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rRCw��U=i��TT SJILDiNu D�PT T0� ❑ 4 �4 i � - � • <br /> APPLICATION FOR CONSTRUCTION PERMIT ���� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILpING DEPARTMENT HEATING SYSTEM: GAS U ELECTRIC IJ_ _^� <br /> 259•8810 <br /> 1 I DEMOLITION I I COMBINATION I ' UILDINt3 l 1 MECHANICAL I I PLUMBING I I SIGN <br /> ONTlEN (M�L�OOR[TS cm iIP PHONt <br /> � 4- rnc 14�IIp �3e1- e [�ci'�aCr� �3.���eswF, qs�G`I l�44-Z3'z3 <br /> Tewwr �� M�itnooncss an zir vi�cxrE <br /> MCMRFGIUNUC910NCI1 MA�AUUH[55 CIIY � LP PIIONF <br /> ,df.�r � GL�,CA.hOVC'i <br /> 0lNEf+LLCONfPM,TOR MALLADCPC66 GITY ZIP PHONE STATF.I.ICCNSCI <br /> �.VfT�.f.-' LZ�� GZ..��(f� <br /> GFGN4lIWLCONTIUCTON MAIlAUU11CYY CIIY LIM PMONG 61�TELICCN$FI <br /> PWNtlMCCOHTMCTOH MA4AUDIIE59 CIIY 21P YNONC 6TAluCCNSF� <br /> GAOS OF WOIIK "' . --- •. .. <br /> �NEW I I ADDITION I I ALTERATION I I REPAIR I I bEMOLITICN I I WOOpSTOVEIFRPL INSERT I I 9UILDINO RELOCATION <br /> 'I7 (�y� 1 CON/Tn,CT PER60N FNU PI IUN1F ND. r_�1�1 <br /> cprtRAGIPHICrUFwonH � u" /,1�"`-'l./ l.�y��C. SIe.V�S' lfrl-1'2�J2� � <br /> G[SCRtl1F WOAK M'U SOUMe FOOTnGt IANM VF[� <br /> r�1" ul _Co+wkn�ue.ti� 1521.�_�o2��r . . . <br /> 1 HEREBY CERTIFY THAT I HAVE READ AND EXAM�M�D THIS <br /> _�i„p�..C� �vQJYIIA.CL;�" �-2A-lL�-✓�-CA� APPLICATION ANp KNOW THE SAME TO BE TRUE AND CARRECT.ALL <br /> LEWLUtS 11UNOf GRC7�FP7Y�FH0�I BEICW Une7TACMFWRCAPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNINQ THI5 TYPE OF <br /> WORK WI4L BE COMPLETED WITH WHETHER 5PECIFIED HEREIN OR <br /> �oT�._, e�ocH oc ... NOT. TFIE ORANTINQ OF A PERMIT DOES NOT PRESUMC• TO 61VE <br /> 1�k,�,r�a,brool[._ q�v 2 AUTHOflITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTMER STATE OR LOCAL LAW REGULATINO CONSTRUCTION OR THE <br /> PEflFORMANCE OF CONSTRUCTION.THAT I qM AUTHORIZED BY THE <br /> '"��'�,Q�LQ/ �l,Q q (11 n M . Z I O C OWNER OF THI$ PROPERTY TO PERFORM THE WONK FOR WHICH <br /> — I v � APPLICATION IS MADE AND I COMPLY WITH 1HE 57ATE <br /> �( �� , CONTHACTOR3 LAW 1827 RCW AND 286.200 WAC. <br /> 5�}25 15-t- -f�P �E x Q-t�-a- �-��xv� ...— <br /> PhOJkCIOODfICSS• • . • CuunllMf � U2555(o Nrf <br /> C111YVAIMlMIICIN[ p�� � ' �� <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EpUIPMENT FEE <br /> WA7ER CLOSET(TOILET) � wC-..nniNf, .p UNITS-H.P. � <br /> � BATHI�U9 ' • � FORCEOAIRSVSTEMS-B.i.U. M E.A. �� � <br /> LAVATORY�(WASH BASIN� / i �' UNIT HEATERS-B.T.U. M <br /> �SHOWER � CLOTHESDRYERS � <br /> � KITCMEN SINK 8 DISP i I VENT�LATION FAN ; <br /> DI5HWASHEFi � � RAN�E HOOD T <br /> LAUNDRYIRAY � I WATERHEATBR ., . �_ <br /> CLOTHESWASHER � WOODSTOVE , <br /> , _... . <br /> _ URINAL �_ METAL FIREPLACE 8 CHIMNGV � — <br /> �RINKING FOUNTAIN i FIREPLACE INSERT ' <br /> � <br /> FLOOR ORAIN � HEAT PUMP T— <br /> BACKFLOW PREVENTERS ; GAS PIPING ' ; <br /> ROOF DRAINS-RAINLEADERS i E%HAU6T FAN —� <br /> SINK SERVICE-BAR,ETC.) ; ' � <br /> '- . 'i• -� ' �^ .. <br /> � i <br /> . ._ .. ... . ... ..� .._ <br /> � <br /> -- ... -' ' � <br /> i <br /> , _. ._ �....._. _ .. �_ <br /> � • <br /> SUB70TAL S i SUBTOTAL S � � <br /> PERMIT f � PERMIT 5 � ^ <br /> TOTALFEE S � 70TAlFEE E � <br /> FOR OFFICE USE ONLY: <br /> �IqNTRfTH�LK OC�NAGTR�(9( SIO[iGi➢�f.K �,�, PLNICIICCNNlIMB6R fLC RtCkir7�rto. <br /> ?re 20.._ ,d.l,6v"�i'.y 3c��;.`L 3o SOj�'G: <br /> USki�2 tul�ntn `� vec.wYt� � F@ES VALUATIDN FEE <br /> V BUR�INp 7 � i � <br /> '�TPt01COMif.NIOWABLE IYPCDfCOHST.1C704 OCCUWcr w�anw[IPMCYNIIt • •-� - <br /> � . ..., rf_� 3 I f'LUMBING _V ... . 7� <br /> J!-, � <br /> ;¢[OFoInp No.M'Ar AiFS OASEM6NT MF.CHANICAL `aD �� <br /> /52i SF t � I /�/t� ' � <br /> S�L 5G GA�c "" <br /> JCCUVNlCV�OAU fIB[SopNRIFq6RE0U MEIGIITLINITATION ADOITIONAI.P�I�NCIILCK j <br /> 1 <br /> ��l R -s�wlNneea- � <br /> �— <br /> 1kA50NFOfISPRWKIFR6 � �� ' / �'----' <br /> BTATE BUILDINO SURCHMGE i� '� <br /> vin�ccav riiwsnnvaovcpev �CITYOFEVERETT puPllcwORKs Z i ' <br /> LOCALSALES <br /> J� � Z ,3 TAX GODE IS 3105 tou� �� — <br />