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APPLICATIQI FOR CONSTRUCT(1N PERMIT � <br /> TO BE COMPLETED IN BI.ACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: U GAS ❑ELECTRIC ❑ ✓ —� <br /> 259-8810 <br /> I 1 DEMOLITION ! 1 COMBINATION !.I BUILDING I 1 MECHANICAL f J PLUMBING IJ SIGN <br /> OWNEF HAM1AOD11F55 CI}Y ZIP PIqNE <br /> S�v� hq�c,cvzo It�pl OA�Cs Av. F,veeer ww� 9pzo� '�s'i sob9 <br /> �[NANI WRApDPE$$ CIIV EIV PIqNE <br /> AFCNIIECIOROESGNCP M.IRAOD11E55 CIIV ZI� PIIONE <br /> G(NEflKCqI1F�Ci0F 4AM1AODPE55 CIlY 2iV FNONE SiAEIIC[NSE• <br /> ��nc C�,a��c.rs 1.�� �0�� Caun.P� pc f_vFzcr 1.��-9ffzoi zs�i3�i P��FGr oseJ,u <br /> IAEGINIiGkf.pllPl.LiOR M�iIADJRE55 CiIY ZIV pNq1E SiMCIiC[NSE• <br /> PIUMBNGCpiIP�CtOR MNI�ODPE55 CIIY ZIP PNONE SGLEI�LFNSE• <br /> cor�ra�ctcncearvnn � Cl'?! G <br /> /o�v9 i2 <br /> orscaiee wonK�Ho sau�nc roor�ce rtrvav[o cor�*�cr vcasaH nHo orrovc rq <br /> L�rr'�:aFo 7�frsQFr G4�E FD O�SorJ 25`i i3�/ <br /> i HEFEBY CERTIFV THAT I MAVE READ AND E%AMINED TMIS <br /> veoeoseous[or euaoea /q��� APPLICATION AND NNOW THE SAME TO BE TRUE ANO CORFECT ALL <br /> �� PROVISIONS OF LAWS AND ORDINANCES GOVERNII:�THIS TVPF OF <br /> lEWl0E5CRIPipNCiPflOPEHtY�51MM'NBEIJYlONRiAC11ftNCCPIES� WORK WILL OE COMPLETED WITH WMETHER SPECIFIE�HEREIN OR <br /> ior ��K � NOT.TNE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTNORITV TO VIOLATE OR CANCEL TNE PROVISIONS OF A�Y <br /> G.v SIl'� Pfs1J OTHER STATE OR LOCAL LAW REGULATINC,rUNSTRUCTION OR THE <br /> PERFORlA�NCE OF CONSiRUCTION.THAT�AM AUTMORRED OY THE <br /> OWNER OF TMIS PR�PERTV TO PEflFOflld TNE WORK FOR WMICH <br /> APPLICATION IS MADE AND I COMP!.V WITH TNE STATE <br /> 1'MCCt lAX I O NUROEN <br /> b 3sz- 3�- vo�- �r CONTPACTOPS LAW 1827 FCW AND 29G200 WAC. <br /> CCNStPUL1pNlWNLEM1�CR,ApDFE55.iElEVNCN(NIINBFP /��� !�/� /�� <br /> x /! � <br /> %(' <br /> PROJECTADDNESS ��OI 6.O.�S A� �������� M�� . <br /> c,.r�i�.r v.n <br /> VLUMBING MECMANICAL <br /> NO. TVPE OF FIXTUPE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> \VATER CLOSET�TpILET) A C—A.NNOLG UNITS—H.P <br /> BATHTIIO FORCEDAIRSYSTEMS—BTU. M E.A. <br /> �AVATORV�WASHBASIN) UNITHEATERS—flTU. M <br /> SHOWER CIOTHESDRYERS <br /> KITCMEN SINK 8 OISP VENTILATION FAN <br /> OISHWPSMER RANGE HOOD �— <br /> LAUN�RV TflAY WATER HEATER <br /> CLOTHES WASMER V100D STOVE <br /> URINA� ldETAL FIREPIACE pVOOD BURNING) <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN HEAi PUMP <br /> BACNFLOW PfiEVENTERS GAS PIPING <br /> ROOF DFAINS—RAINLEADERS E�HAUST FAN � <br /> $INK(SERVICFBAR.ETC.� <br /> � ^ � / n � <br /> A <br /> _— �_ <br /> SUDTOTAL 5 SUBiOTAL S <br /> PERlAIT S PERMIT $ <br /> TOTALFEE S TOTALFEE 5 <br /> FOR OFFICE USE ONLY: [[[ <br /> f110Ni[[1pALK� FEAf15�CX � SIMSEI9�^_, PIAtIC11EC1('�VMB q.� 1[C PCC EN0 � <br /> �-�� 5 i y U� <br /> usv +[ iornnu vecervrsrte FEES VALURTION FEEI/ <br /> _L - G000 !] VES �NO pmlDiHG ,lYZ /�y :G� <br /> �VtEpLOM1]� 1qOftilCNlE9 RwM¢i vVM�LLrv4��,�i <br /> I � PIUMBING i v)� <br /> SREOGW�G f01E5PPMh�E115PE0D 9�SEYENt MEGNANICRL <br /> sr- Cn J ❑ res ✓o - <br /> CCNPMICYlOAp FIREAl�N4PEOD MEIGNILp11lA00N AOOITIONALPIANCHECN <br /> N A n ' <br /> OIHEfl <br /> q[�SVN — <br /> STAtEOWIDINGSURCNAPGE / i�;"�l <br /> MtAxlOY PUNS�FPPOVkDBY CITYOFEVERETT PUOUCWORN$ 0 ��;� <br /> %� LOCAL SQES <br /> n.�c ��j � TA%COOEIS3105 Tou� � ly_� <br />