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APPLICATiI.�� FOR COWSTRUC7 .ON PERMIT <br /> ���-�����u <br /> ...... .. ........ � <br /> ('V('1'CL� <br /> [IUILDWG DEPARTM[NT <br /> 75t) 0010 TO BE COMPLETED I�J INK—PLE�ASE PflINT <br /> UEMOUTION ! COMBINATION BUILDING I�IECHANICAL _ PLUMBING i 1 SIGN <br /> . trNnin GniiniPnt...:___—_..__ _ . rrtv.._ _. _-__ lm___ _ r��N[ � <br /> �\'� - - �Jo�k,l�_ivJ ( • z�25_ c�c�nc�t.c<�_�r_��ci_E��-�" �`�w -- <br /> � � � ,,,�.,��� �..w���E55 �,�. ��� ��«��E �143 • 5�12 <br /> � � - <br /> C � H �RGIIiICC10R0E510NEf1 IM0.11DW�E83 CIfY rP VIqNE <br /> `� y <br /> "' �' � GfriFIUICM�innf.t0� �'ni1�00RE".5 G�V 2iP M�ONE UQNSE• _ � <br /> � H <br /> K (7 <br /> O S O tnr��nrnr.q raannr�nn 4eai�nUDnrs•� r.�ir__—___,n:—_" r��rar �v prr.r� <br /> '° " '° �uml.o K I lql�_� i 2y R� n�ti Win-klamd q�0.3H 82l •HSyZ�SUNLOWSl467�) <br /> Vf M <br /> � O � Fiuom�iacm�mec�on +u�unr.nrss ---u�v zid— r�rons i�co���. <br /> � �] <br /> O M <br /> x n op rins:cKvronn <br /> C� R' nC NEW � I ADOITION 'XALTERATION �� FiEPAIR ' OEMOLITION � ! WOODSTOVE/FRPLINSEHT I I BUILOINORELOCATION <br /> Z y7 1(r�nvris��,nnv[�ACH1onuREaqRnEu00[lnrtr cONlacrnEn9NlANonr�ONENO <br /> n� � 2•O� <br /> � H y �.:•inie�_f rrn^[er v,nnx� ( 0 --- <br /> N �L�[':��.�;i�fW^'�•�u;�i<)M�Ci00IA6EI1rvOlVt� <br /> M y <br /> O Vl ��r� . _ _.. <br /> � 1 <br /> � C �. —� ' <br /> � � Y r�.��:,r.Fnusraou� nm I HEREBV CERTIFV THAT I HAVE READ AND E%AMINED THIS <br /> z '`�.�� 1 n �(�fyy�, APPLICATION AND KNOW THE SAME TO BE TRUE AND CORFlECT. �LL <br /> H O v�. ---- -- `, - PROVISIONS OF LAWS ANO OPDINANCES GOVERNING THIS TVPG OF <br /> ivnu c[scmruonoFP t t�v�s��hl+neiw�one cHrwatOv�[s1 WORK WILL BE COb1PlETED WITH WHETHFR SPECIFIED HEREIN OR <br /> ior eiotK or — NOT. 7HE GRANiING OF A PERMIT �OES NOT PRESUIdE TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OP ANV <br /> OTHER STATE OR lOCl.L LAW REGULATING CONSTRUC710N OR TH[ <br /> — PERFORIdANCE OF CONSTRUC710N.THAT I AM AUTH7F71ZED PV TNF: <br /> OWNEfi OP THIS PROPERTY TO PERFORM THE YIORK FOR WHiCH <br /> APPLICAiION IS lAADE AND I COh�PLV ��/ITH THE ST�TE <br /> � CONTRACTGRS L�W 18 27 RCW AND 296200 WAC. <br /> SiC•U�unEOrCt'rUav[tcnr,neUnqniffO�GENT oetE <br /> — I�.�� 0�03�12� <br /> - -- -- - _ SuCtlf�.oK. �C . �:t�1 -(�.a;I.00)"n <br /> �,,:.,.� ,.�,>,��:, SCtn'n2 Gt/J Q1�C�U2� <br /> AfR'�-�IIISfrtYB11SME5SlY;EN`.f 110�fIO0U5�Nf^.:NANE <br /> PLUMBING MECHAl11CAl <br /> ' �� ��0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMEIIT FEE <br /> I WATERCLOSET(TOILET) M1C-Af�NDLGUNITS-MP. <br /> BATHTUB _� FORCED AIR SVSTE615-BS.U. M E.A. <br /> ' —- - UNR HEATERS-B.T.U. M <br /> UVATORV�YlASf1�ASI�U - <br /> ' '�� SHOWER _ _ CLOTHES DRVEFS _ <br /> ��� NITCHEN SINK 6 DISP � VENfILATION FAN <br /> -- —�— RANGE HOOD ' <br /> DISHWASHER - <br /> LAUN�RYTRAV ' WATEFil1EATER <br /> ��. CLOiHES WASHER �— YlOOD STOVE � <br /> ' !� URINAL ' METAL FIREPIAGE E CNIMNEY � <br /> � DRINKING FOUNTAIN FIREP�ACE INSERT _� _ <br /> FLOOR DHAIN HEAT PUbiP .. <br /> �� BACKFLOW PiIEVENTERS _T_ � GAS PIP�NG �_ <br /> �+ � ROOF ORAIN$-RAINLEADERS _ EXIIAUST FAN <br /> _ SINK ISERVICE-BAR.ETC.) �_ _ <br /> � <br /> !--' _ ,— � <br /> SUB TOTAL S SUB TOiAL f ;CCi;t <br /> - -- �- PEF1h1iT S � 5�Q V <br /> PERMIT S <br /> ��1 ' iOTALFEE f TOtALFEE f <br /> � �:�..�.tcFIBKM AEMSFiBM:N S�OESEIPY:R IR�NCIIEI:NlNYBFN fEF RECEIPTNO <br /> , : ;�.�e ioturc• v�eu�isrE FEES VALUATION FEE <br /> ��� I VES I � NO g�noeb <br /> ��.� �iuM1514lOMMF hiti0006fR1Ulu anryr. �oaowueown -- _.__. — <br /> �� p��LIBINO <br /> ...� � r rypp IA OF SIq145 RAS[YENf 61EC11ANICAI <br /> � IVES i � NO — - � - <br /> � , . .�.�.a�rtOM fuiFSofuRtFuS�HOO �E��ttsnt�tqr� Ot�IER __ <br /> I I VES ! 1 NO SMIEBIMOR765UfIL11ARG[ ' <br /> __- _. � <br /> n.e� .•�rM SeRNkLER4 � <br /> S1ATE ENEM3V SWIC/Ui16E <br /> ... ,, •..ccer vuus�rrra:mm CITYOFEVERETT vuei�cwo�tKs <br /> LOCAL SALES <br /> �TAX CODE IS JI05 TOUL <br />