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APRLICATIO� FOR CO'NSTRUCTI " N PERMIT ��� <br /> TO BE COMPLETED IN BLACK INK—Pi.�•ASE PRINT <br /> BUILDING DEPARTMENT �HEATING SYSTEM: �GAS J ELECTRIC J __ I <br /> 259-8810 —— <br /> DEMOLITION COMBINATION BUILDING �MECHANI.AL PLUMBING SIGN <br /> . � ��n�noonese ��- <br /> �, ��I i .���' ��t lR l 1""� � � " if !�� �,,' �' ��;r'7-f— � K��l 1� �'�lS'- L/ �.(;- 1 <br /> C,Ni� h!dILADD E55 ZiP .1�`•— <br /> I �� CITV PI O( —�T-- <br /> FCHRECTORDESIGNER �.1AILAODRE55 CiTY 2iP PMONE <br /> �R:EqALCONTRACTOR �.1AILqpDRE55 CITY Zli� PNONE SiATELICENSEa <br /> A'�CHAIJIC�LGON7qACTOR ��L�pORE� � �Q pi1y, <br /> �� �' I� (� ' A /`��(��/� /'� ^�/ StAtE LICEI�SE� <br /> �I'rill • lF ��� 1 �I i L �C ��—{—�ZIP 1 "1�L�I PHO' RCl� ���I <br /> � � <br /> ,�'I�.!l81NGCONTRACTOF MAILqDDRE55 CITV 2iP PHONE TpTE�IiCENSEn <br /> `� � _ /�i�RT�l�l�l-I�>'�K� <br /> ';C�lTRA TPRICEOPYlOPK <br /> UFSGqIgF.WpqK 45pUAREF00TAGEIN Ol� e, C 1T�GTPERS NANOPHON[NO.. 1 <br /> 1 /1��� � ��/' C c Cl��l! <br /> ( i � A �� .0 � QC' I,l <br /> i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED 1H15 <br /> �����.orosEousEOFe�isc qppLICATION AND KNOW THE SAME TO BE TfiUE AND CORPECT.ALL <br /> �` A ' PROVISIONS OF LAWS AND ORDINANCES GOVEflNING THiS TYPE OF <br /> �,s.c�.�oescaianorvoFaaoaearr�sNowr�ee�owoanTrncNnvocovies WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> i��� e�ocK pF NOT. THE GRANTING OF A PF_RMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> _ OTHEF S�ATE OR LOCAL lAW REGULATING COPJSTRUCTION OR THE <br /> — PERFCRA7ANCE OF CONSTFUCTION.THAT!APd AUTHORIZEO BY THE <br /> �1�_.��_� �.3c� —1�,� OWMER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> PnRGELTAXIDNU1dBEP / — APPLICATION IS MADE AND I COMPLV WITH THE STAT[ <br /> CG�JTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> .;y�J�ST�a C t1L 1N'LENOER :, DRE ,TELEPHON 2�U1.16BR / -� - <br /> y ,,�g i <br /> l'�Y/ � `�I�;( J'� H2 1F �,. � ,. �t�_�-�- � i>y���9�1 1 i r h !�/i%�-i� <br /> PROJECT ADDRESS _,, � unc L-'z'�'�"�'-� -�;ri -- <br /> arvu�.�snrsci¢cnx uo - — <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT F'%E <br /> WATER CLOSET(TOILET) __ A�C—A�HNDLG UNITS—H.P. <br /> BATHTUB _ FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> _ LAVATORY(WASH BASIN) UNIT HEATEPS—B.T.U. M <br /> _ SHOWEr'. CLOTHES DRYFRS —�— <br /> ._ KITCHEN SINK 8 DISP VENTiLATION FAN � <br /> _ DISHWASHER RANGEHOOD --r <br /> LAUNDRYTRAY WATER HEATER <br /> _ CLOTHES WASHER WOOD STOVE <br /> URINAL METAL FIREPLACE(WOOD BURNING) —f �, <br /> DRINKING FOUNTAM FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS ,l� GAS PIPING � <br /> ROOF DR�INS—RAINLEADERS T EXHAUST FAN <br /> SINK(SERVICE—BAR.ETC.) <br /> SUB TOT�L S SUB TOTAL S O ; " <br /> _ __ PERMIT 5 PERMIT 5 /�"; � <br /> TOTALFEt S TGTALFEE S <br /> FOR OFFICE USE ONLY: <br /> cnorn<rie�ch ne�r�sE�oncv sioeseroncK vinucr+ecKauraoen r��r- Receinriio <br /> �7� <br /> � <br /> usEzoNE �oTnaEn vncnNTsirE FEES VALUATION FEE <br /> . ! YES � � NO pw�owG <br /> iVPEOfCOtlSi. NO.OFSTORIEJ acu:.�.:+ i.oc�Crr:�.i^:oi.i.ns — — -- <br /> . ca;��r p�UlA�ING <br /> SIZEOFBLIX'i. FlpESPRINKLEfi5PE0'D �/SEMENT MECHANICAI <br /> �-�. YES -'�. NO <br /> OCCUPF.GYLOAO FlREALARMREOD HEIGHTlIM11iTAlION ADDITIONALPLANCHECK <br /> REa50N -- — _ OTNER I <br /> STATE BUILDING SURCHARGE ,' <br /> .--rt3v ri,v�snrna�venn� CITYOFEVERETT �uBLiGwoFKs � <br /> LOCALSALES <br /> o�rr TAX CO�E IS 3105 rora� <br />