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APPLICATIC 1 FOR CON�TRUCT� �Pi P�RMIT �� <br /> TO BE COMPLETED IN BLACK INK-PLEASE PRINT ��r <br /> HEATING SYSTEM: [J GAS U ELECTRIC ❑ � I <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> DEMOLITION f 1 COMBINATION k BUILDING I 'MECHANICAL I PLUMBING ' : SIGN <br /> OIVNER �,� MARApOFE55 Glv ZIP Pr+.�":C . <br /> _Iki1Z--k+-�1�E;� ��✓'—b�AcvA_ �F.��.�-�' �� �-�-14-ra <br /> iLtlANi MAILA OFFvS G�IY :IP PHO'l2 <br /> nHC�uiC.CIOH�ESiGNER MAllAO�RESS GIiY Z��' PHONE <br /> ��� G[NEHALCONTPFCTOR 61AiLADORE55 CITY cil PMONE SIAT6tC6bE �-�( <br /> C�y � � [�y �vr-�� RR'L03 �SlI3d 5 �fJ(faL�J� <br /> F"� 6 cC��ANiCAL CONTRACTOB MAI�pqE��� ��TY Z�� PHONE STAiE UCENSE• /���K, <br /> aym <br /> ~ ��" PLU'.���4G GONiRACTOP 41AIL AOORE55 CILY ZiP PHONE S1pTE LICENSE� � <br /> y H � <br /> tC y� I <br /> � H� RY1tRACiPPICE�YORN ' <br /> �H `�c;32. <br /> H xt" C[SCfUBEWORKANOSOU�REFOOiAGE�NVOLVE� LORi\CTPERSONRN�PHONENO � <br /> C� Of� 1�Fr��Y]r_ .Gd�i�'�-��1--�r.q <br /> HC ; <br /> ���yyy �1LlC,l�l�Y�(.LTIH�S�LI��QGD—�A�.s'._13C11t� %3�-�J?,�3�J <br /> ��C' _�� ��r'�_ i HEREBV CERTIFV THAT I HAVE READ AND EXAMINED THIS I j <br /> rnoanseo use oF o^aoirvc APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALl � <br /> a y� PROVISIONS OF LAWS AND OADINANCES GOVERNING THIS TVPE OF �, <br /> � <br /> t H H it;c��o scaiP*io OFPROPERtt�SHOWNBELOWOPATTFCHiWOGOPiES� WORK WILL BE COMPLETED WITH WHETHEF SPECIFIED HF.REIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE � <br /> y H �or etocK oF AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF AtJY <br /> nG d y OTHER STATE OR LOCAI LAW REGULATING CONSTRUCTION OR THE <br /> 3' �� PERFORMANCE OF CONSTRUCTION.?HAT I AM AUTHORIZED BV THE <br /> z y y OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> i <br /> y py _ APPLICA7lON IS MADE AND I COMPLY WITH THE STATE � <br /> fARCEL TA%I.D NUTABER CONTRACTORS LAW 1827 RCW AND 2962001h'AC. E <br /> CO,�STRUCTiO!�ICtN LEN�ER,ADDPE55.TEIEPHONE NIIMBER <br /> si�mn�.__�� � _—.2�- <br /> PROJECTAODRESS . <br /> . ' , vn�_s: '��c �.o <br /> P W MBING MECHANICAL� <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> ��� WATER CLOSET(TOILET) _ A�C—A'HNDLG UNITS—H.P _ � <br /> �� 6�THTUB FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) UNIT HEPSERS—B.T.U. M � <br /> —� <br /> �� SHOWER CLOTHES DRVERS <br /> �I KITCHEN SINK 8 DISP VENTILATION FAN <br /> . DISHWASHER RANGEfi00D <br /> LAUNDRY TRAY WATER HEATER . � <br /> � � � WOODSTOVE i� <br /> CLOTHES WASHER <br /> !1 URINAL ' METAL FIFEPLACE(WOOD BURNING) ' <br /> DRINKING FOUNTAIN FIREPLACE INSERT � _ <br /> � FLOOR DFAIN HEAT PUMP ' � <br /> '' � BACKFLOW PflEVENTERS GAS PIPING � _ <br /> ROOF DRAINS—R�INLEADERS EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) - <br /> �� � � <br /> i � <br /> � � <br /> �� SUB TOTAL S SUB TOTAL S <br /> PERMIT 5 PERMIT 5 <br /> TOTALFEE S TOTAIFEE S ' <br /> FOR OFFICE USE ONLY: <br /> �RONiSLIfiACN PE�RSCIUACN SIDESETOACK PIANCH[CeNUMOfiI �[E � OO �ECEIPiNO <br /> �q ��,� a <br /> uscza�e �ornn[a VACANi51T[ FEES VALUATION FEE <br /> [,� VES : i NO BUILOING <br /> rvrfavco��s�. rvo.ovstowes a,u���cY xoo�on�����:,:.�.��� --- <br /> L40'.1° pLUh7[�ING <br /> SiZEOFOLDG. FIRESPRINKLERSPEO'D BnSEMENT MECIiANiCAL � <br /> n ves n No <br /> OCCUPANCVLOAO FIREALR1iMPE00 NEIGHTLIMIiAT10N ADDITIONALPLANLHECK � <br /> i <br /> OTHER i <br /> �' <br /> R[n50N <br /> STATE BUILDING SUFCHARGE <br /> INLANE�Y PLANSAPPf10VFD0Y CITYOFEVERETT PU�LICWORKS <br /> LOCALSALES <br /> �,,�,� TAX CODE IS 3105 TOTAL <br />