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APPLICATIO'' FOR CONSTRUCTI"�N PERMIT �✓� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> I HEATING SYSTEM: U GAS U ELECTRIC �J <br /> BUILDING DEPARTMENT <br /> 259�8810 <br /> I I DEMOLITION I I COMBINATION V'BUILDING �rl'1�1ECHANICAL IN'�LUMBING I I SIGN <br /> OWflE� M4i1.�OURF55 f.liv ]IP 1'NDI![ <br /> /�dy�uru�._l��s 2�9�g-57�Es.�._�d���� 9�a�z �l��- 73ys _ <br /> �RinNi Mnii nooness cnr zm PIIONE <br /> f�,�xr ➢�,yNs. E��xt <br /> Mf,llliC-ClnfiPFGGNFR MML�ODqESS CIIY ZIP PIIONE <br /> �d_V�F,uTce2� H6�5 _2��-5_7�� s.�Gc,�oadw�,/lc �� - 7395' <br /> f.F.❑ �ICf,NIpAC10R MA�lMOf1E55 CI1V ZIP PIIONE STRTEU.ENSE� <br /> —��r�� f,��� GILV 2II' PIIONG Sir1TElICENSE� . <br /> M CIUNIGM rpNlMf.tOP MMl�DDIIE55 <br /> _�.��r� ltirrJ�J�N'�_,�OdC�/_wJcl./�� - <br /> CIUMAINQr,p��tO�GOR IdMl�f10PF5 G!ly ZIP FIION[ SiNEI.ICENSE/ <br /> C,ONIMCI fNCEOf WORR <br /> s.F�,e_ 12�s�'F,u�,y�d._a_��'u"�Fws4rd _ -- <br /> ncsr,niac w�nK n�iu sounne roo�nr,e n+voiveo �in i rensoe i�uoue uo <br /> _---5_�F_R , — �� �Arn�'s �f8b� 'I39S __. <br /> I HEREBY GERTIFV THAT I HAVE READ AND EkAMINED TI�IIS <br /> rnnrosroucF oy0 owtoprt+c APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> �T�_(_q�_L�L�w�d �� �'V PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> iccni.�escnu•nrniorrnn�enrv�snowe+onowoant*ncu�w3cories� WORK WILL BE COMPLETED WITH WHETHER SPECIF'i°D 4EREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRLSUME TO GIVf <br /> ior___��_— mocK or — AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THf: <br /> _.__.__ . _ ___ ____---- --— pERFORMANGE OF CONSTRUCTION.THAT I AM AUTHGRIZED BY TI�1f <br /> �,���{� —� �� — OWNER OF THIS PROPERTY TO PERFOf1M THE WORK FOR WHICII <br /> I� _ APPLIC�OIJ IS MADE AND I COMPLY WITH THE ST�Tf <br /> rn i -�7nx-i,n,,..r�+uranFn (y'�y.�-�y CONTR ORS LAW 18.27 RCW AND 296.200 WAC. <br /> ���L1=lQ�^�.-f—�^�-`g _ <br /> fpNSIRnUf.✓�lifO,Nl1OAN1.[N�E11.p0UR[55.1EL PIIONENUMitffl � /O �3 <br /> /.9�1 �� �v,7 "L.�� 0�1 . <br /> 96N11Ui1F. <br /> PR JF�C� DRE�S� _ — <br /> � / r��E 5. F ���.��s�„«z�,���st� <br /> PIUMBING MECHANICAL <br /> TYPE OF EOUIPMENT FEE <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. , <br /> WATFR CLOSET(TOILET) _ AIC—A�HNDLG UNITS—H.P. �__ <br /> BAiIITUB FORCED AIR SYSTEMS—O.T.U. M E.A. �____ <br /> —'__ _ <br /> LAVATORV(WASH BASIN) � UNIT HEATERS—B.T.U. M __. <br /> _�— __ _ , --'_._ <br /> —� SHOWER _ CLOTHESDRYERS <br /> - - — ' VENTILATION FAN <br /> KIICHEN SINK 8 DISP '_ --�— - <br /> �— -- RANGE HOOD '— . <br /> � �ISHWASHER � . <br /> I.AUNDRY TRAY ' WATER HEATER _�— <br /> -_� _ —T--_ WOOD STOVF _- <br /> CLOTIi[S WASHER , METAL FIREPIACE(WOOU DURNING) <br /> URINAL � — <br /> DRINKINC FOUNTAW �_ _ FIREPLACE INSERT _ - . <br /> FLOOR DRAIN HEAT PUMP — <br /> BACKFLOW PRBVEN'.ERS ; � _ GAS PIPING �-- <br /> ROOf DRAINS—17A:NLEADERS --_—T � E%HAUST FAN _- <br /> SINK(SERVICE—BAH.ETC.) ___._�__ — <br /> __— i <br /> __ — 1 — _ '__ <br /> _ _ ' <br /> - --i-- <br /> -�_ —' <br /> , � SUB TOTAL S I_, <br /> SUB lO7AL S _ _r_ __ pEFiMIT S <br /> ---- ---- ------ PERNiT $ -_ — — TOTALFE[ $ --.. <br /> -- � TOTAI FEE $ <br /> FOR OFFICE USE ONLY: <br /> rnoNisernncK nEnnsetoncre sioesEioncK � rinnc��ECKnui.men ree )� Aec�v�/� / <br /> . _- 1� - �- <br /> I_:J_ zU — " - - , VALUATION FEE <br /> u.Fzpw:_, iornnen V�C4NTSIlE FEES '/ <br /> _ .� i `�,� � � ES I].NO yUII.DING G(�tylS 7(J/ �OJ <br /> IYPf�t f0451 NO O�S10RIF5 M:cu���K.v xa N lmTNrvfiiMnS — . . <br /> �"��" � PLUMDING �� ��V�_ <br /> �J— Z �• / , <br /> 54F Of PI pC flqE S���NKLF.fi$REO�D A�SEMCtR / lALCHANICAL ((f O �OL� <br /> �Soo sP+ n vEs fU'�io ---- � <br /> o S R V — ADDITIONALPLANCHECK '__ <br /> OCGVPARCvtOM1 fIRE�UnIAP[OD IIEIf.HILIMIt�110N ' � <br /> N�J' �� 7� OTIIER�j, /r,� l� iL'�� <br /> nrnsor+ _�iJ:J <br /> SINE BUILOING SU(iCHAfiGE <br /> � <br /> uimkr nr -� rtnrus nrrnovFo or CITY OF EUERETT ruouc wonKs ��!��v'- ' <br /> J � LOCAL SALES � ; <br /> ���E a z �3 TAX CODE IS 3105 TOTAL (c�/.� � _�,% <br /> �� <br />