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/ � <br /> � APPLICATION FOR CONSTRUCTILN PERMI� e°e'�« <br /> r�tVe,v,�� TO BE COMPLETED IN INK—PLEASE PRINT Un h eaaP� � <br /> cirv cr <br /> everett HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑____� <br /> BUILDING DEPARTMENT - <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING MECHANICAL . .PLUMBING SIGN <br /> OWNER M11LI.U�RE55 CItY IIP ��qNE <br /> X �Jf �.(��—Ci�a���1ar 75 /$ lJr FGer (,��0� Cvoinf� 9�` l�; 353-3�,FS <br /> ieHurt M�i��oonrss urr nr orqxc <br /> •Rf.MI1EClORDFSRN[R MAi��ppFE55 LILY IIV F1qNE <br /> GENEP0.CpltMC10R M�MOOP[SS CIiY IIV PIqKC l'ONSE• <br /> X r)r �AF! <br /> GE �NKeLCCNiFAGtpfl MML�COPE55 LItY 11F FMONE LKLHSE/ <br /> PLIIMNINGCONiP�LiON MACIADFESS Citv IIP PIWN[ IICFNSE• <br /> Cl��0�Wp�k <br /> t/NEW PDDITION ALTERATION REPAIR . DEMOLITION WOODSTOVEFRPLINSEflT _�. BUILOINGRELOCATION <br /> a�e Pm.✓CN 69U `°"�.i�'"Msou(�-.44 i�.11 ]✓�'��� <br /> CON111�CL VNiCE O�WONM 1�������—/�—�� �� <br /> DLSC-iBEWOf1l(�N��IE� GEINVQVEO � � � � / <br /> ao'ros u ccsnm�owc � I HEREBY CERTIFY THAT I MAVE REAO AND E%AMWEO THIS <br /> /}}q APPLICATION AND KNOW THE SAME TO BE TRUE AND COHNECT ALL <br /> imuocscn�a orvaov�PnivrovmeE�owoneneu�ccunconiE.., PROVISIONSOPLAWSAIl�ORDINANCESGOVERNINGTHISTVPEOF <br /> WORK WILL BE COMPLETEU WITH WHETMER SPECIFIED HEREIN OR <br /> w* oiacx or NO7.THE GRANTING OF A PERMIT DOES NOT PPESUME TO GIVE <br /> AUTHORITY TO VIOI.ATE OR CANCEI TME PflOVISIONS OF ANY <br /> S P P R �2 f�� OTHER STATE OR LOCAL LAW REGULATING WNSTPUCTION OR THE <br /> PERFORMPNCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY 7HE <br /> OWNEfl OF THIS PROPERTV TO PERFORM THE WO��K FOR WMICH <br /> _ APPLICATION IS MADE AND I COMPLV WIiN TME STATE <br /> CONTRALTORS LAW/927 PCW AND 296200 WAC. <br /> S�GNRU1iECiCCNiP�LtOA0R�l1LNpHP[D�GENi GlC <br /> X "jTl•�^,��.unv �-�/in+w� <br /> rr�Pi[ct�oon[ss �G� {71�1 �'�fdQL�� Q-�9�y� <br /> X _ ( /� MM .1N15L1Y0115 SSlKENSENOLNOPO5ME55N�MC <br /> �'{ <br /> PLUMBINC MECHpNICRL <br /> NO. TYPEOFFI%TUHEOflITEM FEE N0. TYPEOFEOUIPAIEM FEE <br /> f WATERCLOSETITOILET) '— NCrA'HNDLGUNITS—H.P. <br /> � BATHTUB FORCEOAIRS`!STEMS—B.TU. M E.A. <br /> _/ LAVATORY�WASMBASIN� — _ UNITHEATFRS—BTU. M <br /> � SMOWER GLOTMES�RVERS <br /> KITGHEN SIHN 8 DISP VENTILATION FAN ' <br /> T <br /> DISHWASHEF RFNGE HOOD <br /> LAUNDqV TRAY W�TER MEATER <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL METPL FIHEPLACE B CHIMNEY <br /> �RINKING FOUNTAIN FIREPLACE INSEHT <br /> FLOOR�RAIN NcAi PUMP <br /> BACKfLOW PRGVENTERS GAS PIPING <br /> ROOF�Rl.INS—RAINLEADERS E%HAUST FAN <br /> SINK�SERVIGE—BAq,ETC.� <br /> SUB TOTAL E /U ; — SUB TOTAL S <br /> PERMIT E PEflMIT E <br /> TOTAL FEE S /J '� TOTAL FEE S <br /> FOR OFFICE USE ONLY: <br /> in;q��ai� nURSE�aacn SWESE�9ecN rUMCNEchMUMeEn IEE z� AEc[ivrNO <br /> 9a a�Gsa.. ]0 �9as' <br /> i�:.�.:i,��tv iater�re vec�-Hr1snE . FEES VALUATION FEE <br /> h�� � I � N� OUII�ING � O /D� �cb <br /> I�i'IOILONIS�IIOWIBIf t�%G/LGN51kN4 uCCnN(� M1..n'.m^5 <br /> tl <br /> � i <br /> °'Pp PLUMBMO <br /> --��/ �' �o aa <br /> ::i:[C��LW NOOPSICPIES B/.SEM[Ni MECHANILAL <br /> $76 SF 1 0 - <br /> �H:NP�NCYl0�0 liPESPRNtlLEflSPWD NEIGNiOYiUipN ROOILION4LPlANGNELN <br /> k� IS/ <br /> OtNER <br /> �n r.sa�ron srH rvKi[ns —T <br /> STATEOUIL�INGSURGNPPGE y ��p <br /> ��u. in. tt�r+sevrnwmnr CITYOFEVERETT pueucwonKs <br /> �� LOCRLSALES <br /> I 'y N�� TA%COOE IS 3105 ror�� ��� I r6 <br />