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:, ,,�� _ ' <br /> � - APPLICATIS,.� FOR CONSTRUCT.JN PERMIT ;��'�' <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT ��r <br /> HEATING SYSTEM' �J GAS 'J ELECTRIC J _ -- � <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> `; DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> 01V6EN <br /> MAIL A�DRE55 LItY 21P CMONE <br /> �I�r �c 1"L4`( �� l���i 1 l� �' .,-,� , ['cC��i l��e�i fr_ E�lf�i'r�T 111A �;: .,�, � �..��)-�.'t ��_- <br /> �FN�Ni ` MNLnDORE55l LiIY .i� PNONE <br /> An6uTECTOR�ESiGNER MPiIqDDRE55 dTV ].iP PHONE <br /> GEN[i1ALCONTRACTOP MRiLR�OryE55 C�iV LIP PMONEry�1G3 StAiELICENSE� 711YAbL�_ `1`� <br /> �aVrr��� T�E�ICaIJ �f CE N`T���cTlc� WC AoZ�: B�Px.E Av� t�1 :�E�,Tri� Io33-Ol�l�3 � <br /> A•�ECHANICALCONTR�GTOR M4ILRDDRESS GITY ZiP PHONE STAtELCENSEt <br /> �C'7H� CWIdOWGCONTPACtOA MAILRDOAESS CCV ZiP P��OYC: SIATCLiC'_t�5i• <br /> � <br /> [�1 <br /> C�y LLASSOFWORN <br /> H NEW � ADDITION ALTERATION x REPAIR DEMOLITION WOODSTOVEiFRPL INSERT BUILDING RELOCATION <br /> Y H � COYTACi PENSON/.HD PNONE NO <br /> r 3915 p�^� �� <br /> H �M corvrancrPnceoFwoaK �� ✓O I -t$ Llfl!C.K 1'E'P-R-F-e1COD (-�53-04�(03 . <br /> fCy� D[SLRIBEWORKANp50U/• - OO1AGEiNV06'fD Q.�C��11�JC� �� j ,iF <br /> oxo �Ef't,AC� �oTf��l f+�ul`�z �u�f- Bui�a (���Nn�ncu — — <br /> � y H �ROPOSEDUSEOFOUILDRIG i HEREBY CERTIFY THAT I HAVE RGAD AND EXAMINED THIS <br /> ,� x � �,xl��"� ����r�t F,��� APPLICATION AND KNOW THE SAME TO[3E TRUE AND CORRECT.ALL <br /> � PROVIS!ONS OF LAWS AND ORDINANCE£GOVERNING THIS TVPE OF <br /> �j p � �ecn�oEscni�noNOFPROPEervi=�owveeiowoannncr�Fouacpaies yyORK WILL �E COMPIETED WITH WHETHER SPECIRED HEREIN OR <br /> � H iot Z e�ocK �_ oF E�-R-� NOT. THE GRANTWG OF A PERM1UT DOES NOT PRESUME TO GIVE <br /> ���yyy AUTHORIIY TO VIOLAT[ OR CANCEL 1HE PROVISIONS OF ANV <br /> L��� �15N "w��E"L��'tIN(� PF�NI 'r ai �Y�-�� OTHERST�TEORLOCALLAWREGULATINGCONSTRUCTIONOFiTHE <br /> C", PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY TNE <br /> ',"r. y 3 .i ,�, , /� _ 7- _ � OWNER OF THIS PROPERTV TO PERFOFA4 THE WORK FOR WHICH <br /> C � y � APPLICATION IS MADE AND I COLIPLY WITFI THE STATE <br /> yy CONTRAGTORS LAW 18,2j RCW AND 296200 WAC. <br /> F�1 � � � <br /> g ;, ; i � <br /> � �, �i <br /> � d � x �' I�����.�� '�,�, a������� l'r�� ' � �`� _� �- <br /> , � :,,,� <br /> y VROJECTAODRE55 <br /> � �n yZU� ('c�C+'rFr�L�F!� � <br /> � PLUMBING MECHANICAL '.., — --- <br /> NO. TYPE OF FIXTURE OR I'EM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET ITOILETI _ �C—A HNDLG UNITS—H P. <br /> BATHTUB FORCED AIR SYSTEMS-0 T.U. M EA. _ <br /> � LAVA�ORY IVJASH BASIN) UNIT HEATERS—B.T.U. M <br /> I � SHOW6R CLOTHESDRYERS ' <br /> �� KITCHEN SINK 8 DISP _� VENTILATION PAN ___�. <br /> DISHWASHER RANGE HOOD _ <br /> LAUNDRV TR�Y ' WATER HEATER <br /> ' �� / CLOTHES WASHER �_ �'�'�OD STOVE <br /> I ��� URINAL METAL FIREPLACE&CHIMNEY <br /> DRINKING FOUNTPIN FIREPLA�EINSERT <br /> --� <br /> FLOOR DRAIN H[AT PU�+1P <br /> ' BACKFLOW PF'.VENTEFS ; GAS PIPING <br /> �,I fi00F DRAINS—RAINLEADERS EXi:.`:CdT FAN <br /> SINK(SERVICE—BAR.ETC.) I _ <br /> �� - <br /> SUBTOTAL 5 S ' SUBTOTAL 5 /�� <br /> II PERMIT 5 _ PERMIT 5 �_ <br /> 1� TOTAL FEE S �1 <br /> l __ TOTALFEE S S <br /> \. FOR OFFICE USE ONLY: ^` S' �O , <br /> FilONiSET �K � REAq5ET0AC�K SIpESETOPCK PLANCn[CKNUMBCIi f[E �EC[IPT O <br /> �' i.. i r. �� ��,�i i ,�r',� ._�, ;� 0, ' 7 ln�2�'_ <br /> i�or+E �nREn vacnNrsrtE FEE$ VALUATION FEE <br /> yy e� , /� �J�I �i�. ^ <br /> ' � � (.L.. L BUILDING 7 Ci� C/-' ~ ��/J� ��� �J ,V� <br /> ttPE�1CONt5.AllOWFBIf 1ViE0FLONYt.AClllAl ocrpuicv q0�w+ur5ci.:�s — ' <br /> � R, PLUMBING S��O�' <br /> SiZE OF BLOG. NOAF SiORiES BASEMENT MECHANICAL �Q O <br /> — ADDITIONAL PU1N CHECK <br /> OCLUPANCVLOAp FIRESPRNKLEPSREO'D HEIGHitiM1;4TION � <br /> 2 U SPRINKIER <br /> REASONF RSPRINNLER$ —�— <br /> STATE BUIL�ING SURCHARGE y �S� <br /> PlIAVEOY PV•NSRPFROVED9Y CITYOFEVERETT PU�IICWORN$ <br /> LOCALSALES <br /> `T— TAX CODE IS 3105 roTn� -�=,=50 �, <br /> y .v, •�o <br />