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FROM:EUERETT BUILDING DEP1T T0- �66433475 r.iEiW 17� 1992 2�13PM N412 P.02 <br /> � <br /> ��" ����APPLICATION FOR CON��TRUCTION PERMIT <br /> 7953-OcD 'OO�—���TO BE COMPLETED IN BLACK INK—PLEASE PRINT �\v�a�err <br /> • BUILDING DEPARTMENT HEATINfi SYSTEM: JbFOAS �j ELECTRIC U_� �� <br /> 259•8810 <br /> I I DEMOLITION I.I COMBINATION BUILDINO l 1 MECHANICAL I I PLUMBING i I SIGN <br /> ONR7EH MArtAOD'R/[A$ �i ���/J� CRV.�J� /��� �JSJ�IP� �}� pHOQNt (J 2 <br /> TFN�NT. �� MARIIDDY�IDl4r�/CL� �Of/O GXGCE'i/IGL.L, L!Jl�JnDOD7 lS��/ ��✓�� <br /> -7 <br /> dRf.MIiFC1UNUCSIUN[II A1AI�ApUHlyS CIIY L� PIIANF � <br /> �,�-uv aS 11L�`'h�' <br /> 0lHEMlCONiR�TOA MAKADDRC6C CI7Y. L/ PHON! STATFUC!NIC� <br /> .��-�' ��' , , _ COLoNC/a�/� P <br /> MFCXANIOALCIX/TMCTf7R MhLLAU{M!`3tl G1Y ^ 21M �^MONG 61ATCLILCHSE/ <br /> PWMtlINCCONTRACT(M MALAUDIIC89 CI1Y 21P hMONC � 6TA1lUCCN9F1 —� <br /> �.� 630'wonK ' � <br /> NEW I I ADDITION I I ALTERATION I I REPAIR I I bEMOLITION � I I WOnD9TOVE/FRPL INSERT I I BUILDINO RELOCATION <br /> i nEA60N Aem mwNF NO <br /> �,�,�,����,��� �` 79.1�00. oo . . '1�z.��- L � - � �-�a? <br /> ocsr.axcvro �+t�sou�neromncciGvavFo <br /> .�l��rn�'v�. is�D�� �Jta� <br /> Y eouecorouanwn 1 HEREBY CER7IFY THAT I HAVE READ AND EXAMINED THIS <br /> ���Z :i� � L' ��- APPUCATION AND KNOW THE 3AM6 TO BE TRUE AND COHRECT.ALL <br /> �ea��u C�nrnoNof►npvcaTv�6 iEIOWDft�tt/�C,X,FWL�R�COPI.��/�-y� PROVISIONSOFtAWSANDORDINANCES�OVERNINOTHISTYPEOF <br /> �or �_, s�ot�c pc�f.ilGW�ODJL/71„ WORK WILL BE COMPLETEO WITFI WHETHER SPECIFIED HEREIN OR <br /> NOT. THE ORANTINQ OF A PERMIT DOES NOT PRESUMC• TO 61VE <br /> � � AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> �'a' OTMER STATE OR LOCnL LAW REGULA71Na CONSTRUCTION OR THE <br /> � PERFORMANCE OF CONSTRUCTION..THAT I AM AUTHORIZED BY THE <br /> � " ���� OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> • • • • APPLICATION I6 MqpE AND I COMPLY WITH 1HE STATE <br /> � �CONTRACTORS LAW 18.27 RCW AND 298200 WAC: <br /> • ._ x�����_/�.2.� <br /> PI�JkI'7I100110ES tWN1 NTI � <br /> �.�-r✓�`5"�0 <br /> ,5'I� �a„_rt'v;r.�.c�LN �'rl- . �nt 9��o:-t u�.�...M� �. • - ��-- <br /> PLUMBIN6 f MECHANICAL <br /> . NO. , TYPE OF flXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT ' PEE <br /> s WATER CLOSET(TOILETJ � AlC--AMNOLp UNITS—H.P. i <br /> � � BATFiI'UB � ' J FORCED AIR SYSTEMS—B.T.U. M E.A. ; <br /> LAVATORY(WASH BASIN) , _ �_' UNIT HEATERS—B.T.U, M � _ <br /> �SHOWER � CLOTHE8 DRYERS ! <br /> � � KITCHEN SINK 6 DISP ' i VENTILA710N FAN ; <br /> �_ DISHWASMER _ � � RANfiE HOOD —�— <br /> LAUNOqYTMY •� WATERHEATER . ; <br /> CLOTHES WASHER � WOOD STOVE � <br /> URINAL � ' METAI FIREPLACE d CHIMNEY � _ <br /> ORINKIN6 FOUNTAIN' � FIREPLACE IN6ERT i <br /> FLOOR DRAIN � HEAT PUMP —� <br /> BACKFLOW PREVENTERS ; � QAS PIPINO ' ; <br /> . _ �ROOF DRAINS—MINLEADERS � �; E%HAU6T FAN —�- <br /> SINK SERVICE—BAR,ETC. ,� , ' ,. <br /> � <br /> i � <br /> . ._ .. _ .. _ � .._ <br /> � <br /> —' " " � ' . <br /> . _. . ' . _-i--- <br /> ��� � . <br /> SUB TOTAL S ; SUB TOTAL S ' <br /> PERMIT S � PERMIT S �� � ,,, <br /> TOTALFEE S ' 70TALFEE S ' <br /> FOR OFFICE USE ONLY: <br /> 'KXIT6f•TRACK II:l.RSGiPS:X SIDCCGiYAGK M.N7GIC�I(�7IIf��f.R � �!G � HEC 7�^S C• <br /> Lv 2'0� �ul�t- S �Toa.�-�'- �'� <br /> istxune � 2 to�� (/�� v,�c�trtsne � FH66 VALUATION FEE <br /> � 7 �s BUIL�INp (Lf � <br /> meo�coxTc.uiow�nt irrcorcnwsi.�tiWl � .an�ircum� . .�. , <br /> TJ'_ _ PLUMBINO �_ ; <br /> .,�. <br /> �1 kq�SFt NO.(7ffiTW1� nis¢uo MFCFiANICAL � <br /> o Si 2 � <br /> xuvnuGvlOAU M[LvprmFq6RE04 NliG11TLWRA110N ADDmONA,PIANCII�CK � <br /> N N o AI.bN /D i <br /> cb$ON�OII IIPR W KI f P6 • '�•^•�— <br /> BTATE BUIlDINO SURCMAR6E i <br /> ��Kcev " ri�'v+snonovcoev �CITYOFEVERETT runucwoAKs w ; � <br /> � I� LOCAL SALES <br /> 2 z `13 TAX GODE IS 3105 tot�� �Q <br />