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APPLICATIO'� �dR CONST�UCTI N �'(�RMIT ��►� <br /> TO BE COMPLETED IN BLACK INK—P!_EASE PRINT � <br /> BUILDING DEPARTMENT '�'�=/+TING SYSTEM: J GAS U ELECTRIC U <br /> 259-9810 <br /> ! ! DEMOUTION �COMBINATION ��( BUILDING xMECHANICAL �(PLUMBING �; SIGN <br /> owr�en rananoonrss — <br /> �'(r' cm z�r w+or:e <br /> �J.Y�e �f�, 1\�)i 1 (� r+ �1� �i� U �L`Z'�TE'C�' �1�� ';t�7 1 �sr y- <br /> TENANT qILq00RE5 ry7y Z�p PRONE <br /> ARCHITECTORDESIGNER ldAILADDRESS CITY ZIP PNONE <br /> GENERALCONTRACIOR MAILADDFE55 GI7Y ZIP PHONE STATELIG Fa <br /> �itQu1C l5 f K l <br /> ��Ln_ �l�r{ �p lL1i 1 C.C�L1n �AR �C� 1 y �L^�J��,i�.L ���41-7 14 4 <br /> MECHANICALCONTRACTOR IZAAADORE� CITV ZIP PMON[ STATELICFNSE• <br /> PI/.b�M��INGCONTRACTCR h1AILADDRE55 cCITY ZIP PHONE STATEUCENSE• <br /> 1.��a (����,_m n CNP Ru�_ <br /> CONTR�CT PRI E OF I:ORK <br /> _.50, CXX� <br /> DESCRI�E WORK AND SOUARE FOOTAGE INVOW ED GONi�CT PERSON�ND PNpNL NO <br /> ��,y� �4 7- Z1� _ <br /> n � d � 34- ya3v M�}�,��. <br /> I��Jltl nOr�aC�nm,fo � � <br /> --L�� i HEREBY CERTIFY THAT I HAVE READ AND EXA�AINED THIS <br /> rr�oF �sen ose oF evaoiNc APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECi ALL <br /> J PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEG�LDESCRIPTIONOFPROPERTV�SHO\'lN�ELOWORATTACHTWOCOPIES) WORK WILL BE COMPL[TED WITH WHETHER SPEqFIED HEREIN OR <br /> ioT`� `� �' o�ocK �— or f1.11]�'til�' n�V (j NOT. THE GRANTING OF A PER�dIT DOES P10T PRESUME TO GIVE <br /> AUTHORITV TO l'IOLA?� OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAI :AW REGULATING CONSTR�.;TION OR THE <br /> /�-(7" PERFORMANCE OF CONSTRUCTION.TH,1T I AM AUTHqRIZED BY THE <br /> �t,�S'b o z -3 00- a, 3 �) /�� ao-- OINNER OF THIS PP�PER7Y TO PEqFORM THE WORK FOR WHICH <br /> {{�/-�jS�—f�— APPLICATION IS MAD[ AND I COA7PLY WITH THE STATE <br /> PARCEL TAX I D.NU610ER <br /> �,Jr» CGNTRACTORS LAIh'18.27 RCW AND 296100 WAC. <br /> CONSTRUCTIO'l LOAtI LENDER.���FESS.TELEPHONE NUTADER <br /> � �E,ri� �,mk s � � - �� � �:� �v�� ?-�•y3 <br /> PROJECT ADDRESS �` / _ ,'7 s.r.wnmi __� <br /> n�rr <br /> o2/��Q !'<.�,:-t �d✓. -�i'<-_ tirv�us:rv�ssuc�r�si-mo —_ — <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI7(TURE OR ITEM FEE NO. TYPE OF EOUIPMENt' FEE <br /> � WATER CLOSET(l"OILET) A/C—A'HNJLG UNITS—H.P. <br /> BATHTUB FCRCED AIF SYSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M <br /> SHOWER CLOTHES DRYERS ---T <br /> KITCHEN SINK&DISP � VENTILATION FAN � <br /> DISHWASHER � 1� R<,NGE HOGC --T— <br /> LAUNDRY TNAY ' � WATER HEATEH <br /> � � <br /> _) CLOTHES WASHER � WOODSTOVE ; <br /> URINAL � MLTAI FIf;EPI.ACE�WCOD BURNING) <br /> DRINKING FOUNTAIN � FIaEPLACE INSERT ' <br /> FLOOR DR�,IN � HGAT PUMP , <br /> BACKFLOW PRE-VENTERS ; G?S PIPING � <br /> ROOF DRA�PJS—RAINLEADERS T 3 E;<HAUST FAN <br /> SINK(SERVICE—BAR.ETC.) , — <br /> — <br /> — --. � <br /> �— <br /> SUB TOTAL c ' SU�TOTAL S � <br /> PERMIT S � PERMIT $ ; <br /> TOTAL FEE S TOTA!FEE 5 <br /> �OR OFFICE USE ONLY: U ,� � ��_� ���,� ��; <br /> �'flONTSETBACN . REARS[iB�N, SIDEStiAC� PLAN���NOh�Fj1) F��� /�J RECEIPyryC�/�� <br /> ( (1� / C 6 p <br /> usezoNE� ^ �or� VACANTSRe FEES VAIUATION PEE <br /> �� :1�:(�� ❑ YES jy�NO <br /> � BUILDING � ��C� � C)�'. <br /> NO.OFSTORIES oc[UrAv[r r:aorvnTw4cbN�i3 � <br /> nreovco sr ` _ <br /> � — I�I I ao°3 � PLUMBWG �i U _ <br /> SIZE OF BLOG FIRE SPRINKLERS REO'D AASE6IENT � <br /> IGIC �� -I� ,(�.,(, MECHANICAL �[) i C,-�� <br /> , � Z t , n ves ����o <br /> OCCIIPAN/�C'V/L1OAD FIpEAIARMRE00 HEIGHTUMITATION ADDITIONALPLANCHECK � ��� � <br /> IV fr G OTHER .-�� /,;.\ ID ' O�7 <br /> �+rA50N — � <br /> STATE BUILDING SURCHARGE ;S, � <br /> C�iAKL�Y PLANSAPPBOVEOBV � <br /> CITYOFEVERETT PUBLICN'ORKS �� � � ��� <br /> "S�� LOCALSALES <br /> on,e �-,�_ �) � TAX CODE IS 3105 rorni J� ; <br /> _ �j � y"� <br />