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❑ OEMOLITION ❑ COMBINATION ❑ BUILDING � MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PROJECTADDRESS= ���� Co=/3� /�✓� �✓i 98Zo/ <br /> .�G/�//�/CCO � �20E, �os 'F SGOt/GN r?� 98290 3�7 y/93 <br /> OVMER Mq�ADDRE55 CIIY ZIP PNONE <br /> [�.4C� ,C ,/'i'C�.C'A�/ /CoL-• �oc�tY c�i/ � 98Zo/ ZS8-/ZS�/ <br /> iENANT MqL4)ORC55 CIiY 7�P P��pryE <br /> ARCNRECT d1 DESIGHEfi M111 MOnE55 CIIY lIP PNOHE <br /> GENEMICONLMCTOR M/JL W�I1C55 pIY 7iP PpONE SI�IE IICENSE• <br /> _ c � z <br /> YECN�NIC�IGONTR�C70R MAILADDRE55 ry,tt IIP PIIONE Si�TEIICENSE• <br /> PIUMBMGCONTR��10R MqL�100RE55 �IIY ZIP P1pNE ST�7ELICENSE• <br /> CONTMCT ppICE OF WORK <br /> �Z�SD — HEATING SYSTEM: �GAS ❑ ELECTRIC p <br /> DESCPoBE Wdil(ANO SOU�RE FDOTA6E INVOLVED CONi�CT VCRSON�VIO PHONE NO <br /> T ,o� �� ./o -� <br /> 4^42 �C,r GC � Ai �1 <br /> I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> VipVOSEU USE OFg Nc APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> /��� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> lECQ0E5LRIPiIpJOFPRMERtt�SHOWNBEIOWpiATTACNTNqCOFIESj NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or aiocK oF__ AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATF OR LOCAL LAW REGUL4TING CONSTRUCTION OR THE <br /> PENFORMANCE OF CONSTRUCTION.THAT I.�M AUTHOpIZED BV THE <br /> OWNER OF THIS PROPERTY TO PERFORM 7:iE WORK FOR WHICH <br /> AF�PLICATION IS MADE AND 1 COMPLY WI7H THE STATE <br /> PMLEC TAII I.D.NUMBER CUNTRACTORS lAN'1827 RCW AND 296.200 WAC. <br /> / <br /> CANSTNIILPONlON1tENDEq,AWf1C55.TELE1'110NENWBER X __ //- C��O .�j <br /> _ SIGNANRE _ D�fE <br /> CITY BUSINE55 LICENSE NO <br /> PLU1il81NG MECHANICAL <br /> NO TYPE UF Fl%TURE OIIITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> —.�—__ <br /> N'e�=R CLOSET(TOILET) A/C—AMNDLG UNRS � <br /> BA7+ITUB ; FORCED AIR SYSTEMS ; <br /> lA'/ATORY(WASH BASIN) � HEAT PUMP , <br /> f-IOWER � UNITHEATERS � <br /> '•.iCHEN SINK 8 DISP i CLOTHES DRVERS � <br /> U•3HWASHER � HANGEHOOD � <br /> IAUNDRY TRAY ; WATER HEATER ; <br /> CLOTHES WASHEH � WOODSTOVE � <br /> URINAL � MEfAL FIREPLACE(WOOD BURNII•1G) <br /> DRINKING FOUNTAIN ; FIREPLACE INSERT(WOOD BURNING) � <br /> FIOOR ORAIN � GAS FIREPLACE � <br /> BACKFLOW PREVENTERS ; GAS RANGE ; <br /> SINK(SERVICE—BAR,ETC.) � 2 GAS PIPING <br /> E%HAUST FAN <br /> � � <br /> � <br /> i i <br /> SUB TOTAL S ; SUB TOTAL S C)O <br /> PERMIT S � PERMIT S i C' <br /> TOTAL FEE f � TOTAL FEE f ' (�O <br /> FOR OFFICE USE ONLY: � 3,3 Q� <br /> FRfklT SETp�CN pE�R SF.TBACR SIDE SETB�CN PUN CIIECN NUMfl[R fEF �Ff.EIPT NO <br /> USE IONE im enE� VaG�Nt SIIE FEES VALUATION FEE <br /> �— <br /> _ ❑YES ❑NO BUILOING � <br /> i <br /> NEIu11TLIMITAiION NOOFOWEtUNG SIZEOfBLDGrtI <br /> UNIiS <br /> PlIlM01NG <br /> G�JPIINCY NOOfSfVtlES OCCUPANIL0�0 B�SEMENT MEf.�InWUI , <br /> ❑YE$ G ND � - <br /> FINES?PINKLERREO'D RF�SQY A�DIIIONAIPI�NCnfGN <br /> —�-- <br /> on�en <br /> FIREAUPMREO'D RFASpN — <br /> SLAI[01111UIrv6511OC11Ali0E <br /> TYPEOFf,ONSi Pl�NS�PMOVEDOY CITYOFEVERETT �Uplif.WO11K5 <br /> LOCAL SALES — --t-- <br /> UAtE TAX CODE IS 3105 TOTAL <br />