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APPLICATIC 1 FOR CONSTRUCT' 1N PERi1AIT ��' <br /> TO BE COMPLETED IM BLACK INK—PLEASE PRINT , <br /> HEATINGSYSTEId: UGAS JSELECTRIC ❑ __ 1 <br /> BUILDING DEPARTt.i[NT <br /> 259 BB10 <br /> ��. ' DEMOLITION '� I COMBINATION :�I BUILDING �. 'MECHANICAL '�.�!PLUMBING ��. �. SIGN <br /> �-,�m�p m.n aorn�css orv z.^ eHoxe <br /> /l�l��iu�/���anr ��c cr�v!' o7Hyd7 /�_'��r� N� �/in4�<n �� Y15=r.do�' <br /> r�.,.�„ «.��;ooAEu � ��r :�P P�oNE � <br /> �% � <br /> fli�p�pESiLNFP IAAM1MIXiE55 CITY ZIP PHONE <br /> .�...c.,CO�lrq�Rl MA�LAD�FF55 LILY 21V PINY:E SiAiELFENGEI <br /> � .� �]A�CONLMGiOR NAII/.00Bf55 CIiV ZiP PXONE S1A1ElCENSE• <br /> ..._.'LiCIXlip>CIDN MAR���PE55 CITV ZIP PWJNE SiAiELiCENSE� <br /> �"IP�l,1V iCE�f WOR✓ <br /> � �S �f�L' 1-c�i/1� /�c�n <br /> rF�.esewoneevoso neromneenrvaveo l con*c ren exovrov� u�rn3,� <br /> ) d GI Su / y.IS-/�d�0�1 _ <br /> .f11yr��L`,C'*rA_ +��� h TA're/�� linrs 77 — -- <br /> lUps�. Lev�//AA� ' 0 J�Q�4t i HEREBV CERTIFV THAT I HAVE REFO AIJD E%AMWED THIS <br /> �naroscnuscv}m�oirvcn / ���YL/lrt��NCWS�d��� APPLICATIONANDKNOWTHESAMET06ETRUEANDCORRECTALL <br /> S` ��p.fG�n //ind/Hff PROVISIONSOFLAY/SANDOPDI9ANCESGO'JERNWGTHISTYPLOF <br /> it:�:cr.�_amnarvocraov[erv�sr�axxocmwoeertnn�rxrotowEsi WORK WILL�E COIAPLETED WITH WHET✓ER SPEGFIED McREIN Oa <br /> NOT THE GRANTING OF A PERIAIT OOES N0T PRESUTAE TO GIV[ <br /> ��.'— o�°�^ O° AUTHORITV TO VIOLATE OR C�NCEL THE PROVISIONS OF ANY <br /> OTHER STATE Ofi LOC�L LAW REGULATING CONSTRUCTION OR THE <br /> - ---- PERFORh1ANCE OF CONSTRLICTION.THAT I AM AUTHORIZED BV TH[ <br /> OWNER OF TMIS PRPPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MAOE AND i COMPLY NITN THE STATf. <br /> ra�c;�*+r i o r�uueen CONTRACTORS LfbV 1B27 RCW AND 296200 WAC <br /> S�I�I� —��2 'C/3 v� <br /> m�;s�nucnor��oAs�enoca.nooness,rE�ev�,�we Huunen � <br /> �f / a" �3� <br /> PROJECT AOORESS -"�''�n� __ <br /> o�a n v[rr7f' �Yao� - - <br /> PLUMOING .11ECNANICAL� <br /> NO. TYPE OF FIXTUflE Ofl IiEM FEE N0. TYPE OF EOUIPIAEM FEE <br /> YIATER CLOSET ITOIL2T� A'C—A'HN�LG UNITS—F P. <br /> 9�.THTUB FOflCE�AIRSYSTE1.15—�.TU. M E.A. <br /> IAVFTORY(WASHOASIN� � UNITMEATERS—d.TU. M <br /> SHOWEP CLOTHES DRVERS _ <br /> _.1_ KITCHEtlSINHSOISP VENTILATIONFAN __ <br /> DISHWASNER RANGE HOOD <br /> _ ,_LAUN�RYTRAY _ WATERHEATER _, <br /> CLOTHE;WASHER VJOOD STOVE <br /> URM�L METAL FlREP�ACE(WOOD BURNING) <br /> URINKING FOUNTAIN FIREPLACE INSEFT . <br /> PLOGR ORAIu HEAT PU.'AP . <br /> BACKFLOW PREVENTERS GAS PIPING _ <br /> 900F DRAINS—R�INLEADERS E%HAUST FAN _ <br /> SINK(SERVICE—BAH.ETC.) <br /> —�_' <br /> SUBTOTAL 5 SUBTOTFL S _ <br /> PERMIT S _ PERlAIT S <br /> TOTALFEE 5 TOT�LFEE S <br /> FOR OFFICE USE ONLY: _ <br /> i„r,IHIBnGN PGf16E1MCM SIpESETB�CN PUNCIIfLxNWlllPi �CE IIECPai�lO <br /> 2021 <br /> .,.. �.r wrenee e�enrnsir¢ FEES VALOATION FEE <br /> G YES :] NO Bw�oiHo / (,� .� � �'> <br /> �„,r��yg� N0.0F610NE9 IwtW'� xopPttwK.�xiE <br /> PWN.BING �� i l��_� <br /> ,.i��[l[%3 fIHESPflWNLEHSHEOD NI.SE4ENT IAECNANICRL <br /> ❑ VES ❑ NO ...- <br /> .,_o�'ANCyIOAD iIHEAIMMflWD N[IGNLUMrtI.iIC11 A�OIiIONALPIANCHECK _ <br />� OTHER '' <br /> r-�n�.:ti <br /> STATEBOILDINuSVRGHARGE �,'�? <br /> :.n.,.�u. rw�snernov[oor CITYOFEVERETT aunucwoaKs <br /> LOCALSALES . <br /> � �.,.,,. ThX COOE IS 3705 T�TA� �- ' <br />