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� i�i � <br />ay <br />azx <br />C r-+ <br />9HN <br />1 <br />Ie�Ci <br />H 's1 <br />� H 'il <br />N � <br />t�l O [�7 <br />H C7 <br />H�g <br />�Y �] <br />zH�yH <br />r F+ H <br />g `� <br />c] C7 V� <br />�c�r <br />ZHl�/� <br />HOtn <br />t <br />1 <br />� <br />ppPLiCATIG_J FOR �ONSTRUCi, Jt�l PEF�iVI1T � r <br />TO BE COMPLETED IN BLACK INK—PLeASE PRINT ,.. <br />HEl,TING SYSTEM: J VAS J ELECTRIC J__-- -_ <br />6UILDING DEPARfL1ENT '— <br />259-d810 <br />DEMOLITION COMBINATION BUILDING X MECHANICAL PLUMBING SIGN <br />—.- K�'l AUDRL55 Giv �' �J J I�nOG[ C <br />.LP � <br />1„�e� `�OIL- �-i'" PI S� _� v� �1t W/� 355= 7 f!--5 - <br />..�� In P110NE <br />1� I.IA4ADf»65 . GiiY ZIP <br />.� �utCGTOfl0E51GNER IARIlA0DRE55 ��'Y Z�P <br />- Qiv Zi� VNONE SiATEIiGENSE� <br />.'dRAICONiR�GTOP IARILADDR[SS <br />-- PiY 2iP PHONE STATELiCENSE/ <br />i. �:.�mN�CRLLONTRRCiOR MAi�AD��E55 <br />- MML�OORE55 G�TY 2�P PHONE STATELiGENSE• <br />ri rYP',NG CONIFACTOR <br />C.':iRACT FNILE OF WORN <br />I�IS.'.a10E WORK ANO SOUAAE FOOTAGE INVIXV[� <br />����0� OSE� USE OF BWIG�NG <br />i t::AL DESCAIPiqN OF PROPERTv ISNOWN BEIOW OP AitAGN <br />i �.;r niocK or <br />(.�p�G —OUO- Ol'1. —0O <br />anPC[i1nxID.NNAPEA <br />ronsrnucrior�iw�i+�E�eca.nouness ieirvHoneuuuoea <br />PROJE����FJESS��7�/�� ,�� <br />!r <br />PLUMBING <br />ryp, TYPE OF FI%TURE OR ITEIA <br />bYATER CLOSET�TOILET� <br />BATHTU� <br />LAVATORV I�'�SH BASIN) <br />SHOWER <br />KITCHEN SINK & DISP <br />DISHWASHER <br />� LAUNDRVTFAY <br />CLOTHES WASHER <br />UAINAL <br />FOR OFFICE USE ONLY: <br />In:!:TSLIDI.CK RE�RSL'BACe <br />tISE ZONE <br />, �rE or CaHst. <br />S¢E OF BLOG. <br />OGNPANCY L <br />RfASpN <br />IOiAREh <br />PNONENO <br />� HEFEBV CERTIFY THAT I HAVl READ AND E%AMINED lF'IS <br />APPLIGATION AND KNOV� THE SAME 1J BE TRUE AND CORRECT. ALL <br />PFOVISIONS OF LAVlS AND ORDINANGES GOVERN!NG THIS TYPE OF <br />WORK WILL BE COId'LETED WITH WHETHER ^PECIFlED HEREIN OR <br />NOT. THE GRANTING Of A PE �MIT DOES NOT PRESUIdE TO GIVE <br />AUTHORITY TO VIOLATE OR JANCEL THE PROVISIUNS OF ANV <br />GiHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSiRI1CTION. THAT I AM AUTti0P.i7ED BV THE <br />OWNER OP THIS PROPERTV TO PEHFORM THE WO�aK FOR WNICH <br />APPLICIITION IS MAD[ AND 1 GOMPLV WITH 1�HE STAt[ <br />CONTRACiORS LAVJ 1�2% FiG�Y AND 296200 WAC. <br />�������� ��` � - - <br />fEE NO. TYPE OF EOVIPMEN7 _ <br />A C—A HNULG UNITS—H.P. <br />� FORCEDFIR;iYSTEMS—B.T.U. M E.A. <br />, UNIT HEATERS—D.T.U. M <br />SUB TOTAL S <br />PERMIT S _ <br />TOTALFEE $ <br />SiGE SETBACK <br />FIPE SPR'NKLERS REO'D <br />FIR[ PIAqM <br />VAU4T SITE <br />: �' YES ; . NO <br />occu=nnc. xomwrtwv�ux�z <br />onn. <br />0n5BlENi <br />"� VES '. . NO <br />HEIGHT IIMIT�iION <br />�.���k��v r�nr+sorrarvroov �ITY�FEVERETT <br />� LOCALSALES <br />�,,,., TAX CO�F IS 3105 <br />RANGE <br />FIREPLACE <br />HEAT PUMP <br />GAS PIPING <br />f3UILDING <br />PLU1d81NG <br />IdECHANICAL <br />ADDITIONAL PLAN CHECN <br />OTHER <br />STAIE 6UILOiNG SURGHARGE <br />PUBLIC'.VORKS <br />rorn�_ <br />TOTAL 5 <br />dlT G <br />1L FEE 5 <br />� iE � nwei�t Ho. <br />a <br />