE USE ONLY: <br /> FRONTSEIO�CK REARSEIBACK SIDESETBACK PLANCMECKNUMDEP FEE RECEIPTNO. <br /> IIS[20NE IOTAREA VAGANTSIIE FEES VALUATION FEE <br /> OUILDING � � <br /> Ivf�OlLONISALLOIYAOLE 1TPEOfGOHS7ACIWL oCN��vtv NO.OfMrtIUNGUxnS � <br /> . ��o PLUId�ING � i <br /> —r— <br /> SiZE OF OLD6 NO.�c cipHiES OASEMENT � <br /> MECHANICAL � <br /> oCGUPnNCYIO�D FIHESPRNNLERSRE]'D HEIGHTUMI7ATICN ADOI110NALPLANCHECK i <br /> i <br /> SPRINKLER ' � <br /> � <br /> nFnSONfOiiSPRINKIERS ----� I <br /> STATE OUILOING SUFCHpqGE . i � <br /> �r�inkeor T rinusnrrnoveoov CITYOFEVERETT PUtlLICWORKS ' <br /> � LOCALSALES � <br /> TAX COUE IS 3105 Torn� � <br />