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APPLICATIC^`! �OR Ct�NSTRUCT°"7N PERMIT �� <br /> TO BE COMPLETED IN BLAC'i INK—PLEASE PRINT <br /> HEATING SYSTEM: �l GAS U ELECTRIC �OAIF <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> DEMJLITION COMBINATION `BUILDING MECHANICAL : PLUMBING SIGN <br /> OWNER MAILAO�RE55 CIiY ZIP 9�✓�� PNONE <br /> , ,,, _ - � .� ,. . , , . c��� 1••� „ • .., . . •�„�. a �� – l�^�? <br /> �� .; � <br /> TENANi. MAIL ADDRESS � CITY 21P _ . _�. �HDNE _ '" '__,_�_�. _.__. <br /> A , . <br /> . .. _. �_��.�——'___ " ____�" <br /> ARLHITECTOR�ESIGNER MAILAD�RESS dTV ZIP PMONE <br /> �__�_��.__'__���—_ <br /> C. ,.r, �i _.__'__ "___ '__ <br /> GENERALCONiRACTOR MAILADORF55 CITV ZIP PMONE ST�TF.UCENSEa <br /> ���� <br /> �-.��� <br /> MECMANICALCONTRALTOR ` MAILADDFESS QTY ZIP PMONE STATEUCENSEM <br /> PLUMBING CONTRACiOR MML fJORE55 GITV 21P PHUNE STATE UCENSE Y <br /> CLASS Of WORK � <br /> �'NEW . I ADDITION . ALTERATION REPAIR ��. DEMOLITION WOODSTOVEIFRPL INSERT ; i BUILDING REIOCATION <br /> — `� ('i� , CONTAGTPEFSONAN�PMONENO. <br /> CONTRAGTPRIGEOFWORN �D '7'l�) � / ��� �- � �� 11�� �� � �� � ����� <br /> OESCRIBE WORN AND SOUAFE FOOTAGE INVOLVED � :,�� � <br /> .',. .> >:'Of <br /> =/7F)in,�, r"r�)r/ � " � ' ' t r' � � <br /> PPOPOSEDUSEOFDUILDING �� . ` (� i HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br /> � T m�` � � ,"� �'S APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> LEGAL�ESCRIP710NOF PRJPERiv I`.HOWN�ELOW CR�TTA FOURCOPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING 7HIS TYPE OF <br /> WORK N'ILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> ioT ,:L oiocK f]p0 Di>9or -z-`� , i'� a 1� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> �' OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> r�e — JJ -Q�t PERPORMANCE OF CONSTRUCTION.THAT I AM AUTHORI2ED BY THE <br /> � <br /> OWNER OF THIS PROPERTV TO PERFOFiM THE WORK FOR WHICH <br /> +j�l/ ruv7 - - 0 '- APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> • CONTRA .. AW 1 . 7 RCW 9tJD 286200 WAC. <br /> � �- .- g�_ <br /> — % uo t �t/ �� � <br /> �.� � 7 , y- . L, x � '[�'�Q' <br /> L/ GC/ �)f'^nFr- 1. > te <br /> SK.NI.tUFE <br /> PR0.IECT ADDRE55 <br /> GrtY0U5ME55LiLFN5EN0 <br /> PLUMBING MECHANICAL <br /> NO. TYPE O�FDfTURE OR ITEM FEE NO. TYPE OF EUUIPMENT FEE <br /> WATER CLOSE`(TOILET) � 0.�C—A/HNDLG UNITS—H,P. � <br /> BATHTUB FORCED AIR SYSTF.MS—B.T.U. M E.A. ' <br /> LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M � <br /> SHOWER ' CLOTHESDRVERS <br /> NITCHEN SINK 8 DISP i VENTILATION FAN � <br /> DISHWASHEF RANGEHOOD r^' ' <br /> LAUNDRY A ; WATERHE �I <br /> CLOTH � WOOD S V � ' <br /> URINAL METAL FiREPLACE 8 CHIMNEY ' <br /> DRINKING�OUNTAIN FIREPLACE INSEflT <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING , <br /> ROOF DRAiNS—RAINLEADERS EXHAUST FAN ' - <br /> � <br /> SINK(SERVICE—BAR,ETC.) � <br /> i <br /> i <br /> SUBTOTAL 5 SUBTOTAL $ <br /> P[RMIT $ PER�AIT $ <br /> TOTALFEE $ ' TOTALFEE $ <br /> FOR OFFICE USE ONLY: >rNo..Z� <br /> FRONTSEiBRCK ' H[ARSFTAACK/ SIDESETBACK / PLANC�H�IU�� � FE[�� O� RE���^S <br /> j3 0 <br /> usezoru� �oTaRE^ vncnNTsire FEES VALUATION FEE <br /> DIiILDING pj �G� <br /> iYPE01WNi5ALL01VABLE 7YFEOFCOHSi.ALlIIA P'.aoqy�v xo0�Mrt0.ixuuxns � <br /> -ry_� °°.rn:� pLUMBING ' <br /> _Y- .1L � <br /> SREOFBLDG. NO.OFSTORIES OASEMENT MECHANICAL � <br /> � <br /> �� SF I � ' <br /> ADDITIONAI PV+N CHECK � <br /> OCCUPAYCY LOAD FIRE SfPNKLENS REO'D HEIGNi LiMITAT101� i <br /> NJ / SPRINKLER <br /> REA..ON ORSPRINNLERS ( � <br /> S7ATE BUILDING SURCHA(iGE U <br /> INTRHEBV PLANSFPPROVEOOV CITYOFEVERETT PUBLICWOFKS � <br /> LOCAL SRLES � <br /> J l� � Z6 TAX COUE IS 3105 TOTAL i� / ' �D <br />