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`i(' , <br /> �'�i" `i APPLICATIO�J FOR CONSTRUCT�J ��P�IU�,���'(; ° �'`� <br /> ���E��n , TO BE COMPLETED IN INK—PLEASE PAINT Il1 <br /> GTYOF LI Mn�r � »s� <br /> eve rett _ _.__ -- - -- -- -- <br /> - <br /> HE/1'fING SYSTEM: GAS U ELECI RIC IJ . _._ " <br /> --- - <br /> BUILDING DEPARTMENT I—___---- ------ —L'�-�F-GUEREIL <br /> 259-8810 tild�;. Pcrndt Cuunte; <br /> i I DEMOLITION � � COMBINATION � � BUILDING MECHANICAL � �PLUMBING i SIGN <br /> � �n ranannnn�ss --- r.nr u•---- - ruoy�� <br /> . �/. <br /> �,�'� ' J�('-� — C--c �l�'� il }ii1 «! r l �. �� r � -�. _� f, .�:;C% �� :>_`>>>-L���`� <br /> TENpN l ! .� MAIL ADORESS ` CITY ZIP PIIONE <br /> (����'�(' — <br /> ANCIIIT�'.TOR[1GSIGNER AIAILPOIIRESS CI�Y 21P FIIONE <br /> G �. �CQNTflRCT fi� _� . 1 L��I1RES57�,.'( �() II ,I\' �I l T�LI�CC(/�II./_,�� ..��' Vr�I�CLSI�I U[ i/-J�L_/ <br /> I � <br /> / <br /> MFGIIANIUL NTfiACTOR MAII.�UDRE55 Clll'� ZIP PIIOIlE IICENSf.• � <br /> PLUM91NGCON7BAGTOfi AUIIADDRE55 CIIV ZIP PI�Oq[ LICENSGI <br /> __'__"_' ____'-- __" �� �...�/ �/, I <br /> CUSSOF WORK �' <br /> I I NEW I I ADDITION ' . E��TION I � RFPNFi I I DEMOLITION ' ; WGJDSTUVEIFRPL INSERT I I BUILDING RELOCATION . <br /> / / / — -- f,ONiAGi VEII501!FIlU 1'110Y6 NO I, <br /> CONifl�CT PPICE OF Wnf1N i k. �i l l`� ____ ___ I <br /> OESCNIBE WO AND S 11 HI:P 1 GG IryVO l.V[(J I I <br /> `C �n`�/�e 1' �°l� l ' I � <br /> PROPOSEDUSEOFO���LOIIG C �F I HEREBY CEr7TIFY THA�f I HAVE READ AND EXAMINED THIS <br /> L )��" /� APPLICATION AND KNOW THE SAME TO BE TFUE AND CORRECL ALL <br />� LEGAIDESCPoPTIONOFPAOPER7V�5110WN^ELOWORA1TaC11F(ri�RCOPIB51 PROVISIONSOFLAWSANDORDINANCESGOVC-RNINGTHISTYPEOF <br /> WORK WILL BE COMPLETEU WITH WHETHER SPECIFIED HEREIN OR <br /> - ior eioc:K oF ____ NOT. THE GAANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> � AUTHORI7�Y TO VIOLAIE OH CANCEL THE PROVISIONS OF ANY <br /> OiHER STA7E OR LOCAL LAW FEGULATING CONSTRUCTION OR THE <br /> — - PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNFR OF ThiIS PROPERTY TO PERFORM 71iE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> SIGIlAlI111EU1 CUNt1iAC10110RRU11101112E0AGENi DAIE <br /> PRQIEGT�DDflF55 _ '—'—_ —___.__—_1 ��'ll�'�.1 1_ 1/' �1G ��1.