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APPLICATIa_ . �OR CONSTRUCT; ��N PERMIT � <br /> TO BE COM'r�ETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: J GAS J ELECTRIC � / <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING I MECHANICAL !� PIUMBING SIGN <br /> �OW y Qry� IArARppD/R7E55 ✓ GiV ��,e Z�o/ PtH+O�NE- 7 <br /> �I /� /IW '/ 40J ywNl�.aiL' �� �uL�iL� �JJ — S� ��J <br /> T ANT AiniLFD�RE55 QTY ZiP PHONE <br /> ARCHITECTOROESIGNER IAAILADOPE55 CITY ZiP PHONE <br /> GEN R LCONTFACTOR M LAD E55 pTY 21P PHONE S7ATELiCENSEv <br /> ��o� /Zi�rau���Os /Uyos� �Tmo%'ry�/" �c�0 ��-Lnz_ �/t>✓sil/S/36K/� <br /> MECMANICFLCONTRAGTOR MA:LqDDRE55 CiTY 21P PHONE STATELICENSEe <br /> P�UMBiNGGONTRACTOR MlILADDRE55 CITV 21P PHONE STATELICENSEx <br /> CONTRACT PRICE OF V/ORK � <br /> � vo <br /> DES�iIB�Y1Q�KlAN_JDSDO�REFOOTAGEINVOYED C ` � /J�r`� CONIACTPE NpPIIONE=O. /� vL�� <br /> r I�(a� /J �J <br /> �'6 s Gr �f 3 —z,� z <br /> I HEREBY CERTIFY THAi I HAVE R[AD AND EXAMINED THIS <br /> aaoauseo use oF ew�oir+c APPLICATION AND KWOW THE SAME TO BE (RUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND OR�INANCES GOVERNING THIS TYPE OF <br /> LEGAL�ESCRIPTIONOFPROPER7Y�SNOWNBEIOWORATTAGMiWOCOPIES� WORK WI!_L BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING Of A PERMIT DOES NOT PRESUME TO GIVE <br /> �or e�ceH aF — AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STAI'E OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORA1ANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> PARCELTA%ID.NIIMBE r APPLICATION IS MADE AND I C01dPLY WITH THE STATE <br /> ��j'<f� - (�'�- pOy 'ODO U CONTP CTORS LAW 18.27 RCW AND 296200 WAC. <br /> CONSTRUCTIONLOANLENDER.ADDfiESS.TELEPHORENUMO�R ,� 37� � ///, -�� � � i�� <br /> (.1/✓� �IJ%C �Jr��r:� (/ <br /> PROJECT ADDRESS sic ru� - o�re <br /> cn ,si�+Essi�cEr�scHo <br /> PLUMBING A7EC.HANICAL <br /> NO. TYPE OF FUCTURE OR ITEM FEE N0. TVPE OF EOUIPMENT FEE <br /> / WATER CLOSET(TOIL'cT) A/C—MHNDLG UNITS—H.P. <br /> BATHTUB FORCED AIR SYSTEMS—B.T.U. M �.A. <br /> LAVATORY(WASH�ASIN� UNIT HEATERS—B.T.U. M � <br /> T <br /> SHOWER ' CLOTHESDRYERS <br /> KITCHEN 31NK&DISP VENTiLATION FAN <br /> GISHWASHER � RANGEHO.:J <br /> IAUIJDRY TRAV WATER HEATER <br /> CLOTHES WASHER WOODSTOVF <br /> URINAL METAL FIREPLACE(WOOD BURNING) <br /> DRINKING FOUNTAIN FIREPLACE IMSERT � <br /> FLOOR DRAIN NEAT PUMP <br /> --�— <br /> BACKFLOW PREVENfERS GAS PIPING <br /> ROOf DFAINS—RAINLEADERS EXHAUST FAPJ <br /> SINK(SEPVICE—BAR,ETC.) <br /> i <br /> i <br /> SUF3TOTAL $ SUBTOTAL S , <br /> PERMIT "� PERMIT S <br /> TOTAL FEE 5 TOTAL FCE 5 <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBACK � PFARSET�nCK SiDESETBACN � P�A`ME��UMBER FE/�n�� PE/OJ <br /> J if^ ) i• / r�/ d�,� d �C�3� <br /> !i(/ !C/ �t <br /> usezone LOT.IREA vncnr+rsi . FEES VALUATION FEE <br /> �„—� . YES . 1 NO BUILDING '� 'L � � ' <br /> iVPEOfCONSt. NOOFSTORIES oc�rnea �n0�o'r[io�a�i;;:s <br /> 'youT I pLUM11BING � <br /> � �. J � <br /> SIZEOF�LDG. FIRESPRINRLERSREOD BASEMENT MECHANICAL � � <br /> 387 SE oo O �-. ves � � <br /> OCCUPANGY LO/D� FIBE NLPFM R[O'D HEIGHTLIMRATION ADDITIONAL PLAN CHECK �� _ <br /> �d O Z� , OTHER <br /> T— <br /> REASON <br /> STATE BUILDING SURCHARGE � �) ) <br /> INTANtBY PLANSf.PPROVE�BY CITYOFEVERETT PUBLICWORKS y <br /> J�� LOCAL SALES <br /> oA,E�r-, 3 c� TAX CODE IS 3105 rorn� �3G;,j(� <br />