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; APPL�CATIG`�.d FOR CONSTRUC'i:��N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />HEATING SYSTEM: U GAS 'J ELECTRIC U_ � _ 1 <br />L'! iTi � <br />l��r`� <br />syy <br />H �� <br />�t o <br />H xl <br />� V] M <br />x <br />��d <br />ON <br />H�g <br />4] V � <br />H C. <br />a H C�9 <br />1 <br />t HH <br />gy <br />C] C y <br />��r <br />xym <br />H O [n <br />BUILDING DEPARTMEhT <br />259-8810 <br />DEMOLITION COMBINATION BUILDING MECHANICAL `�PLUMBING SIGN �-:. <br />� offlYl /1 FII�"l.141LADDRE55^O A/X /3V CITVt_U� CJl1 OC�! P��JNZ� /_`/IG�I r, <br />f NANT AIAILADDRES�J CIIY 21P PMONE <br />RRCHRWiORpE51GNER MA�IADCRE55 CITV ZiP PNONE <br />G@�EFALCONTFACTOR MAllA00RE55 CITY ZIP PHONE STAT[LICENSE� <br />MECMANiCtiCONiPACTOR AUIIA��RE55 CN ZIP PH�NE STAi[UCENS[a <br />5$ OF NORN <br />NEW . ADDITION <br />CONTR4CT PqICE OF <br />D[SCHip[ YlORN NNO <br />IEGAL OES�RiPtiON OF PROPF <br />��1 BIOCK <br />NO. T' <br />WATEF C <br />� BATHTUB <br />KITCHEN SINK <br />DISHWASHER <br />LAUNORVTRA <br />DRINHING FOI <br />FLOOR DRAIN <br />ALTERATION REPAIR <br />oF <br />SUB TI <br />PERMI <br />TOTAL <br />FOR OFFICE USE ONLY: <br />FPONTS-T9�CN �FARS[TBAf.K <br />USLl06[ �OTAREA <br />rvPfOf[ONlSPLlOWABIE 1YNCOFLONSi.ACiUAI <br />Si2[ OF OLDG. NO. OF STORIES <br />OCCV('ANGVIOAD FIRESPRNKLEPSREOD <br />i�lV YC 0Y I P�pNS <br />DEh10LITI0N WOODSTOVE/FRPIINSERT <br />I WNTACIPERSONANDPMONENO <br />FEE <br />_T <br />��— <br />�—.— <br />r� — <br />�� <br />fE IICENS[ • <br />� LUS �`'0� p,� <br />BUILDING RELOCATION <br />i HEREBY CERTIFY THAT I NAVE RE�D AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />!'ROVISIONS OF LAWS AND ORDIN�NCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT THE GR�NTING OF A PERM1IIT DOES NOT PRESUME TO GIVE <br />AUTHORIT' TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSiRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OYiNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COAIPLY WITH THE STATE <br />CONiRACTGRS LAW 1827 RCIV AND 296200 WAC. <br />x li�d—�-�'jL1� CCSCl1.?� �--�_ <br />'...: n:.�.. wrc <br />;rP��[`.� :51CDIS •. <br />MECHANICAL <br />JO. TYPE OF EOUIPMENT FEE <br />A�C—A HNDLG UNITS—H.P <br />FORC[D AIR SYSTEMS—B.T.U. M E.A. <br />UNI� HEATERS—B.T.U. M � <br />—�— <br />CLOTHES DRVERS <br />VENTILATION FAN � <br />RANGE HOOD �— <br />L WATER HEATER �' ��. <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACLINSERT <br />HEAT PUMP <br />GAS PIPING � <br />EXNAUST FAN —�— <br />SNESE1pRCN PLANCN[CrcNll�.�t3tn <br />VACANT SITE FEES <br />DUILDING <br />�([�nAHCY I�J 01[I�1Ilti1�Y���115 <br />caav p�UM01NG <br />UTSEMENT MECHANICAL <br />HEIGHTUMrtAnoN ADDITIONALPLANCHECK <br />SPRINKLER <br />STAiG 001LUING SURCHARGE <br />CITY OF CVERETT Pl1�LIC WORKS <br />LOCALSALES <br />TAX CODE IS 3105 TOTAL <br />SUB TOTAL 5 <br />PERMIT 5 <br />TOTAL FEE 5 <br />rEc � neeemiNo <br />� <br />