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APPLICATIC"7 FOR CONSTRUC7''"9N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BLIILDING DEPARTMENT HEATING SYSTEM: GAS ❑ELECTRIC ❑ <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING �MECHANICAL PLUMBING SIGN <br /> OWNEF MA�LADpFESS dTV ZIP PHONE -�,, / <br /> fl.L. S[InIG�Rz�1D 909 PR�lFIC /}�/ �'�fQ�Tj 25L �ca�y <br /> TENAHT MRILADDRE55 CITY ZIP PHONE <br /> �.aC41TELTpRDESIGNER MAILAODRE55 GTV ZIP PNONE <br /> GENERALCONTRR6iOR MAILADOPE55 GITV IIP PHONE SiATEL�GENSE• <br /> 7���%'/S�z�l� U�ulmotla�UacFw� t,uc�!1d.tLyr�f A/.¢ Ufth-loft� TND.rr p�Pr-ris <br /> NELHANIC�LCONiR�CTpR MAIL�DDRE55 CRY 2iP PIIONC STQELICENSE� <br /> PLUMpM4 CONTq�CTOR MRIL ApDRE55 GIiY ZIP PHONE STATE UG[NSB• <br /> CLA55 OF WOqI( <br /> NEW ADDITION x ALTERATION REPAIR � DEMOLITION � WOODSTOVE/FRPL INSERT BUILDING RELOCATION <br /> CONTACT PERSON PND PNON[NO <br /> CONTFACTPPICEOFWOqK 's � _ � <br /> DESCRIBE WORK AND SWnRE POOTAGE INVOLVEO -- <br /> �./1 TD -��Ff/�il� <br /> raoao5eou5eoFem�owc 1 HcREBY CERTIFY THAT I HAVE READ AND EXAMINED 'HIS <br /> _y3�S�7 �D/LYJZO�S APPLICATION AND KNOW THE SANE TO BE TRUE AND CORRECI' ALL <br /> iecn�oeseairrroNcsraoPenrvisNowrveeiowoRnnneNFa:ncories� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTVPE..�F <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEPEIN OR <br /> 101 _ 6�VCK oF __ NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> _ . __ OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THF <br /> PERFOHMANCE OF CONSTRUCTION.THAT I AM AU7HORIZED BV TfIE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATIGN IS MADE AND I COMPLV WITH THE STA?c <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> i PROJECTA DRE55 ���/ ��'-"^EQ�{��i�VNl�L//YJ ���'=J <br /> S��ill[1� -��� I1�i <br /> 7 <br /> .R�BVSiNF95 t�Lf NSF NQ <br /> PLUMBING MECHANICAL <br /> NO. TYPE Of FlXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT �E <br /> WATER CLOSE7(TOILET) A�r—��HNDLG UNITS—H.P. <br /> BATHTUB FORCED AIR SVSTEMS—B.T.U. M E.A. <br /> LAVATORY(WqSH BASIN) UNIT HEATERS—B.T.U. M <br /> SHOWEF CLOTHES DRYERS <br /> KITCHEN SINK 8 DISP i VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> UtiINAL METAL FIqEPLACE&CHIMNEY <br /> _ DRINKING FOUNTAIN __ FIREPi.ACE INSERT <br /> _ FLOOR DRAI!J HEHT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> _ SINK(SEFVICE—BAR.ETC.) � <br /> SUB TOTAL 5 SUB TOTAL $ <br /> PERMI7 $ PERMiT $ <br /> TOTAL FEE $ TOTAL FEE $ � <br /> FOR OFFICE USE ONLY: <br /> �RONTSETB/CN qEARSETNACK SIDESEi6ACY PIFNCH[CKtIUM9EP FEE R[CEIriNO <br /> ��l� <br /> USE 20NE LOT RRER VqCANT SIiE FEES VAWATION FEE <br /> BUILDING ' <br /> ivPCOf LpNiS ALLOWRBLE I iVPE 01 CO/i51 ACllel occuo�x:v xo arrm^.uu�.,.r�s --� —.---._ <br /> t4ouv p�UM81NG <br /> SREOFB�DG NOOFSTOFIES BTSEMEIIT MECNANILA� <br /> OCWPANCYLOAD FIRESPflNKLERSFEO'� MEIGHTLIMITATIOR ADDITIONALPLANCHECN <br /> SPRINK�ER � <br /> R[ASpN f OR OPRINKLERS <br /> _— _'_T <br /> STATE BUILDING SUPC,IARGE <br /> ItiT�NEBY P�ANSRPPROVED9Y CITYOFEVERETT PUBLICWORKS ' <br /> LOCAI SAIES <br /> TAX CODEIS 3105 TOTAL <br />