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APPLICAT'id_. FO�i CONSTRUCT,'� �N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDWG DEPARTMENT HEATING SYSTEM: ,1(I GAS .7 ELECTRIC J <br /> 259-8810 <br /> DEMOLITION I COMBINATION BUILDING J�MECHANICAL I PLUMBING SIGN <br /> � �G 'NER � �dA�LA�DRESS CIT ZIP PMONE <br /> �if— l.�1�eo�p � �Ge2� Ui��,,� �_��Cve �r Ff- klp • �zs� -.��06 <br /> TENANT MPIL ADDFE55 CiTV 2iP PNONE <br /> AqCHITECT OF�ESIGNER tAAIL AODRE55 CITY 2iP P110NE <br /> GENERALGONTRFCTOR IAAILADDR[SS C17Y 2iP PMONE STATEUGENSE• <br /> IAL NCRLCONTP4CT0 /� '����DDFE55 GrtV 1 Zif PMO��[ SIATEUCENSE• <br /> ��� /� =(..L� iS"D-6/V " 9S"� �drn� 9��� SS/G7S"y 1'.,c�atTn�1 Cas�4 <br /> PWN�INGCONTqACTOR IdAILAO ES CiTY 21P FHONE STATELiCENSE/ <br /> CONTRACi PRICE OF WORH � IJ� <br /> /��� / '_ <br /> DESCRIBE\NORK AND SOUARE FOOTAG[INVOIVF� CONTACT PEPSON AN�PIIONE N0. .Tn�-- .I�`�L' <br /> ��n jI � —'I <br /> 1 <br /> �'g � O7S� <br /> I HEREBY CERTIFY THAT I HAVE RtAD AND EXAMINED THIS <br /> PROPOSE�USEOFBUILOING APPLICATION AND KNOW THE SAME TO BE TRUE AND COFR[CT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> iEca�oescaianoNOFraoNeerr�sNonNee�owoannacrrnvo�ories WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �ot e�xK oF — pUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONS'?UCTION OR THE <br /> — PERFORAIANCE OF CONSTRUCTION.THAT I Ald AUTHORIZED BY THE <br /> OWNEfi OF THIS PROPERTY TO P FORM THE WORK FOR WHICH <br /> APPLICATIO MADE AND COMPLY WITH THE STATE <br /> vnacet t.+a i o r+cn+oea _ / CONT/ ORS W 8. 7 RCW D 296 20 WAC <br /> ID.S-7 DUO �D j l3Dr�, <br /> CONSiPUCT10NLOANLEN�ER.A7DRE55.TELEPMONENOMBER � _3 j p <br /> PROJECTADDRESS sc�++�un o"'E _ <br /> t�*�ous�atss ucrrvu vn <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FUfTURE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILE7) A/C—A�HNDLG UNITS—H.F. _ <br /> BATHTUB FORCEJ AIR SVSTEMS—B.T.U. M E.A. _ <br /> IAVATORV(WASH BASIN) � UNIT HEATERS—B.T.U. �A <br /> SHOW ER CLOTHES DRYERS <br /> KITCFIEN SINK 8 DISP VENTILATION FAN . <br /> DISHWASHER RANGE HOOD _ <br /> LAUNDRYTRAY WATER HEATER <br /> CL 1THES WASHEF WOOD STOVE <br /> Uf NAL METAL FIREFLACE�WOOD BURNING) <br /> DR NKING FOUNTAW FIP.EPLACE�NSERT <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PF7EVENTERS � GAS PIPING <br /> FOUF DRAINS—RAINLEADERS � 'E!XH�US FAN " <br /> S�NK�SERVICE—BAR,ETG) � Jl�� N� '- <br /> ' __ <br /> �_ ---T <br /> SUB TOTAL $ ' SUF3 TOTAL $ v�G � <br /> PERMIT 5 � PERMIT S J� � <br /> TOTALFEE $ TOTALFEE $ <br /> FOR OFFICE USE ONLY: <br /> nEceirr No <br /> FqONT SGiB�CK REAR SETDACK Si�E SET6AGK PLAN CNECN NIIMBER PE[ <br /> use zoNe LOT PREA vncnNT sire FEES VALUAi ION FEE <br /> " .- YES �i NO BuaoirvG <br /> 1VPEO�WNSi NOAFSTORIES Otc��npq�r xoO�owEu�'iGuu�,�s — <br /> LP°0` PLUMBING <br /> 512EOPBLDG FlRESPRINKLERSREO'D �ASEMENi MECHANICAL � <br /> �-, YES ❑ NO — <br /> OGCUPPNGVLOAD FlREALARMFEOD HEi�HTU1dITRTION <br /> ADUITIONAL PLAN CHECK <br /> OiHE(i � <br /> ——�— � <br /> PEASON <br /> STAiE DUIL�MG SURCHARGE <br /> INTqKEBY I PLANSAPPROVEO�V CITYOFEVERETT PU�LICWORN$ <br /> LOCAL SALES <br /> oA,E TAX COUE IS 3105 TOTAL <br />