Laserfiche WebLink
APPLICA�IC� � t�OR COf��TRIJiC'T�'�N PE�iMIT �� <br /> T'J BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDWG DEPARTMENT H=ATIt�GSVS7EA1: JGAS J ELECTRIC ❑_ � <br /> 253-8810 <br /> DEMOLITION - ! COM6INATION � , BUILDING �MECHANICAL . �PLUMBiNG : �. SIGN <br /> nwu[a uecr.�^_arss urv zr a�o��e <br /> 1-IPYL�� ,'vRa�KS �?.3=?I �ac(�vv.�r_�t't�Etr u^p 3S3- I�SS <br /> �INA�ii WM1ADORE55 J�. 'P oNONE <br /> PRpetEL10R0E5GMEP M�KIDCAE55 Crtv T ��NE <br /> . IPALCpliRALfOR WhWDRE55 UIV lIP PN(Y!E SUIEUCENSEI <br /> �,;C'� ,UeC,e�,,� C�,�.szcrn «c.nc5 1?DI pRCA Uicw �a �vrzrTr WP <br /> �-cH�xww mn�c�an M�wr,00nEss ��� i.::� ziv vr�or�E s.r.*ciK[nsc. <br /> RCn_n:q(itqll �C10N 4�LLAppNE55 L�tt !iP PIqN[ Si�iELICENSC• <br /> [O'ILPALt CfliCE OF WLNN �1 <br /> � (� liCJO <br /> CI""�IBEWOFY.AIs. ��NEfCOi1GfINVClVEO UJNL1C1iEfl5CM.V1'JPWNENO <br /> :y�.�F Isa'rµ SZm , Ua..� �km _ <br /> _ � <br /> —__—.._-- I HEPEBV CERPFV THAT I HAVE REf�D AND E%AMMED THI$ <br /> rr�oroscouseo�eunowc APPLIGATION ANO KNOW THE SAME T06E TRUE AND CORREC.T ALL <br /> �"�:^"H[ PROVISIONS OF LAWS�NO ORDINANCES GOVERNING THIS TVPE OF <br /> ime�cescnirr�avo�raottniri51ro+.vee�owonen�u�*wocaries� WORKWILLBECOMPLFTEDWITNWHETHERSPECIFIE�HEREiNOR <br /> ior a�a� a NOT.THE GRANTING OF A PER1dIT DGES NOT PRESU1dE TO GIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE ?ROVISION$OF ANV <br /> OTMER STATE OR LOCAL LAW REGLI�qTING CONSTFUCTION OR TME <br /> '- PERFORM/+NCE OF CONSTRUCTION.TMAT I AM Al1iNOfiIZED�V TNE <br /> OWNER OF TH.o PROPERTY TO PF.RFORM THE WORK FOR IYHICH <br /> �<r�r�irnKroHuue[a APFUCATION IS MADE AND � COlAPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCY�PND 296200 WAC <br /> ;;Y.-.Ir.:;Ll'.ftl t G.q L[HpER.I.00FE55.iftEPNCHE NU40EB <br /> PFiOJECT ADDFE55 ��� <br /> .�e� <br /> J Pl1l G� . . . <br /> PLUMBING MECMANICAL � <br /> N0. TYPEOFFI%TUREORITEM FEE NO. TYPEC:cOUiPMENT FEE <br /> WATLRCLOSET�TOILET� AC—AMNDLGUNITS—HP ' ` <br /> 84iliTU6 FORGEDAIRSVS�EM$—B.TU. M EA. � <br /> IAVAIORYIK'ASHBASIN� UPYTHEATEfiS—B.TU. M ' <br /> S�:OYlER CLOiMES DHYERS <br /> KITCHEI�SINK 8 DISP VENTILATION FAN <br /> OISHWASHEF FnNGE HOOD <br /> LAUNDRVTRAV WATER HEATER <br /> CIOTHES WASMER VlOOU STOVL <br /> ❑RINAL 11ET4L FIREPLACE�WOOD BURNING) <br /> ORINNING FOUNTAIN FIREPLACE INSEPT <br /> FLOGR ORAIN HEAT PUMP <br /> BACKFLOW�REVENTERS GAS FIPING ' <br /> FOOf DRAIN$—FpINLEAUERS E%HAl15T PAN � <br /> SINK�SERVICE—BAP.ETC.� ' <br /> —� <br /> Sl18TOTAL 4 SUBTOT�L 5 <br /> PERMIT $ —� PEFMIT 5 � <br /> TOTALFEE S TOTALfE[ S --- ' — <br /> i�OR OFFICE USE ONLY: <br /> ��uv�5lRucx PEensEinecF soESEtoecn rurvce¢NNVVFFn v[L nERb'nlo <br /> y � <br /> ��.e.ieaz im�Aee veenNrSrtE FEES VAWATION FEE <br /> —. VES ' NO pURD'•+G - . � • <br /> :�norcoxst Hoorsroems rc�miuv.�x. ----"— , -- <br /> v°Pi"'° Fwra5nlG ' <br /> s¢[O�BlOO iiRESVNxKIERSPEOD Be5[uFNi 61ECHANIGAL � <br /> '�..' YES . NO ; <br /> (`.CCUPIJ1CVl0A0 iiOEKAPYqWD NE�GNI�O➢d1iVN AO�tilOtIALPWNGHEGK ' <br /> OTHEF <br /> nfe;�n _ — —— <br /> STAtE�UitOiNG SUPLNAP,[ <br /> ��nn.cer r�em�a��vnortom CITYOFEVERETT puauCwoaKS <br /> LOCALSALES <br /> .., TAX COUEIS3105 To*a� � . . <br />