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APPLICATIO.J FOR CONSTRUCT �N PERMIT �� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEM: GAS O ELECTRIC p <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> � DEMOUTION i COMBINATION i BUILDING �ECHANICAL �LUMBING SIGN <br /> O ER MAILADORESS GiV �21P FMDNE <br /> ��_��-.�e_� c��051���1 uer ��Y� 4SaDl�SLS� '"'2S"f�-�2�3__ <br /> TENANi MRIL RODRESS CITY 21P PHONE <br /> qRGMITECTORDE5IGNER MAILADORE55 GIN ZIP PHONE <br /> GENERALLONiPACTOR nMA�LADDRE55 GTY 21P PHONE STNTEIILENSER <br /> MEGNANICRLCONTRACTOR „MARADDRESS CITY 21P PMOkE STATELIGENSE• <br /> PlUM01NG GONTRACTOR �µpl`pD�RE55 CITY 21P PHONE STATE I 6ENSE� <br /> LLA55OF WORK <br /> �� NEyy DDITION �I � ALTERATION . . REPAIR : DE OLITION ! '� WOODSTOVE/FRPL�NSERT I ! BUILDING RELOCATION <br /> I GONTACT PERSON AIJD PMONE NO. <br /> CONTPAGTPRICEOFN'ORK D ` <br /> UESCRIBE WORK RND SUUARE FOOTAGE INVOLVED ` <br /> v�aovoSEpp$EpFBI11LDING ` i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> RL'.� l�e�_T'� � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGRlDESCRIPTIONOFPROPERTVISHOWNBE�oe�ti ACHFOURCOPIES� VJO9K WILL BE COMPLETED WITH WHETHER SPECIRED HEREIN OR <br /> 1< <br /> tor �I 'I'� BLOCK 3 oc /-4J C � NOT. THE GRANTING OF A PE(iM1T DOES NOT PRESi IME TO GIV[ <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THC <br /> OWNER OF THIS PROPERTY ?O PERFORM THE WOFiK FOR WHICH <br /> A�PLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> a4os u� X� �`�, �,C01�. �-a��.�,r- <br /> � � sicv�mae oeie <br /> PRQIEGT ADOflE55 <br /> CI1V BVSINESS IICENSF NO <br /> PLUMBIN6 MECNANICAL <br /> FEE NO. TYPE OF EDUIPMENT FEE <br /> Np, TYPE OF FO(TURE OR ITEM p�C—AIHNDLG UNITS—H.P. <br /> WATER CLOSET(TOILET) <br /> BATHTUB i CED AIR SYSTEMS—B.T.U. M E.A. _ <br /> LAVATORY(WASH BASIN) UNIT EATERS—B.T.U. M <br /> SHOWER CLO ES DRYERS - <br /> KITCHEN SINK 8 DISP NTILATION FAN -. <br /> DISHWASHER RANGE HOOD <br /> LAUNDRYTRAY � WATER HEATER � <br /> CLOTHES WASHER � WOOD STOVE '— <br /> � METAL FIREPLACE 8 CHIMNEY <br /> URINAL ' <br /> DRINKING fOUNTAIN I FIREPLACE INSERT ' <br /> FLOOR DRAIN ' AT PUMP ' <br /> BACKFLOW PREVENTERS � GAS ING <br /> ROOF DRAINS—RAINLEADERS � EXH ST FAN <br /> SINK(SERVICE—BAR,ETC.) <br /> � <br /> � SUBTOTAL $ � <br /> SUB TOTAL $ <br /> PERMIT $ / ^ ' � PEFMIT $ <br /> TOTALFEE 5 � TOTALFEE $ <br /> FOR OFFICE USE ONLV: ReceiaTr+o <br /> FRONiSETBACN RERRSETBACN $IDESETBACK PLFNCH[LKNUIdBER FEE <br /> 37��� FEE <br /> USE ZONE <br /> LOTAREA VACANTSITE FEES VALUATION <br /> BUILDING <br /> NPEOFCONSi.ACiUAI occuvpxa NOOruwnuNGuxns � <br /> ivPEOFCONiS.AILOWABLE cAouv ' PLUMBING <br /> SREOFBLIX'i. NJ.OFSTORIES BTSEMENT MECHANICAL <br /> ADDITIONAL PLAN CHECK ' <br /> OCCl/PANCV LOAD FIRE SPRNKLERS REO'D HEIGNT IIMIiATION � <br /> i <br /> SPFINKLER T— <br /> REASON FOR SPRINNLERS STATE BUILDING SURCHARGE <br /> INTPNEBY PIANSRPPROVEDBY CITYOFEVERETT PUBLICWORKS <br /> LOCRLSALES <br /> TIU(CODE IS 3105 TOTAL <br />