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_ <br /> APPL�CATIa.J FOR CONSTRUCT. )N PE��.4�T ��i*'� <br /> TO BE COh9PLETE�IN BLACK INK--PLEASE PRINT <br /> � HEATING SYSTEM: ��AS J ELECTRIG J � <br /> BUILDING DEPARTME��i <br /> 259-8810 , , <br /> �EMOLITION COMBiNATION BUILDING MECHANICAL PLUMBIiVG SIGi� <br /> ' C'::�:c�y.�� lAA:LAOCiESS CIiV ZiP PNOtlE I <br /> < (r"�sfh� �' 7�;i/Pr'� �7> �-ri<<i'✓C C'�✓;ns/fl�%� yr;a.'; _��,:=��.���99P <br /> tEl1tJ:T MAiLA��(iE55 '� GRY �ZIP PHONE <br /> ni:OniELTORDES�GNER IANLAOOf1E5S Gltt ZIP P��ONE � <br /> .,�.pC�nnLf.ONTPACTOF M�:LADDFlESS CRY ZiP PHONE SinTE:ICENSE• <br /> �ry �. <br /> [rJ Cr �p��i ALGONTRAC!�R IA41LpDORE55 CITY ZIP PHONE STATE:ICENSEY <br /> .o�x C ,U� nh� <br /> ay� PWV.CWGCONTRnGiOR MAILADOFESS Ciiv ZiP PHON2 STATELiCENSE• <br /> y �H CLn55 0F WOFK . �� <br /> NEW ADDITION ALTERATION REPAIR DEMOLITION � WOODSTOVErFRPL INSEFT � . BUILDING RELOCATION <br /> O T.O CONtACTPER50'lANDFHONENO. . <br /> '� H"� <br /> p�H CONTFPGT PRICE OG WORN <br /> DESCNiO ORN DS RREFOOTAGE VOLVED <br /> � He " � � sJ � <br /> PROPOSEDUSEOFpUILDiNG i HEP.EBY CERTIFY THAT I HAVE READ AnD EXAMINED THIS <br /> � ��y J�Qj APPLICATION FlND KNOW THE SAME TO BE?RUE AND CORRECT.ALL <br /> 0 PROVISIONS OF LAWS AM�ORDINANGES GOV3RNING THIS 7YPE OF <br /> Cd� O LEG�LDESCRIPTIONOFPqOPEflTVISHOWN8EL0'.YORRTTACHi00RCOP1E5� <br /> �..� �" WORK WILL BE COMPLE i ED WITH WHETHER:iPECI�lEO HEREIN OR <br /> ay 3 io. etocK oF NOT. THE GRANTING CF A PERMIT DOES NGT PRESUME TO GIVE <br /> C7 AUTHORITY TO VIOLATE OR CANCEL THE 'ROVISIONS OF ANY <br /> r H H OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> g � PERFORIAANCE OF CONSTfiUGT10N.THAT I Ald AUTHOR2ED BY THE <br /> H <br /> n ty N OWNER OF THIS PROPERTY TO PEPFORM THE WORK FOR WHiCH <br /> � Qr APPLICATION IS M11ADE AND I COMPL{ yyITH THE STATE <br /> ���� CONTRACTOftS LAW 18.27 FiCW AND 296.2001VAC. <br /> zyti <br /> HOCn — — �. <br /> .__ X G /.l�r[� � '-Yi .�� 4�/ .� � . � . <br /> Crragcraooaci-� - _�...••:,'»— - .-.•�� <br /> ',:. � /� � � lL�� y� DC <br /> /`�//� � �a,�/��'��J i�I c.'Zl < / ��..ousr.iss��a,�s�•,o <br /> PLUMBING�� MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> e WATERCLOSETITOILET) _ A�C—A:HNDLGUNITS—H.P. <br /> I �� BATHTUB __ __ FORCED AIR S�STEA1S—B.T.U._ M E.A. <br /> � LAVATORV(WASH BASIN) UNIT HEATERS—.i.T.U. M <br /> SHOWER CLOTHESDRVER',i <br /> ' � KITCHEN SINK&�ISP VENTILATION FAN <br /> ` ! DISHWASHER RANGEI�DOD <br /> LAUNDRYTRAV WATER HEATER <br /> � CLOTHES WASHER • WOOGSTOVE <br /> UflINAL METAL FIREPLACE 8 CHIMNEV <br /> 1� DRINKING FOUNTAIN FIREPLAC:INSERT <br /> FLOOR DRAIN HEAT PUMP <br /> � � BACKFLOW PREVENTERS GAJ-'iPING <br /> 4�-,� � ROOFDRAINS—flAWLEAUERS EXHHiiSTFAN <br /> SINK(SERVICE—BAR,ETC.) <br /> ' — � <br /> � — <br /> � SUBTOTAL 5 SUBTOTAL 5 <br /> '(� PERMIT 8 PERMIT S <br /> TOTALFEE S TOTALFEE S <br /> FOR OFFICE USE ONLY: <br /> �—� FHGIliS[iCACH A[ARSEiDACK SIDESEiBACK PLANCMECMNUMOER FEE ❑[CCiPi�lJ <br /> ��'� ', <br /> ue,ezoue totaaEn vncnr+rsire FEES VALUATION FEE <br /> t3W'_L'�"!G <br /> R�f(1ILOyiS.AlL�1VABlE lYPEOitONSt.ALNAL xcu�+ur komvx�u�.c��.�u — — <br /> �a�j° PLUMBING <br /> sJfOGBLDG NOAFSTOFIES BASEMENi GECHANIC/.L <br /> Gf,UPANCYLOAO FlFESPPNNLEfi5RE0'D HEIGIITLII.11lAilON ADDITiOIJALPLANCHECK <br /> SPFINNIER <br /> i e uS0�1 pOR SPRINrcLERS � <br /> SiATE�UILOING SVRCHARG[ <br /> win�nrv Tvir.rism�raovenor CITYOFEVERETT i�uouc;�vorans ' <br /> I � LOf,AL SALES <br /> I TAX COOE IS 3105 TOTPL <br />