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AF'PLICA�IC ] FO�R CONSTRi1JGT )N PERMIT ���� <br /> TO BE COMPLETED IN BLACK INK—PLEAS� PRINT � <br /> BUILDING DEPARTMENT I HEATING SYSTEM: �G GAS LI ELECTRIC J . � <br /> 259-8810 <br /> DEMOLITION COMBINATION RUILDING �MECHANICAL PLUMBING SIGN <br /> �•��Eq r.!nit nooaEss cirv nr ar+o�+e <br /> �LL� �{oln F'� <br /> TENANT M1tAILA�ORESS CrtV ZIP PMOIJE <br /> �RCMITEGTORDESIGNER MAl1ADOFE55 CITY ZiP PMONE <br /> 1ENERFL`ONTRACT�`n��LADDRE55 CITV ZIP PHONE ST�TELICENSEn <br /> ��st L<y <br /> 1.1 4HANI ALGOI�fR�1CTOR MAILA��RE55 RY ZIP PMONE TATE ENSEk <br /> �°� +ur.�'�l�e_ F� n,�,� Z��o� ���. ��c.�� �y�-��+o v�S c,2 ��3c �-� <br /> PLU6IBMGCONTRACiOR tdNLA�DPE55 GiY ZIP PMONE SiA7ELICENSEp <br /> G`L/AS'S' OF WORN - <br /> I�vEW ADDITION ALTERATION REFAIR DEMOLITION WOODSTOVE/FRPL INSERT i BUILDING flELOCATION <br /> /l CONTFCT PEPSON�ND_PHONE NO <br /> CONTqACTPR'CEOFYlORH � v�� � � �"�� ?�?— /�'� �� — <br /> OESCflIBEYlORKANDSOOAFEFOOTAGE N\'OLVED <br /> ��7'q�C ComPh%tN_ �'L��M�'� �1�/�%�`� <br /> PROPOSEDUSEOF3UILDING � i HEREBY CERTIFY THAI" I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE ANC CORRECT.ALL <br /> LEGA��ESCRIPiIONOFPRpPERTY�SHOWNBELOWORFRACHFOURCOPIES) PROVISiONSOFLAWSAND03DINANCESGOVERNWGTHISTYPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> ioT y% e�ocK oF NOT. THE GFANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STA7E OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORRED BY THE <br /> OWNEFl OF THIS PflOPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> x � � �7�;� <br /> sicr�nrunE � onrE <br /> PROJECTAD�iiESS <br /> � 3�'Z�- I<�-�m��/c . ��:�= — <br /> �_. CIiVOlI5wE55uLfN56N0 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) AiC—AMNDLG UNITS—H.P. � <br /> BATHTUB FORCED AIP SYSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M i <br /> SHOWER ' CLOTHES URYERS <br /> KITCFiLN SINK&DISP VENTILATION FAN i_ <br /> DISHWASHER RANGE HOOD <br /> LAUNDRV TRAY WATER HEAT�R <br /> CLOTHES WASHER WOODSTOVE �_ <br /> URINAL METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACE I�SERT � <br /> —r— <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS y GAS PIPING <br /> ROOF DRAINS—RAINLEAGERS EXHAUST FAN � <br /> SINK(SEflVICE—BAR,ETG.) — <br /> i <br /> SUB TOTAL 5 SUB TOTAL 9 ; � <br /> PERMIT S PERMIT S (S � � <br /> TOTALFEE S ' TOTALFEE 5 ' ' <br /> FOR OFFICE USE ONLY: <br /> FPONT SETB4CK REAR SETBACN SIDE SETB�CK PLAN CNECN NUh10ER FEE RECEIPT NO. <br /> �S/a� <br /> us�rorve LOT�REA VACANTSITE FEES VALUATION FEE <br /> BUILDING <br /> frP[OiCOtIiS.ALLOWABLE r�PEOFLOH57AL1UAl o[cuva.cr xaC��wEWHGUWIS � <br /> °A0'�v PLUMBINC <br /> Sn_F.OFBL�G. NO.OFSTORIES BASEMENT MECHANICAL <br /> i <br /> i <br /> ' FIRESPRNKLEfi5RE0'D HEIGHTLIMIT�TION ADCITiONALPLANCHECK i <br /> OCGUVANC LOAO <br /> SPRINKLER <br /> REASON FOR SPRWHLERS <br /> STATE�UILDING SURCHAPGE <br /> iwmkeov r�nusnrrivoveonv � CITYOFEVERETT PUBLICWORKS <br /> LOCAL SALES <br /> TA�i CODE IS 3105 TOTAL <br />