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/�PPLICATIOh FOR CONSTRUCTI�N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEATING>VSTEM: GAS ❑ELECTRIC ❑ <br /> BUILDING DE!'ARTMENT <br /> 259-BB10 <br /> DEMOLITION ' i COMBINATION �BWLDING I I MECHANICAL I�I PLUMBING I I SIGN <br /> r,r—wen unnnoorsss crtv nc rnoH=_ <br /> �v�7r i/ous��/4 RurF/ocirr /4ni GoG�a.2 G-✓�.afar uiA �P7�o/ ao6 �pa55r�uL <br /> �r��+�* unn.00ness cnv zm crwxe <br /> inc�uieaonoEsic��ea uene�oness ci.r ¢�v wwuc <br /> pY� �]Rcdi7er� ico� i/�rr ��o E✓e,eEY %�� �0ao/ ao� a5s��i <br /> GC�F�VALLCNIDACtOP M11LAD�fiE55 LIiV LP FtlOHE S1NELqE.iE� <br /> Y� ' <br /> u([uLNiCkLCMIMC100 MRILADOflESS LfIV ZiP PNONE SiPiEIICCNSE• <br /> i�,b�lCiti6LpliPACi00 MAILAO�FE55 LiiV ZIV PN04E SiI.fELICFNS[• <br /> CL�SSOF WpqN <br /> NEW I I ADDIiION '�TERATION ' REPAIR I ! DEMJLITION i I WOODSTOVEfFRPLINSERT I I BUII�INGRELOCAiION <br /> ���f LONGLiPEPS�N�N nONCNO�1 <br /> cciimncrvniceorwoax {j�_,_4(7B--bOff� ' Cl� � (Olv�. SSCl/ AykEHAn� A2�rJ�T�°C <br /> �i iCRAf NORN AND SOUAPE iC ILA E 1NVIXVLO <br /> a5�- 3�a i <br /> :ncrweowEoreuwc�ve I HEREBV CERTIFY THAT : HAVE REAO AND E%AMINED THIS <br /> APPLICATION AND RNOW TNE SAME TO BE TRUE AND CORRECL ALL <br /> ircuocxnirianorrnov[n*r�sMowHee�o'rvone*reci�vouacovi[si PqOVI510NSOFLAWShNDOqDINANCESGOVERNINGTHISTVPEOF <br /> WORH WILL BE COMPLETEO VlITH WHETH[R SPECIPIED HEREIN OR <br /> �o. eiocR or _ NOT.THE GRANTING OF A PERIAIT DOES NOT PRESUldE TO GIVE <br /> Al1THORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHEH STATE OH LOCAL LAW REGULATItJG WNSTRUCTION OR THE <br /> — PEflFOR1AANCE Of CO"'STRUCiION.THAT I AM AUTHORRED BV THE <br /> OWNER OF 5 V PERTV TO PERFORM THE WORK FOR WHICN <br /> APPLICA ON IS ADE ANO I COMPLV WITH THE STATE <br /> CONiR TORS LAIM1(.1fl2� W AND 296 200 WAC. <br /> / <br /> X � ii�iti <br /> vnon c*<oancss s�,ow�i u:r <br /> �'J/l /�/Itr �3/i-/.i�-i5=i7 ,"O/�CN� n�s��awsrwo — <br /> PLl1MBIN0 MECHANICAL <br /> NO. TYPE UF FI%TUNE Ofl ITEM FEE N0. TVPE OF EOIIIPMENT FEE <br /> WATER CLOSET(TOILET� A/�NHNOLG UNITS—H.P. <br /> BAiHTUB FORCEDAIl1SVSTFM$—B.T.0 M E.A. <br /> LAVATOFV�WASHBASIN) UNITHEATERS—B.TU. !A <br /> SHOWEfl CLOiMES CRVERS <br /> Y.ITCHEN SINK d OISP VENiILAT10N FAN <br /> �ISHWASHER RANGE HOOD <br /> L�UNDFlYTRAV WATER HEATER <br /> f,LOTHESWASHER —r WOODSTOVE <br /> IJRINAL METAL FlREPLACE 8 CHIMNEV <br /> ORINKING FOUNTAIk FIREPLhCE INSEflT <br /> FLOOR ORqItJ HEAT PUMP <br /> BACNFLOW PREVENTERS GAS PIPING <br /> ROOF URAINS—RAINLEADERS F.XH�UST FAN <br /> SINK�SERVICE—BAR,ETQ) ' <br /> —T — <br /> — �_ <br /> SUBTOTAL S SUBTOTAL 5 <br /> PERF7IT $ PEflMIT 5 <br /> TOTALFEE $ TOTALFEE S —��— <br /> FOR OFFICE USE ONLY: <br /> IOONi5Ei11AIX AEAFSELB/.CN iCcSEIDACN PLM/IJpIECNNUMOEP( fCE PE<E�P1N0 <br /> 1 c�.7 J '7(1 % f S/ <br /> u:=lorve mimEn �Acu+rSnE FEES VALUATION FEE <br /> �UILOING p� � �/� ',S'� <br /> Pd(OICON15ulVNAOIt IMFOf[OHLILIIR rcWroK� MOVOMi'��/wurits <br /> � � �'r _� �`°""^ � 4 FWMpWG <br /> f w J _ _' <br /> a=_Ov6UID StOPiES �SE�AEx! MECHANICRL <br /> OCNP�NCVLOAO FlflESPpNNLEP5RE0D NEIGIIiLiMIf�iICN AO�ITIONRLPIANCHEGK <br /> SPRINRL[R <br /> r:nsornonsnnn+.ien= �— <br /> STAiEBWIDINGSUfICHqRGE y iSa <br /> F,uw�nr o�Aiisennnovroov CITYOFEVERETT vUouCwonkS <br /> , ior.nisni�s — <br /> � 7�:,�;.� �-��� � rnx cooe is a�os �or�� _� �. �, z <br /> -- --'-----�----—_=—. -- — ----�- --- ' � <br />