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APPLICATIC}`J FOR CONSTRUC'�N PERMIT 'Y�� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT � I <br /> � � � BUILDING DEPARTMENT HEATING SYSTEM: ❑GAS �.ELECTRIC ❑ _ 1 <br /> A x .,, 259-8810 <br /> y y y � ! I DEMOUTION �COMBINATION �BUILDING iy-MECHANICAL T-PLUMDING � SIGN <br /> C�ty� OWNER MAhA0DRE55 CITV 21P PHONE <br /> Hx� �f�L' �� �3• ,t 3'il(c EvP-fr%-r `�Y�z...3 3wr • ri3cd <br /> �p y� TENRNT AIRILADORE55 CITV ZIP PNONE <br /> 'i1N� <br /> �A FRCHITELTOR�ESIGNER MAILADORE55 Ctt ZIP PIIONE <br /> z I <br /> H <br /> GENERAICONTPACTOR MAIIA�DRESS Cltt 21P PHONE STFTELICEqSEI <br /> o�d /�Sc, � <br /> ,�,��g MECMANICALCONTRRCTOF MAIL�D�R[55 dTY ZIP PIIONE STRTEUGENSEI � ' <br /> �� n ! . <br /> �..� — --__ .i <br /> ,^Y.y� PWMBINGCONTRACTOR MAIIpODHG55 CITY 21P PNOYE S7ATELICHlSB� � � <br /> a � <br /> 4 <br /> g�y <br /> CLASSOF WORK <br /> H NEW I ADDITION �� ! ALTERATION REPAIR � DEMOLITION i '�. WOODSTOVE/FRPL INSERT � BUILDING RELOCATION <br /> n d y atc0 a,✓ � <br /> �,1, � x�%(,� �/ CONiAGT PERSON AND PNONE NO <br /> �� CONTRRCTPRiCEOF\YORK /� �00 G=N -L 3y'b' NS�S <br /> H W OESCRIBC\YOFK AND SOUARE FOOTAGE INK_,VE� <br /> .-`3.OV'- U%/ �Z��y s.�rY G.3c- Y�o°` � <br /> PROPOSEDUSEOFDUII�ING i HEflEBV CERTIFY THAT I HAVE READ AND EXAMINED THIS �� <br /> S�Z APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL I ' <br /> IEGRLDESCRIPTIONOFPROPERTY�5NO1VN8ELOWORATfACNFOURGOPiES� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF � t <br /> ��� WORK WILL BE .^.OMPLETED WI7H WHETHER SPECIFIED HEREIN OR .. <br /> �cr 9 Y-1 o p�ocK 2 2, oF ine �• NOT. THE GRANTING OF A PERMIT �OES N0T PRES�IME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY �. <br /> OTHER STATE OR LOCAL LAW FEGULATING CONSTRUCTION OR THE - <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTNORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WNICH I <br /> APPLiCATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296200 WAC. 'i . <br /> 2�� �'A�vuB r f'�-v� x ��`GC"�-a.,._ �f . cY-�,f�-4� 61-s�4L �i� <br /> PRQIECTAODRE55 ^."���'+t oetc � . <br /> _�L� 17 S <br /> '�1 - CIIVPLISi11L5511C(M1SEI:I �f� . . <br /> PLUMBING MECHANICAL �a• <br /> r <br /> ' ' NO. TYPE OF FIXTUFE OR ITEM FEE NO. TYPE OF ECIUIPMENT FEE �? <br /> � , i <br /> Z WATER CLOSET(TOILET) �b; A�C-A'HNOLG UNITS-HP. � I � <br /> ��1 Z BATHTUB FORCED AIF SYSTEMS-B.T.U. M E.A. —� i <br /> 1 � LAVATORY pNASH BASIN) � UNIT HEATERS-B.T.U. M11 i <br /> � SHOWER � CLOTHESDRYERS <br /> 1 KITCHEN SINK&DISP T; VENTILATION FAN ' ` <br /> '�' / DISHWASHEfi - RANGE HOOD �— � <br /> 1 ' LAUNDRYTRAY _; WATEF HEATER '� <br /> � CLOTHES WASHER � WOOD STOVE � <br /> URINAL METAL FIREPLACE 8 CHIMNEV <br /> '_t DRWN VG FOUNTAIN FIREPLACE INSERT I '�� <br /> ' FLOOR DRAIN HEAT PUMP . <br /> BACKFLOW PREVENTERS GAS PIPING �_ l� <br /> ROOF DRAINS-RAINLEADERS � EXHAUST FAN � � <br /> '_' SINK(SERVICE-BAR.ETC.) ; . <br /> 1a' <br /> �1 SUB TOTAL $ � - SUB TOTAL 5 .� � <br /> PERMIT 5 PERMIT 5 � <br /> -- TOTAL FEE S TOTAL FEE 5 I <br /> FOR OFFICE USE ONLY: J , <br /> FFONTSETBACK PEARSETDAC� SIDESETBA K/ PLANCHELNNUhIpER FEE PECEiPTNO. III �I �,�� � <br /> 7,Q'� ZQ $y � 7 po 30 `/. s.? �'//o v ;� �f . <br /> USE20NE IOTAPEI VACANTSITE FEES VNLUATION FEE � <br /> "�� eui�oiNc 557 ��; — <br /> iYPEGFCONiS.�LLa1VABLE iYPFOFCONS(ACIOAL OCCuvextr xoaOwLLCvcuvnl <br /> �eao � PLU6IBING � ' ' <br /> - -/J lZ•3 <br /> SiZEOFBLOG NO.OfSTORIES BASEMENT MECHANICAL /' i <br /> �z17 'SS'r �i4 �d v' �.�i <br /> OCLUPANGY IOAp FIRE SPRNNLERS NEO'D HEIGHT IIMItATIO�j{. AODITIONAL PLAN CHECK �C ? }; - . <br /> U✓ �v � <br /> SPRINKLER T ' <br /> PEA NFORSPRINKLERS <br /> STATE PUILOING SURCHARGE i�� <br /> iNiANEBY 1'LANSAPPROVEDOY CITYOFEVERETT PUBLICWORK$ _�! � <br /> LOCAL SALES — <br /> .�k� �, q/t/� TAX COOE IS 3105 TOTAL ,� � Z <br />