�1 1(•�1.1 ���/ <br /> {f /�'� ; 1 ; I'1 '', I' '� APPIICARISf.IlY81151t�I�5SIIGFt6ENOPN��lI5ME5SNPME <br /> � l /� l <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE JF EOUIPMENT FEE <br /> WATER CLOSET(TOIIET) � A'C-A�I INDLG l�'JITS-H.P. �_ <br /> BATHTUB ; FORCED AIR SYSTEMS-B.T.U. M E.A. ; <br /> — ----�'---------- ------- � --- --- — — <br /> LAVATORY(WASH BASIN) �— UNIT IIEATERS-B.T.U. M � <br /> _. _---�- �---- �------------- , <br /> ---�----��-�---��-�---- � � -- CLOTFIESDRYERS <br /> SHOW E R __-_--'-'-_ <br /> -- ----- . . . - - --- - -------------------- <br /> KITCI IEN SINK 8 DISP ____�___ VENTII ATION FAN � <br /> _- _.__.__.___.__'____._.____.. ._ . _ . .. _ .._'_._ ___..___..__—_---_ �— <br /> DISHWASHER � RANGE HOOD � <br /> '_____'__'-_---____- ._'__.--,_ - - __ _- <br /> LAUNDRY TRAY ; WATER IIEATER _ <br /> — --- --...-..--- ----- - -- ------ � <br /> CLOTHES WASHER i— WOODSTOVE _ � <br /> - -------- ---- '-- ----'--'-- -- - ----- -- ' -- - <br /> URINAL ' METAI.FIREPt ACF R CI�IIMNEY ' <br /> __ _____—____.__.__._.. .___._.. ._ _ . . _._.--__i_'__ .'—.__' . _ _ -______ <br /> DRINKING FOUNTAIN � FIREPLACE�NSERT __r_ <br />� — -----�--�---'- -- --�-' — HEAT Pl1MP ' <br /> FLOOFl ORAIN _,i__ - <br /> BAfKFLOW PFEVENTERS i GAS PIPING_ _ <br /> � _"_" ' <br /> A ROOF DRAINS-RAMLEADEFS —�--_ EXIIAUST FAN __ _ _ � <br /> -- '-- — ------- —�— <br />. SINK(SERVICE--BAR,ETQ) � � <br /> — - —____- �—— — � <br /> ' — --r— <br /> __ ___ —_— _— _— i <br /> —_ ""---'1— —"— __—__—�_--____ <br /> � — — ; — —T— <br /> - ����� 1 <br /> I <br /> SUB TOTAL $ SUB TOTAL $ • �_ <br /> PERMIT $ <br /> PERMIT $ /S � <br /> TOTAL FEE $ TOTAL FEE $ '30 ' <br /> FOR OFFICE USE ONLY: <br /> -- — — _ . _ _ . ._._ . <br /> FRUNTSETO�CK IiLAR5G70ACK SIpLShId�CH VI�NCIIECKNIIldf1f:11 �« ��� -� <br /> �—__ <br /> usezone !:!� nIiE4 VACAHfSIiL FEES VALUATION FEE <br /> f3UILDING ' <br /> fYP[OfLONISR11019AC1f I,Ptf1lC011S1Af,I11AI �Ktm�Wa xnrvvxwn.cumn5 --- -- - � <br /> cmxiv PI.IlA101NG i <br /> ----�'— <br /> SI]EOFBLDG 1lOOFSiORIGS OASEIdGNI � / <br /> MECNANICAL �O � <br /> OCLUPPNGVIOFD FIRESPf1NKIBfISRLO�� IIf.IG11TI11.11�ATI0N ADDITIONAI PIANCIIFCK i <br /> ♦ <br /> _ -- i <br /> OTH[R � <br /> IIEASON FOR SPRINKLERS -� �— <br /> STATE�UILOING SUHCHARGG � <br /> ' i <br /> MT�NEBY PLANS�PPROVLDOV CITYOFEVERETT PUBLICWORKS � <br /> LOCALSALES 3 , <br /> TAX CODE IS 3705 TaT�� o ' <br />