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�.. ..�..� _ <br /> FROMiEIJERETT BLIILDI►Q'a DEPT T0� 2066433475 ^JRN 17� 1992 2�13PM t1412 P.B2 <br /> ��" 't���APPLICpT10N FOR CONSTRUCTION PERMIT <br /> � TO BE COMPLETED IN BLACK INK—PLEAS� PRINT �'���� <br /> -Jq.�3- CJU-U� - UfJUG HEATIN(35YSTEM: J�OAS��JELECTRIC U_� <br /> BUILDING DEPARTMENT � �"� • , � <br /> 259•8810 <br /> I I DEMOLITION I i COMBINATION �BUILDINO IIMECHANICAL I IPLUMBING I I SIGN <br /> OWNEh IMRhODPCb$ �Ry np ��t - <br /> �r_T `�� i�ylo �3,rJ,� ,� .�i "�o� r3r//e.vr<.� 9Poo7 ���-23�3 <br /> riNANt. MAnl�Doness ��TY nl' VHONE <br /> ' �AR RFC10NbBlIONCII M�q�OUM�YS `(,hy Z�� �IIpNF � � <br /> c!?u �t�3' l��r <br /> OCpNFMI�.C�ON"fR/�iOp MAILADDR[6f CfTY� L► PHON! SUTFI.qlNlCl � <br /> .��. �Z�Xe..� . �'tZrrcL 2cS �-�oY�. C�ILONeJ,�.�/•.�7PN <br /> uFewwiu�u.eon-nncron �wunery enr zir rnoNe eure�kc�+se� <br /> PIUMbINCCIXITMCTpR � MARAUOIIeB! CIIY 21P pMONC � 6TAl4C[NM1F� � <br /> GABsO'wonK ' ' • - <br /> �NEW I I ppDITIOD: I I ALTERATION I I REPAIq I I DEMOLRION I I WOODSTOVE/FRPL INSERT I I BUILDINp RELOCATION <br /> CONTACT PENCON AHII PI IONF N0. <br /> �: camuetnwceorwonK liJ� l'��%. L�'i' , �CLl2/Z�f_ �G(.s�� ..G�9-��� <br /> OCSCAOf N'OqK ANU SOUAnC tOOT�GC t�M VFp � <br /> ���/�,'a� /S�1 t 1� <br /> � NHuro�couseorouanwc� i HEREBY CERTIFY THAT I MAVE READ AND HXAMINED THIS <br /> n F�u,uY 1Pt C APPLICATION AND KNOW TFIE SAMB 70 BE TRUE ANO CORRBCT.ALL <br /> IEMIUk IqI�I`11UNOfVNpGFR HowNeEuiw�nnTrncusWpCopiEc� ' PROVISIONSOFLAWSANDORDINANCESGOVERNINQTHI6TYPEOF <br /> im .J/ _, e�xx oc P7�=/'L!L-�i�OYT/���✓,� WORK WILL BE COMPLETED WITH WHETHEH SPECIfIED HEREIN OR <br /> NOT. THE ORANTINQ OF A PERMIT DOE9 NOT PRESUMC TO OIVE <br /> AUTHORITY TO VlOLATE OR CANCEL THE PROVISIONS OF ANY <br /> ,,,, , OTHHR STATE OH LOCnI LAW REGULATINO CONSTRUCTION OR THE <br /> �/`U� � � pERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> � U OWNER OF THI$ PROPERTY TO PERfORM THE WORK FOR WHICH <br /> • • — APPLICATION IS MApE ANO I COMPLY WITH 1HE STATE <br /> __ _ �j,f��' G ��,al . �CO!VTHACTORS LAW 18.27 RCW AND 288.200 WAC: <br /> /O� [_ <br /> ��_Y� /•/ •�� <br /> rHatci�oon�cs7x' ' ('L D��,Co Nrr . <br /> U /"CLY Y LLt� L �YC✓UT anwwrwiu�Krwe.iro. - . —' ..•— <br /> PLUMBINO MECHANICAL <br /> N0. TYPE OF flICTURH OA IT6M FEE N0. TYPE OP EOUIPMENT FEE <br /> WATER CLOSET(TOILETJ � NG-AMNDLO UNITS—H.P. , � #-��"a <br /> � BATHI'UB �� � • FORCED AIR&Y&TEMS-B�T.U. M E.A. �� ; ' �.� <br /> LAVATORY(WASH BASIN) �—�� UNIT HEATER9--B.T.U� M ' �� <br /> .. ... . � <br /> ��SHOWER � CLOTHES�RYERS � <br /> � KITCNEN SINK 8 DISP ' � VENTILATION FAN ; <br /> DISHWASHER � � RAN�E HOOD —� <br /> LAUNDRYTMY ! � � <br /> , WATER HEATER <br /> CLOTHES WASHER � —i— � � WOOb STOVE � � � ; <br /> _ . URINAL � �j MET0.L FIREPLACE 8 CHIMNEY � <br /> DRINKiNO FOUNTAIN� ; FIREPLACE IN6ERT ' <br /> i <br /> FLOOR�DRAIN � HEATPUMP � ����r <br /> � BACKFLOW PiiEVENTER3� ; QAS PIPINO ' ' <br /> ROOF DMIN3—RAINLEADEPS� � EXHAU6T FAN � �T <br /> SINK SEHVICE—BAR,ETC. ! � <br /> y <br /> � � <br /> - - _ ..., .-- <br /> � � <br /> —_ _ _. � . . � <br /> � <br /> . _. ._ . —�_ <br /> �" , <br /> SUB TOTAL S � SUB TOTAL S ' <br /> PERMIT S � PERMIT S �� 1 <br /> � TOTALFEE S ' 70TALFEE t ' <br /> FOR OFFICE USE ONLY: <br /> •ll9NTSRR�L� IICARRRp1(`X_ � SIDCLCTOAGK � MNICIICCKNIIMBGR �!t-� � NtCkIM1r10. � <br /> �!/ Y/f � \Jl% �� <br /> � <br /> �sezt�r � io�nnu � v�tsrte iE66 VALUATION FEE <br /> —%� ~ _ Bl11LDIN0 S _ �C �i � <br /> �rr�OtCONT6.ulOWAllf irrrorenxsi.uiuu Ottw+'tt Mnanw[({WpyNlit • •••• � <br /> �� �-i.l �°".3 / pLUMBING � .. ..� <br /> � <br /> i1ZEOF01f10 NO.fIfATplIIFS OKG iM • � <br /> /t2� SF t ,Mj�_ MF.CHANICAL �QD� <br /> S62 SF CAL iU ••• • <br /> r,.cuvnHCvlo�U rw�sca�nncq6PE01� HEIGIITLWITATION� ADDITIONAI.PLANCIiL'CK —�- <br /> � � �� BPHINKLER � !D i <br /> 1�I�40N IOf16PFW KI f P6 � <br /> -.�. .� <br /> fiTATE BUILDINp SURCMAR6E <br /> 'IT�KfiBY riiNsnopqpvRper �CITYOFEVERETT PUPIICWOHK6 20i _ <br /> v � LOCAL SALES <br /> TAX CODE IS 3105 '�rn� Q Cf �� <br />