Laserfiche WebLink
,: <br /> APPLIC�AT10.. FOR COPISYRIJCT:JN PEi;M17 �� <br /> TO BE COMPLETED IN BLAi:K INK—PLEASE FRINT <br /> HEATING SYSTEM: ❑GAS O ELECTRIC i,� _ <br /> BUILDING DEPARTMENT <br /> 259-8810 � <br /> DEMOUTION COMBINATION BUILDING r'IQIECHANICAL PLUMBING_ SIGN <br /> CIVNER IAAILRDORE55 �Q, CILY � ZIP PHOtIE r <br /> �} �• (�l/a//��.� - ?ll ��`G;// G'ucR=ll �8268" 3 �/�-s"6vs <br /> ��� TENANi Mr1R ADDRE55 CIIY ZIP PNONE <br /> p ii ARCMITEGTOROESIGNER MAILADDPE55 CITV TiP PHONE <br /> Q►►►]]]y <br /> y�� GENERALCONiqACT�e/ �pM4RADDRE55 CITV ZIP PMONE StAiELILENSE� <br /> �!/ <br /> fC n 6�ECNANICR�CONTRRCTOF MRtLAD�8ES5 CiTV ZiP PHON'r ST4TELICENSE� <br /> ��� PLUMOINGGONT9RCTOR MNILRDORE55 GITY ZIP PIIONE STRTELICENSEI <br /> �� !,� <br /> C1A55p�WORN <br /> O H ✓NtW � ADDITION ALTERATION REPAIR DEMOLITION . WOODSTOVE/FRPL INSERT BUILDING RELOCATION <br /> ��py — �/�� CONTACTPENSONRNDPHOYENO. -- <br /> Y ( <br /> P• o �ONTRPCTPFICEOFWORK <br /> DESCRiBEWORNANO5011R FOOTAG['HVOLVED <br /> �r y Gc-8 �i�/ �L <br /> h+ raovosEouseoFom�oir+c I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> ��?yG/1 APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> �� LEWLOESCRIar'orvo PROP`_RTY�910WNBELOWORATTRGNFOUPCOPi�S� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS NPE OF <br /> C� WORK WILL BE COMPLETED WlTfi WHETHER SPECIFIED HEREIN OR <br /> ior�✓2 ��� etoce _J' ov �/'��r P �/ � NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> �(q OTHER STATE OR LOCAL LAVJ REGULATING CONSTRUCTION OR THE <br /> �� - -r- PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZ[D BY THE <br /> OWNER OF THIS PROPEFTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND• I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> � <br /> �. X <br /> �Ci ���„� y_�i-�z <br /> .:a:nrunt wrc <br /> . PRQIECiA�OD//pES • <br /> � "] �C� I� �� C�rp.-c•.[5.'wlkcFNO <br /> �� PLUMBING MECHANICAL <br /> I ��� NO. TYPE OF FI%TURE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) _ AL—MHNDLG UNITS—H.P. <br /> � j � -- BATHTUB FORCED AIF SVSTEMS—B.T.U. M E.A. I <br /> � LAVATORV(WASH BASIW) UNIT HEATERS—B,T.U. M <br /> � �� SHOW[R CLOTHES DRYERS ' <br /> I ��' KITCHEN SINK 8 DISP VENTILATION FAN �� <br /> DISHWASHER RANGE HOOD ; <br /> i LAUNDFV TRAY WA1ER HEATER � <br /> �� CLOTHES WASHER WOOD STOVE ' <br /> I '��� URINAL � METAL FIREPLACE 8 CHIMNEY � <br /> DRINKING FOUNTAIN i FIREPLACE INSERT � <br /> FLOOR DRAIN HEAT PUMP ' <br /> ' � BACKFLOW PREVENTERS ; GAS PIPING <br /> �'�� ROOF DRAINS—RAINLEADEFS � EXHAUST FAN <br /> � SINK(SERVICE—BAR,ETC.1 <br /> 1 's'_� --_ <br /> SUBTOTAL 5 SUBTOTAL S /S� <br /> PERMIT $ P[RMIT 5 �S � <br /> � ,+� TOTAL FEE S TOTAL FEE S �'� ' <br /> � FICE USE ONLY: — <br /> � FOR OF <br /> fRpllT SETEACY. N[Afi SETBACN Si�C 5[T016N PIAN LHECH N GIOER FEE HECEIPi N0. . <br /> ��s-�� <br /> USE20NE LOTAREA VACFNTSITE FEES VALUATION FEE �� <br /> BUILOINC � <br /> iVPEDfCONiS.AILON'�BIE iYPEOfCONSt.AC1UAl DC[wex6 �OorVxtwacuxrts — � .� <br /> cnwv � p�UMBING �� <br /> SREOFOIDG. NO.OFSTOflIES BASEMENT MECHANICAL �, <br /> I <br /> OCCIIPANCYLOAO fIRESPRNKLER5FE0'D NEIGHTLiMI1AtION ADOITIONALPLANCHECK � . <br /> � <br /> SPFINHLER � <br /> — T <br /> R[ASON FOR SPRINKLEIIS <br /> STATE BUILDING Sl1FCHARGE <br /> INI4KEBY PL�NSAPPRCVEDBY CITYOFEVERETT PUBLICWORK$ <br /> LOCALSALES . <br /> TAX COUE IS 3105 Torni <br />