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APPLICATII,N FOR CONSTRUC'� �ON PERNfIT °`"''" <br /> TO BE COMPLETED IN INK—PLEASE PRINT � <br /> :�.,�.,-,:.,,,,., � � <br /> c rv c� '�.1%�� lv�i� -- <br /> eve ret� L HEATING SYSTEM U GAS ,1 ELECTRIC �. _? _��_ � <br /> BUILDING DEPARTMENT <br /> 259 8870 <br /> DEMOLITION � COMBINATICiN BUILDING MECHANICAL PLUMBING SIGN <br /> �nni�noor+ess - arr zu• �„s•;�� <br /> `i(GlkN4 kRTF��]`I '�YlSot_I I�I(o f-�aY�" /!�r C�as1i =1�2Q' "�J' 2���i4`I— <br /> TENANT MRR qpORE55 C�T' 21P �HONE <br /> pnr.�uiECTOqDE9G4EN MAILPDORE55 . LITV 21P PHOHE <br /> ,f�.[PaLGONiq�GTOR IAAiLA0DRE55 C� 2�P PNONE LICENSE• <br /> � <br /> ['� � /���� _" <br /> y q � !�i.O�ANiC�LLGONiRACTOR M�R��ORE55 CiTY ➢P PHONE LICENSE• <br /> [�7 L�J <br /> A � x Fu;G•LR1GC(N�TRRCTOR M60.A��RE55 CITV ZIP PNONE � UGENSE• <br /> Q H <br /> Y �N <br /> r ClA'SOFWORK <br /> y � NEW ADDITION ALTERATION REPAIR �' DEMOLITION WOOOSTOVElFRPL INSEFT BUIL�ING RELOCATIOIJ <br /> K y � CONTPCTFERSpNPNpPHONENO <br /> 'o rx-i tio.! ���,��aAcrva�ceorwonK�� ljb �k5v� Ov� �I lv�� "Z7� i c12�SDi� 335 -5"L"1� <br /> NH DE6GRil3[WORNPNDSOUAREf00LAG-INVOLVCO \ - <br /> �x � �!'�.,��'_f�>),T,c�-1 C D�l�c� ) -�–�i`c-v=_1%c Ic�t;t-`_ ���L- 2J `c��` � <br /> naoroseouseovowi�wc. I HEREBV CERTIFV THAT I HAVE READ AND E%AMWED THIS <br /> � d ^� APPLICATION AND KNOW THE SAME TO OE TRUE AND CORFECT ALL <br /> o � L']�IkG��- <br /> � n g u au..eescnirnor+oraaoaeen�SHowNee�owonenecHvouacoaiesi PROVISIONS OP LAWS AN�OROINANCES GOVERNING THIS TVPE OF <br /> �� n WORK WILL BE C.OIAPLETED WITH WHETHER SPF�'IFIED HEREIN Oli <br /> H G un e�ocH or' _ NOT. THE GFANTING GF A PERMIT DOES NOT PRFSUME TO GNE <br /> Z H ,3. Al1THORITY TO VIOLA7E OR CANCEL THE PROVISIONS OF ANY <br /> 9 H Cs1 ..�� �{•�j {�L/� OTHER S7A7E OR LOCAL LAW REGULATINC CONSTRUCTION OR THE <br /> 4 <br /> t H y PERPORMANCE OF CO�iS1RUCTION.THA?I AM AUTHOflIZED BY THE <br /> l7 VJ OWNER OF THIS PFiOPERiV TO PERFOPM THE WORK FOR WhICH <br /> �� y _ AFPUCATION IS MADE AND I COMPLV WITH THE STATF <br /> �p � CON�AA.TOFS LAJJ 1t27 RCW AND 296200 WAC. n <br /> �ay sic��aron�crca+rns.rono��evu�oi�izconccm oarc �/.C"1 ' �7 � <br /> [�O � i,r�o��ctnoo-n7Ks .1 �/- _ _- � -_ � - <br /> .. � / �/ I.f a��- ti .� l:. t1Lc�T• <n ueevrsurv .s�r:e �uwNs[uo nr�oousin .;r n�[ �-- <br /> [�� l0 CY <br /> � PLUMBING MECHANIC <br /> i NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WA7EA CLOSET(TOILEiI A�C-A�HNDLG UNITS-H.P. <br /> � '�� BATHTUB _ _ _ fORCED AIR S`.'STEMS-B.T.U. M E.A. ' <br /> ��' LAVATORV IWASH BASIN� UNIT HEATERS-�.T.U. M <br /> SHOWER CLOTHESDRVERS <br /> KITCHEN SINN 8 DISP VENTILATION PAN <br /> DISHWASHER RhNGE HOOD <br /> I ' '�' LAUNDRV TRAY ' WATER HEATER <br /> CLO7HES WASHER �— �NOOG STOVE __ <br /> URINAL METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACEINSERT <br /> � �� FLOOR DRA;N HEAT PUMP <br /> BACKFLOW PFEVENTERS � GAS?IPING <br /> ROOF DRAINS-RAINLEA� E%HAUST FAN <br /> '=t�I SINK(SERVICE-BAR.ETC.) . <br /> I — <br /> �� <br /> �',�I __ - SUBTOTAL S — SUBTOTAL S <br /> � PERMIT 5 PERMIT 6 <br /> �— TOTALFEE S TOTALFEE 5 <br /> FOR OFFICE USE ONLY: <br /> �RONiSEIOFCK ��[ARtiF.il3ACK S�OCSElA4CK VLAH(�1ECNNUM�Ei fE[ HFCLIPINO <br /> � o�� s� y;y,,,/ ��/ » 5.j�v</ <br /> u�:i.ro^1[ �ot naen VACANf SITE PEES VALUATION PEE <br /> /.P_��' ..i �UILOING <br /> I�r�pItCN*SRLLOWABLE ttPEOf[ON51<Ltu>l oc'wviv[v haacmtu•.,c�'s ��� --��, � <br /> {� �9a° PIUMBING ' <br /> ,1C' _ <br /> i OF PIDG NO OF STORIES BASEMENi MECHANICAL <br /> �tY�O Sf Aw <br /> n:'.uo'ANGYLORD F:RESPRNNLEHSREOD MEiGMt{UuiJ/�� N AODITIONALPLANCHECK <br /> I�,�`+-(/ nIJ �/ OTHER <br /> i�i nti0�1[pR SPFINNlERS -- <br /> STATE BUILDING SUNCHARGF �J <br /> ��.�,V.[pv PIANSR�PROVED�v I CITYOFEVERETT PU6LICWOflKS <br /> 9� LOCALSALES Y <br /> q/s I rax cooe is aias ToTA� /Q3 iS,� <br />