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APPLIC/�TiC'�'"f FOR CON�TRUCT'�P! PERMIT ���� <br /> TO BE COMPLETED IN BLACK INK—FLEASE PRINT `� <br /> BUILDING DEPARTMcNT �HEATING SYSTEM: LJ GAS J ELECTRIC !J � <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING XMECHANICAL PLUMBING SIGN <br /> ONRJEii � MAlI.A0DFE55 . CITY ZI? PHONE <br /> � ynL=� <br /> TEtlANT MAILADORESS CIiV 21P PHONE <br /> ARCHIIECTORDE5IGNER MAILAD�PE55 CITY ZIP PNONE <br /> GFfJ�AL CONTRACTO � M1:FIL ADO�E55 GTY ZIP PMONE STFTE LICEWSE a <br /> CJ GL j L S <br /> IAEC Ni q CONTRpC�'OR IAPILADORE�S , �[CIT'/ TiP PMONE STAT ICE EK <br /> �c��S 7tnE'r►� �� /n'y , //�C� �I�,�� �J!��,�`C•_�o �C>J,S� Gi�IJ.�/' <br /> ro �� � ci <br /> PWMBINGCONTRACTOR l.fAILADDRESS CITY ZiP PHONE STATECCENS[M <br /> CLASS OF YIOflK <br /> xNEW ADDITION . � ALTERATION : REPAIR DEMOLITION WOODSTOVE/FRPL INSERT . 601LDING RELOCATION � <br /> �l3� LONT�CT P pON A��NO PHONE /J //�/� L <br /> LONiRAGTPRICEOFWORK � COO �`V`_— /t� / % ���`� � n _ <br /> pESCR18E YlORK pN�SO7U�ARE FOOTAGE INVOLVEO <br /> ��P(-(.. Co�le � IH" 1J.�/��'1 _ <br /> PROPOSEDUSEOFpUILDiNG i HEREBY CERTIFY THAT I HAVE REAU AND EXAMWED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> i.een�oe5caianor+o�OPERTV(SHOWN BELOW OR ATTACH FOUR LOPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> WORK 6VILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or� �xK or NOT. THE vRANTING OF A PERMIT DOES NOT PAESUME TO GIVE <br /> Al1THORITY TO VIOLATG OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MAD[ AND I COMPLY WITH THE STATE <br /> CONTRACTORS AW 1A27 RCW AND 296200 WAC. <br /> " X / . — I/�_. <br /> PR0.IECT AODRESS� � sicrvniuPE �A� <br /> � ' ���O�IC•�2 ! /�, cmousr+essuc�Hser:o <br /> PLUMBING MECHANICAL <br /> ND. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET(7'OILET) A�C—NHNDLG UNITS—H.P. <br /> BATHTUB FORC[D AIR SYSTEMS—B.T.U. M E.A. ' <br /> LAVATORY(WASH 6ASIN) i UNIT HEATERS—B.T.U. M T <br /> SHOWER � CLOTHES DRYERS ' <br /> KITCHEN SINK&DISP VENTILATION FAN i <br /> DISHWFSHER HANGE HOOD <br /> LAUNDflY TRAV / WATER hIEATER <br /> CLOTHES WASHER � � WOOD STOVE � <br /> URINAL METAL FIREPLACE 8 CHIMNEY <br /> DHINKING FOUNI'AIN i FIREPLACE INSERT <br /> FLOOF DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN <br /> SINK(SERVIC,E—BAR,ETC.) ; � <br /> -- i <br /> SUB TOTAL $ ' SUB TOTAL S O ; ' <br /> PEFlMIT S PEPMIT 5 __ <br /> TOTAL FEE S TOTAL FEE $ � � _ <br /> FOR OFFICE USE ONLY: <br /> FFONTSETF3ACK PEARSETBACN SIDESETBACK PLANCHEGNNUMBER fEE RECEIPTNO. <br /> _SI�� 3 <br /> usezoNe ioTaaen VACANTSIiE FEES VALUATION FEE <br /> BUILDING ' <br /> 1YPE OF CONiS.AIlOWAOI[ IYPE Of C0115T AGIDAL o[LuvauCv rea 0�owEw�;s o':ir5 � <br /> ceava PLUMBING � <br /> —i— <br /> 5¢[OF6lDG. NOAFSTORIES B45EMENT �,�ECHANICAL � <br /> _� 3 , <br /> � OCCUF:NCVIOFD FlRESPRNKLEFSREOD HEIGNTLIfdIiATION ADOIfiONALPLANCHECK i <br /> i <br /> SPRIN�<LER <br /> ---i— <br /> FEFSON FOR SPRINNLERS � i <br /> STAIF BUILDIWG SUflCHARGE <br /> RJT�KEBV PLFNSAPPFOVEDBY CITYOFEVERETT PUBL!.�.'NORKS i <br /> � LCCAL SALES — —"'- � <br /> I TAX COOE IS 3105 rerai ' <br />