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�' ` <br /> � <br /> � , s APPLICATIt�N F�� CONSTRUCI.ON PERMITY/� � <br /> TO BE COMPLE'fED IN BLACK INK—PLEASE PRINT `�����T I <br /> HEATING SYSTEM: U GAS �)ELECTRIC ❑ _� � <br /> BUiLDING DEuARTMENT I <br /> :::� 259•8810 <br /> DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING �SIGN � <br /> . ON?!Eq MAiLA00PE55 CiTY LP PHONE <br /> �mmy ZAHE2' /7!G kew.. 7- _ �dr�eT r,r�33 3.3i-�YZY' <br /> TENAHT MRILpD�RE55 CITY ZiP PNONE <br /> ARCNRECTOPDESIGNE� M1IAILADUPE55 dTV ZIP PHON[ <br /> ���►3 GENERALCONiRRCTOR MAILA�DRE55 Cltt 2iP PHONE STATEUCENSE• <br /> o a� PcE .•��o�� S,y;v; 1.�13'i- H„�Y 5'f �dza.�� 5'�a�y ,2fo-r'So3 nc�,u:,, /3cnc <br /> > �'�1 MECH�NICALCONiPALTOR MRILROpRE55 .. CIiY 21P PNONE STAIELICENSE� <br /> Vi <br /> M ��' PLUMBINGCONTRRCTOR A14R pDDRE55 CRY ZiP PNON[ STATE LICENS[� <br /> r� T�"� � <br /> K �� ! <br /> GUSSOF WORK <br /> �il y'i! �CNEW �. I ADDITION � ALTEHATION REPAIR DEMOLITION WOODSTOVE/F9PL INSERT � BWL�ING RELOCATION <br /> ,I CONtAGT PERSON AND PHONE N0. <br /> � O� CONTRRCi PPiCE 0F WOPN �fv `� tA p�� 2 �/J���n.N c�-�'�' �-&C� <br /> H OESnCRIBE WOFK ANO SOUARE F iRGF.INVOtVED <br /> ".tlMC� .�+yyp.� 3 iC 10 �5A4�7l�cn2p •S', N �/F _ <br /> Qy4 PROPosevuseocem�oi�+c, i HEREBY CERTIFV THAT I HAVE READ ANC EXAMINED THIS <br /> � M QF %7'�!L APPLICATION ANO KNOW THE SAME TO BE TFUE AND CORFECT.ALL <br /> sH � IEG�LOESCRIPTIONOFPROPERTVISHOWN9ELOWOFATTALNFOURCOPIES� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> r� WORK WILL BE COMPLFTED WITH WHETHER SPECIfIED HEREIN Ofl <br /> M� ior etocrc or NOT. THE GPANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> �VJ ^�)�„ , • OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> � ----yTi�`—�� PERFORMANCE OF C0IJSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> � 3 ' �,d?' OWNER OF THIS PEOPERTY TO PERFORM THE WORK FOF WNICH <br /> � APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> Sa L CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> X C /c. �-L.`s*'— �/.�ISL <br /> PRQIECT ADDRE55 s`.sero` D+lf <br /> • 1 )IG f-�� ��A�� �,,.a.n�E�s�,�f�s��o <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> �� WATER CLOSET(TOILET) AiC—/i'HNDLG UNITS—H.P. <br /> '�' BATHTUB FORCED AIR SVSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN� UNIT HEATERS—B.T.U. M <br /> '� � SHOWER CLOTHES DRYERS <br /> � � KITCHEN SINK 8 DISP VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> LAUNDRYTRAY WATERHEATER <br /> CLOTHES WASHER WOODSTOVE <br /> � � UFINAL METAL FIREPLACE 8 CHIMNEV , <br /> DRINKINCaFOUNTAIN FIREPLACEINSERT ' '� <br /> FLOOR DRAIN HEAT PUMP —�— I <br /> �� BACKFLOW PREVENTERS GAS PIPING _ � <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN . � <br /> SINK(SEFVICE—BAR,ETC.) . � <br /> �(�� <br /> � '� SUBTOTAL S SUBTOTAL $ � <br /> PERMIT 5 PERMIT 5 <br /> TOTAL FEE S TOTAL FEE $ <br /> FOR OFFICE USE ONLY: <br /> FRONTSEIBACN REPfiSE1BACK SIOESETDACN PLANCMECNNUAI�pEN FEE �[CEiPTNO <br /> �� �1/ Z <br /> usezoNe nnea vncaNrsire FEES VALUATION FEE � <br /> �� � BUILDING / b L� �' '(x7 ' <br /> iVVE NIS.AILOWRBIE IYCEOfCON51ALNRl amvapv:r xna�xLLuvcuSrts . <br /> fR°0� PLUMDING <br /> � <br /> SREOFBLOG NOOFSiORIES BAS[MENT MECHANICAL '' <br /> OCCUPANCYLOAD FIRESPNNKLERSPEOD MqEiGHiLI1,11ipilON ADDITIONALPLANCHECK <br /> UxPGf�� SPFINNLER <br /> RE�SONFORSPqiNNIERS <br /> STATEBUILDINGSURCHARGE L i S �� <br /> INiANEBY PLAN�P�VEDOY CITYOFEVERETT Pu�ucwoRKs i <br /> LOCAL SALES � <br /> � TA)(COUE IS 3105 ror�� � <br />