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pPPLICATIO�.FOR CONSTRUCT�'1N PERMIT � <br /> TC�BE COMPLETED IN BLACK INK—PLEASE PRIN f <br /> HEATING SYSTEM: GAS O ELECTRIC U <br /> BUILDING DEPARTMENT <br /> 259-BC10 <br /> i i DEMOLITION � ' COMBINATION i i BUILDING �ECMANICAI I i PLUMbiNG I'I SIGN <br /> owe�n 1 M�a uioHess�3.6 od �Su cirr zir L y�--..•..-�.,.nar� 69�'7c � 7Yf%/6�:`/ <br /> A�� <., HFMM W% _����� F Y.�aF�-T Z9B2�r .?S�3ss / <br /> TEWWT MULADD'1E55 <br /> •RGNITEGT OR DEBqNFM <br /> MA1LI100I1ES5 pT`/ ZIP ►��E <br /> GENERAIL�MTRACTOR <br /> WiI�UDRE55 CITY ZIP P110qE BTATELIC�MiE,.+�, . � <br /> MEGIUNICKCONTMCTOR MAaADORE55 <br /> CITY 21C PlIOME BT�1EllCi1M[� ' <br /> i/�����. A/R,- �-,�� F?� �aU S / 6 ve 9&'Zo6 Sc�3G zS9-S4�Z I/RGLFtiin& S� <br /> �"' M�0.AOORESS GTV LP PNONE SiATEl10EN8E� <br /> PLUMBqO(1CONTMCTOf1 � <br /> ClA55OF WORN � � <br /> i I NEW I I ADDITION ✓ A�TERATION � : REPAIR i i DEMOLITION I � WOODSTOVE/FHPL INSERT I I BUILDING RELOCATI N <br /> 7�� Cp1IhCT VERSON�ND P/IDNE MG. <br /> I;ONIH��:iYHil:lOfWOHIf '�� 6 � ' �� <br /> OESCN�bE W WM����RE FOOTIIGE MVOLVED <br /> , E ;Y, (,,, - NE�.,S <br /> PROPOSEOUSEOFBURDING i HEREBY CERTIfY THAT I NAVE READ AND EXAMINED TMIS <br /> ` APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> �F 5 i ACi�AN T_. _ pROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEG�lDESCNiPTIONOFFROPERTYISMUWNtllIOWORATTACMFWRCOPiE9� yrORK Wi�l BE COMPLETED WITH WNETNER SPECIFIEO MEREIN OH <br /> i�T yi�K _____ _ or NOT. THE GRANTING OF A PERMIT OOES NOT PRESIIME TO GIVL <br /> AUTHORITV TO VIOLATE OR CANCEL TME PROVISIONS OF ANY <br /> OTHEii STATE OR LOCAL LAW REGULATINC CONSTRUCTION OFi TME <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY TME <br /> OWNEN OF THIS PFOPERTY TO PERFORFA THE WORK FOH WMICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTHACTORS LAW 18.27 RCW AND 296.200 WAC• <br /> � x � /� � - ?s---��-- <br /> .� a�. <br /> PNQIECT�DDIIfBB r <br /> / r U� 4"— {_ �FRET i fil�tlOfiN1651i[[H]t1A <br /> PLUMBING , MECHANICAL <br /> fEE N0. TVPE OF EOUIPMENT FEE <br /> NO. TYPE OF FIXTURE OR ITEM q�C-NHNDLG UNITS-H.P. ' <br /> WATEH CLO''ST'TOILET� � <br /> BATHTUB FORCED AIR SYSTEMS-B.T.U. M E.A. <br /> LAVATOfiY(WASH BASIN� UNIT HEATERS-B•T.U. M ' <br /> SNOWER ' CLOTHESORYERS � � <br /> � KITCHEN SINK 6 DISP VENTILATION FAN ��� <br /> DISHWASHER � RANGE HOOD � <br /> LAUNDRYTRAY ' WATEH MEATER � <br /> CLOTHES WASHER � WOOD STOVE ' <br /> URINAI ' METAL F�REPIACE 8 CMIMNEY � <br /> DRINKING POUNTAIN FIFiEPLACE INSERT ��— <br /> � HEAT PUMP � <br /> FLOOR DflA1N � GAS PIPING � <br /> BACKFLOW PFEVENTERS ' <br /> E%HAUSTFAN ' <br /> ROOF ORAINS-fiAINLEADERS ' � <br /> SINK(SERVICE-BAR,ETC.) ' ; <br /> i <br /> � <br /> � <br /> ' SUB TOTAL S O ' <br /> SUB TOTAL E pERM1T S � <br /> PERMIT f TOTAL FEE S ' <br /> TOTALFEE S <br /> FOR OFFICE USE ONLY: �cFrTeo. <br /> FHONTSETB/iLK REMSETB�CK S�UEC�ETBACN <br /> PIANCMECKMUMBER F� <br /> _ 388YZ <br /> FEES VALUATION FEE <br /> USEZ.XIE LOTAREA VACAN75�7E ; <br /> euaoiHc <br /> � <br /> trnuftox�s.�uow�rt rvrtacu�.tii�a:iuu ou�«..n .aaunu�wwu � <br /> � ' PLUMBING � <br /> � J <br /> 5¢E OF B�DG. N0�OF S70HiE5 BISEMENT MECMANICAL =/� <br /> � <br /> ADDITIONAL PLAN CHECK � <br /> OCCUPANCYLWD FIRESPRNItLER5PE0'D MEI6NTLIMITATION � <br /> � <br /> SPRiNNLER <br /> i <br /> REti50N FOR SPRM��E�` � STATE BUILDING SURCMARGE � <br /> INTMIEB--Y- �s��povEoer CITYOFEVERETT ausucwoAKs ' <br /> LOCAL SALES � <br /> TAX CODE 1S 3105 TOTAL � <br />