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APPLICATIC \J FOR CONSTRUCT �N PEF�MIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> � <br /> BUILI 'ING DEPARTMENT HEATING SYSTEM: ❑GAS [�ELECTRIC ❑ <br /> 259-8E10 <br /> I i DEMOI.ITION I i COMBINATION x BUILDING MECHANICAL I I PLUMBING i I SIGN <br /> OWNER MAILAODRE55 CITV ZIP PMONE <br /> /�/CNA(.'D �J, CAiPC'OLL /Da8,loMBA�D A✓F tf'VE,PE7T 48�0/ a5.�--SiSS'� <br /> TENANT MAILADURE55 CIN ZIP PHONE <br /> ARCHITECT OR DESIGNER MAIL ADDRE55 pTV ZIP PMONE <br /> GENERALCONTRACTOR MAILADORESS CITY ZIP PHONE STATELICENSER <br /> owv�e — <br /> MECHANICAL CONTflACTOR MAI:ADDRE55 CITV ZIP PMONE STATE UCENSF.p <br /> PLUMBINGCONTflACTOR MAILAUOPE55 CIN ZIP PHONE STATE�ICENSE• <br /> CLA55OF WORK <br /> �NEW I l ADDITION I �'�. ALTERATION � I REPAIfl �. 1 DEMOLITION . I WOODSTOVE/FRPL INSERT I I BUILOING RELOCATION <br /> � [�'//� CONTACT PEFSON AND PHONE NO. 1�✓ .3U.Z',�/�,� <br /> CONTRACTPFICEOFWORK � / OO� � � 7 rc Aeo A.�.�o,cG- a�s"0.- �.5�� <br /> DESCFIBE WO AND SOUARE FOOT GE INVOLVED I <br /> �7 5 `�'��.�e?a / <br /> PROPOSE�USEOFOUILOING i HEREBY CERTIFY THAT I HAVE RE.aD AND EXAMINED THIS <br /> GARA6 F �0.� CAQS APPLICATION AND KNOW THE SAME TO F1E TRUE AND CORRECT.ALL <br /> LEGPL DESCRIPTIONOF PROPERTV ISHOWN BELOW OR ATTACH FOURCOPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPEC:FIED HEREIN OR <br /> �oT BLOCi( oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PFlOVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AId:�UTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERF(1RM ThE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CCNTRACTORS LAW 18.27 RC,W AND 296200 WAC. <br /> io�8 to,rrB,�Q� ,a�E E e� x :?� � G�l%� s/o�y� <br /> PROJECT ADDRESS SiGrvnrU o E <br /> LITY 805 W ESS UCENSE IiJ. <br /> PLUMBING MECHANICAL _ <br /> Np, TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF E�UIPMENT FEE _ <br /> � <br /> WATER CLOSET(TOILET) � WC—AIHNDLG UNITS--H.P. <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> LAVATORY(WASH BASIN) � UNIT HEhTERS—B.T.U. M i _ <br /> SHOWER ' CLOTHES DRYERS ' <br /> KITCh'.EN SINK&DISP � VENTILATION FAN � <br /> --�- <br /> D�SHWASHER RANGE HOOD ' <br /> LAUNDRY TRAY ; WATER HEATER ' <br /> CLOTHES'NASHER WOOD STOVE __ � <br /> URINAL ; METAL FIREPLACE 8 CHIMNEY ' <br /> DRINKING FOUNIRIN � FIREPLACE INSERT � <br /> FLOOR L�FAIN HEAT PUMP ; <br /> BACKFLOW PREVENTERS ; GAS PIPING � <br /> ROOF DRpINS—RA�^�LcADERS � EXHAU�T ri�IJ ' <br /> SINK(SERVICE—BAR,ETC.) _ � � — <br /> � � <br /> _ _ � <br /> _ _ — � <br /> — � � <br /> SUB TOTAL $ ' SUB TOTAL $ ; I <br /> I <br /> PER141T $ � <br /> PERMIT c � �— <br /> TOTALFEE $ ' TOTALFEE $ ' . <br /> FOR GFFICE USE ONLY: I <br /> FRONT SETBACK AE�A SETBACK SIDE SETBACK/ PLAN CMECK NUMBER FEE flECEIPT NO <br /> � • o - ,S � ��� -7 , 20 7 /�.�_ <br /> I <br /> USE20NE.y � '�TAREA VACANTSITE FEES VALUATION FEE_� <br /> �li� BUILDING p � 06 <br /> TYPEOFC01lT5.,\LLOWABLE I TYPEUFC011Si.PCTUAL OtLUPaNCY NUAfM1CUJx�_urnts � <br /> GPOUP PLUMBING <br /> —��L �Z-�— -� � <br /> SREOFBLOG. NO.OFSTPRIES BASEMENT MECHANICAL � <br /> s���= N" � <br /> OCCl1PAN'.Y10.'.� FIRESPflNKLERSREO'D IGHTLIMITA ION ADDI?IONALPLANCHECK � <br /> i <br /> �� n[� �� SPRINKLER i <br /> REASON FOR SPRINN�ERS I�D <br /> STATE BUIl01NG SURCHARGE l7 <br /> INTANEBY FVNSAPPROVEDBY CITYOFEVERETT PURLICWORKS T- <br /> 11 LOCAL SALES � <br /> � JT� �a�g qZ TAX CODE IS 3105 TOTAL //a, ;Sp i <br /> ' c <br />