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,�„ ",".�� � uu«u uvu ucr i �u: MR 15� 1992 9�30RM pB50 P.01 <br /> ��,� , � ' 3� N �:;._- <br /> ,;� ��� ApPLICATI ~N FOR CONSTRUC'. iON PERMIT ���� <br /> "" "�� TO BE COM^I.ETED IN BLACK INK—PLEASE PRINT <br /> `y, <br /> j�i;' <br /> �� CUILDING DEPARTMENT H[ATING SYS7FM: AS Cl ELr rRIC U__ � <br /> !`5�'259-8810 � �� <br /> �^_ -I t DEMOLITION I I C6rABINATION i i BUILDING y1olECHANICAL I i P�.UM1IBIPIG � i SIGN <br /> ��.� p�� ��� CIIY Z�P FlIDNE <br /> I.;� J.L�-����il� E O1,U���C�'..��1'L�"��3��c=��l�e2.� _ <br /> i�V` M��ADMiFS9 Ciiv ilP PMONE <br /> '�G� TEN�NI <br /> L,:;. <br /> �'''•�CMITECTUFUk910Nl0 MARMDPFSR G�� ZV PNONE � <br /> �Af. <br /> ' �l RALLf)NTP�CTON MQADM[SS -. . f v ilr �MON[ SUT[IICEN$C� <br /> I�." _. <br /> ,.y;. I�fP�S►►2 d�i wn'Y,I�� 0� 3�. I�i��Q� - ,o����l <br /> `�W'. CNM C�ICONTMCTOfI II.�DDRF66 CITV 710 FNpNE 6��1ELICCNFF• <br /> � <br /> II�'� .PIUABMOCONiNACTIXI MTLADDNF65 CIIY 71P f91pNE � FUIEIICCNSF• <br /> �� . G►660FWORK —_'�. .. • . - <br /> �4,�yj��I I NEW I I AD�ITION _ TERATION I ( REPAIR I I DEMOLITION I I WODDSTOVEJFRPL INSERT I I 9UILOINp RELOCATION <br /> }_ s U� . / NiACTC R6 4DPMUNENO <br /> _; �� � _�_-�e��l <br /> ,t:� RAGI PH�Ck t7r wUnK / 4 - — <br /> . .--1—.' <br /> . ;�:�- ernroc woa�c 1rn AnF���aY mva,,ve��� � <br /> � 1., . _._�� c� <br /> t Useoreurair+e I/� I HEREBY CEFTIFV TNAT I HAVE READ AND EXAM�NED THIS <br /> ..£1�:; �^ , 11 _u . AI'PLICATIGN AND KNOW TNE SAME TO BE 1fiUE AND CORRECt ALL <br /> °a.;, • ��-�Ld-- PR.VISIONS OF LAWS AND ORpINANCES GOVERNING THIS 7YPE OF <br /> :�r�: lCd�l pFBCRIP110N OF I"t.WM7Y(SXAYM DCLOW OR�71�CN iWN WM2Y� <br /> WORN WILL BE COMPLETED WITH WH�TIi[R SPECIFIED HEREIN UR <br /> �`,.. �oi BlocK___ or ... NOi. THE GRANTING OF A PERMIT DOES NOT PRESl1ME TO CIVE <br /> AUTHORITY TO VIOLATE OR CANCEL 7HE Pfi0VI510NS OF ANV <br /> OTHER STATE OR LOGAI LAW REGULA7ING CONSTRUC710N OR THE <br /> � � ' ��� � �� PERFORMANCE OF CONS7RUCTION.THAT 1 AM AUTH0f71ZED BY THE <br /> + �':• OWNER OF 7HIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> .. ... � • ApPLICATION IS MADE AND 1 COMPLY WITH THE 5TATE <br /> � CONTRACTORS LAW iQ 7 pGW AND 200 WAC. <br /> .. _ - x . 3-S -�� <br /> r,T�DqE'B/9 �; �� srtN D��� <br /> 3� (:.�/ �/) ^:/Y Cn.eueMFnM1.��iHcrrro - — <br /> IL <br /> PLUM6.HO MECNANICP.L <br /> { _ <br /> � N0. � TYP!OF FI%TURE 0?ITEM FEE N0. TYPE OF EUUIPMENT FEE <br /> "�ATER CLOSET(TOILETJ � A/C—NHNDLG UNITS—H.P. <br /> . . '�' _ ..,--— �. <br /> �, �yr.:'• gA7NNg _ ; FORCEP AIR SYS7EMS �U.T.U. M E.A. _;_._ _ <br /> � __ . <br /> � � LAVATORY(WASM BASIN) � UNIT HGiTERS—B.T.U. M _ ._T_ <br /> — � � � CLO'�HES DRVERS : <br /> tiHOWER <br /> Y.ITCHEN 61NK 6 DISP � ; VEN1lLATIGN FAN _ ._ �_ <br /> '� —' � —� RANGE HOOD <br /> ' ' DISHWASHER . <br /> f�;..� I.AUIiDRV TRAY ...� �- ; WATER HEATER _ ,__ <br /> 1 t��� ClO7HE3 WASHER � WOOD SiOVE � <br /> _ . —,— <br /> �t . URINAL � METAL FIREPLACE 8 CHIMNEV . '___ <br /> �! DRINRIN;�FOUNTAIN 1 FiREaLACE MSERT ___�_ <br /> �;,'�_ FLOOR bR,\IN � � HEAT PUMr ` _� _ <br /> BACKFIOW PREVENTERS ; G�S PIPIIJG �� <br /> ��f FOOf DRAINS—RAINLEADERS � EXNP.USl,FAN L --� <br /> SINY,(SF9VICE—BAR,ETC.) . ; _ ._ �...— <br /> ___. ' -- -- � "�— <br /> _' - - i <br /> � —r- • — . .. -- — � - <br /> � � <br /> ��}.� � _�_ -.. _ ._ - ---�---' <br /> ��� SUBTOTAL S SUU70TAL S _��$-' — , <br /> .:;t. �� .. ..._� PERMIT S —... � _y PERMIT S _... /J��!—_. <br /> ' —"�1� <br /> ' ��� T07AL FEE S ' TOTAL FEE 5 �L�`,_ <br /> ` ` FOR OFFICE USE ONLY: ' <br /> FNOMSl1MCK NEAp6titl�CK SiUF.SFTP4G6 f'lN7f.N�N •) cR1 FEE REf.fIVTNO <br /> Cl <br /> URG7UNF �oTnn�n v�cu�rsirc FEES VALUATION FEE <br /> � <br /> , PUII�ING � <br /> fVGFOffANIS.MlOW�01t IYPEO{COMSIq;IWI o[c;R�b[r �qor[MiWw:uvn – ""--"-.... ._ . . — <br /> "�" � PLUhlBING <br /> —. —i-- <br /> 612EPFEtOa. NO.UVSIVnics gA6EMEHT p�[GH4NICAL ' <br /> __._..,__.t_.._ <br /> • _'—_""'"'— � <br /> � OCCvp.wcrtono flREfiPP^�'IFH511E0'D NFK:NttwI7AINx� � ADOITIONA�PUNCHECK _ _ <br /> — i <br /> �. � SPflINKIEH i . <br /> � REASONf(N1`31`nINKI[aS ---"'— — <br /> I` STATE BUIL�INCi SURCHARGE � <br /> �� .......�� �. .. . .. _ -.. J ... __ <br /> ��Nceer weas�� vove CITYOFEVERETT runucworas <br /> �c LOCALSALES <br /> TAX CODE IS 9105 TOTnI <br /> �, <br />