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APPLICCaTI� J Y=OR CONST�UCT )N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT �� <br /> L HEATING SYSTEM: �GAS J ELECTRIC J _ _ _ J <br /> BU!LDI�C: D[PARTI�iLNT <br /> ?55 6810 <br /> DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> -=•-r.cn �AniLaoDRE55 cnr � Z�a PUOr�� <br /> t�EAM CPJ ��•c. 35��1 �naA� �ve,.a v�A 4rtzo� Z58- `-f 3 3 � _ <br /> icrinHr n�n�inooaEss cnv ziv crcne <br /> S�L� <br /> %•��O�i1FCLCPDESiGNEH MAllP0�RE55 CIIY TiV �HONf <br /> S�aN�� <br /> tIL':iliLL:ONiMC10P MAILA�DRE55 CILY ZIP PI�ON[ SiA1[LiCENSE• <br /> �AME�_ 13EAML� �IU"OE. __.. <br /> t'E N.R:'-04lLONiF�L109 AIAILRDOReSS GIiV ZIP PHOtif SiPT[IICENSE� <br /> H O H <br /> r�i � � PWA�pINGCONiMGtOP I.NiLAD�RlSS CIIY 21P PMON[ SiATEIICENSC� <br /> (T� a <br /> :U y <br /> CLASSCF WORN <br /> A H V� �EW ADDITION ALTERATION REPAIR �EIdOLITION WOODSTOVE.FfiPl WSERT _°UILDINGRCLOCATION <br /> t� ^ �CiP(I:�O4ANDPMONENO <br /> K�n ir�:rnnc*anicEOFrio�K ll.� �20d51-���V� ._ <br /> H� n:sceio[wonk nN sounnE roomoc�vva�.rco ,�r� <br /> '�9H� Nt...� �o„s �r 2y � 3y15 ' �3�i � _ <br /> � �"� r•ricvoseouseorouno���c I HEREBV CERTIFV THAT I HAVE READ AND E%AMMED INIS <br /> .y,. O� S.Y 2 — APPLICATION AND KNOW THE SAM17E TO BE TRUE AND CORRECT.ALI. <br /> � yCy ircn�oesceivnar�ovraoren.vis��owNeEiowor�nir��cr�rouecoriesi PROVISIONSOFLAWSANDORDINANCESGOVERNMGTHISTYP[Of° <br /> O H WORK WILL BE COMPLETED WITH WHETHER SPEC�FIED HEREIN OH <br /> ;q � �y �or �_ eiocrc or �Cti.V . C.�J NOT. THE GRAN7ING OF A PERMI'i DOES NOT PRESUME TO GNE <br /> O AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> �.'n,.�` � �� OTHER ST�TE OR LOCAL L�W REGULl+71NG CONSTRUCTION OR THL <br /> �H �— � — PERFOFMANCE OF CONSTRUCTION.THAT I AM AUfHORIZEb BY 11�� <br /> y x OWNER Of THIS PROPERTY TO PERFORId THE WORK FOR Y.'HICH <br /> �..i y APPLICATION IS MADE AND I COI.IPLY WITH THE ST�1T[ <br /> gu1 CONTRACTORS LAW 1827 FCIN AND 296200 WAC <br /> g d� — a.s��-�/5 3 <br /> �i "�r __ X — 6��5 � ��- --- <br /> � — — <br /> H O f�/� r�vai[cr no�n�ss �. ." ' __ •.�.� ____ <br /> �+- 2 `)Z �/ l��t..� c.«s r ./���. --— ., .., <br /> �[(�� PLUMBING MECHANICAL <br /> I {�� NO. 7VPE OF FI%TURE OR ITEM FEE NO. 7YPE OF EOUIPMENT FEE <br /> \NA7Efi CLOS[T 1TOILETI ��j':_ �C—�f_NDLG UNITS—H P. _ <br /> � � DATHTUB ___`�; � f ORCED AIR SVSTEMS—B.T.U. M E.A. <br /> � �_ —"— ��'1 UNIT HEAiERS—B.T.U. M — <br /> _q_ LAVATORYIWASH�ASINI <br /> �I 1 SHOWLR �' I_ CLOTHESDRVEFS <br /> � KITCHEN SINK 8 DISP __5'_I B VENTILATION FAN _ <br /> � �ISHWASHER ���_ L FANGEHOOD _ _ <br /> LAUNDPVTRAV �'; � WATER HEATER _ . <br /> � I_ ' '� CLOTHES WASHER �:_� �VOOD STOVE __ _ <br /> i � � METAL FIREPLACE 8 CHIMNEY /y� _ <br /> URINAL ���-J� <br /> DRINKING FOUNTAW FIRGPLACE WSERT __ <br /> F OOR DRAM � HEAT PUMP _ _ <br /> I ,t 1 BACKFLOW PREVENTERS GASPIPIN��P=�`t�.:'��__-��rv � - _ <br /> � ROOF DRAINS—RAINLEADERS �L E%HAUS-i FAN <br /> a SINK�SERVICE—BAR.ETC.) _Z__ F/REQL9(y� � __ <br /> � 1 � —� — .. <br /> .�e'� <br /> SUBTOiAL 5 SUBTOTAL S _ <br /> '='�' PERMIT 5 ����_ --�— TOTALI FEE S --��� <br /> 70TALFEE 5 <br /> FOR OFFICE USE ONLY: GLS�G �53 <br /> FRONi5E1pM1CK RCARSITII�f.K SI�E�EiBACH / PL�NGM[CK�.UPPIH FC[ PfLEIPLNO <br /> �� ' �S ' ,5 u���resr�F s 3•���/e, ;--3 0 lr�J7 <br /> u;�t iornnen ��ncaNtsrte FEES VALUATION FEE <br /> j� 5 � .�7 Y�J eu��u�Nc __�33 Li 1 7�`8 - <br /> ttfEoltoN�sALLowRelE t�rEarcapStAClu�t o-[.��n•.s . . ,n — t' � <br /> �J "" PLUM�WG � — <br /> ! )E Of�loG NOAF STORIES OrSEM[Ni � MECHFNICAL — <br /> ZG'io Sf tb'7I Sf �1, -- — <br /> O(C�COPANCYLOAD FiRFSPRNKLER5RE0'D NEIGNiIIIAIMi'�JN �DOITIONl1LPLANCHECN � <br /> I <br /> up 7 � SPRINKI[R <br /> nrn<-�t�ron Srm•�rytn; — <br /> STATE BUIL�ING SURCH�flGE _� �U <br /> , ;.�i r� ,:.usA���acvcunY CITYOFEVERETT ruoucwor+Ks Z(} I— <br /> J�} LOCALSALES - <br /> 7 ���y Z TAX COOEIS 3105 T�TA� _ <br />