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�,���.��;�,T'��HI FOR CONSTF�UCTI�N PER�Vfi'F ��"'"�" <br /> , . ,. „ <br /> TO BE COMPLETED IN INK—PLEASE PRINT � <br /> „ -,.. <br /> cu v or <br /> everett -- - - - <br /> - <br /> i HEATING SVSTEM:�GAS J CLECTRIC J = _ _ _ _. _ , <br /> BUILDIMG DEPARTMENT -- <br /> 259-8810 <br /> DEMOLIT�ON COMBINATION /�BUILDING MECHANICAL PLUMBING_ _ SIGN <br /> -- PHONE <br /> :yl�� --- MMI��f)NEJS C �1 <br /> Qly ]I� <br /> a.�4; � �� 1 : <br /> � � m �'�i G� ',:�I�_'� !•1G 252� �1Ct�l Ca'_�_,1 EJ( f��_ �-( Qr' ?� 3 � - <br /> p � � �isi.Vl MAILAD�RE55 CItY Z�� <br /> PIIONF <br /> �' "3 y , - CIiY ZIP PNONE <br /> .�;-�n�[CTORDFSIGNER MAiLA0DRE55 C`, (� � 't.l <br /> ' 1' �JIIS SIiP-�/t� /�'5.�.��C. I��. iSU�I �I � Bi-�2E0 P-L) 13E1.lCJuC , WFl � 00 7 <br /> K � n _ ��n. Z�p FHONE LiCENSE� <br /> H %1 ,d!�[nnLCO�RNACTOP 1AAIROOHE55 <br /> � y � ���'� �in. Z�p PHONE UCENSE� <br /> H � !�Ii.�NN�CIuCONiRAGTG9 1A�il/�DDfVE55 <br /> C � <br /> tl7 <br /> x n O �,"9JINGCONTPACiOA MAII�DDRE55 CiTV 2iP i'MONE IICEN5E1 <br /> � :' R <br /> �"� C �IlSSOF WOPNv <br /> � y � NEW J. ADDITION . ALTERATION REPAIR DEMOLITION WOODSTOVEFRPL INSERT BU�LDING RELOCATION <br /> H y - /� i/31 921Sr cnNucrrEasoNn�voaHw+eNo , �� . I ;� <br /> Sti ,F{ �^ (' e;L TA�P-A 51 rt_!-� �` � 1. "• <br /> � ,.�v rtraceoFwoa� Y/��c7'UYJ ���� �� <br /> f1 G N _ <br /> _C.� � r ;��.sc�iBEWORNANO50WREf00iAGEINVO�VE� — I� � — <br /> z � o- 6Zy <br /> s,� ( ,; � � <br /> a <br /> �i^0�'(�u� h*�0 RC�eJAT�Vt�1 �C-«I L�G-� 1� � ., <br /> H O H ���ovoseouseoFouaoine j�'(')rGC[ �� � "�� I IIEREBY CERTIFV THA7 I HAV[ READ ANO E%AMINEO THIS <br /> ��( -•j� Q�hJ C L_ C�( l� . 71.� APPLICATION AND KN01Y THE SAME TO OE TRUE AND COFRECT.ALL <br /> ,�r,ni oescaicna+oF raovean�si�owN ee�owoaarTncr�rouRcoP i PfiOVISIONS OF LAWS AND ORDI4ANCE5 GOVERNING THIS TVPE O`r <br /> - - � WORK WILL BE COtdPLETED WITH WHETHER SPECIFIED HEREIN Of7 <br /> ,,., � Z' BiaK z. oF �"2t���C'� I�-�� � � NOT. THE GRANTING JF A PERMIT DOES NOT PRESUME TO GN[ <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF �NY <br /> �7. �SV LcT iZ- OTHER STATE OR LOCAI.LAW REGULATIIJG CONSTFiUGTION OR THE <br /> PERFOR�dANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY TIiF. <br /> OWNER OF THIS PRO�ERTY TO PFRFORM TH[ WOHK FOR WHIGH <br /> APPLICATION IS 1dADE �ND I COAIPLV W:TH THE STA�E <br /> � — CONTRACiORS LAW 1827 RGW AND 296200 VvAC. <br /> SIG��AtU9LC�COHIRAC10nORAu��+ORi.'EOAGE91 f�'� <br /> X <br /> u�>�_ci noDntss <br /> — � -- - - <br /> npPGL 11 I '-�.�'+ES. O�SENOPHb�Il51NP55NAlIE <br /> ����� -�z5 JtCM1 CRE-`�I (�JCP-EiT <br /> �� � PLUMBiNG MECHANICAI. <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER GLOSET�TOILET) A�C--AHNDLG UNITS-Fi.P. _ <br /> I '�r.� B�THTUB _ FORCED Alli S`.'STEMS-B.T.U. M E.A. i_ <br /> �I LAVATORV(WASHBASW�_ UNRHEATEIiS�-BTU. M <br /> SHOWER CLOTHES�RYERS _ <br /> I - KITCHEN SMK 8 DISP VENTIL4TION FAN � <br /> --� <br /> � DISHWASHER S' � RANGE HOOD <br /> LAUNDRV iRAV � WA7ER HEAT�R <br /> � � CLOTHES WASHLfi WOOD STOVE <br /> UFINAL � METAL FIREPLACE 8 CHIMNEV <br /> DPINKING FOUNTAW FIREPLACEINSERT __ <br /> I ' FLOOR DRAIN HEAT PUMP <br /> �� � ' GAS PIPING <br /> BACNFLOW PREVENTERS �_ <br /> � ROOFDRAMS-RAINLEADERS - E%HAUSTFAN <br /> SINK(SEFVIGt-BAR.ET0.) " <br /> t 1�I ?J� , l. <br /> �� - - <br /> —_ _—� <br /> w. SUB TOTAL 6 = � - <br /> �' ' ' — _ SUB TOTAI S _���'I = - pERM1T S —_� <br /> �� PERMIT $ TOTAL FEE $ � �, �� <br /> TOTAL FEE $ /, J <br /> FOR OFFICE USE ONLY: '3 u/. �$ <br /> I�rt',JiSEiOAGK i�1�R5EiBACN SiDESElOACN PUNGHECRNIIIAf1(� ��� <br /> n[cocrrvo <br /> � � �, 'J.5 � ��77��J 1�'1��� `� �� � <br /> �.�r.c zone �or naea vnc��+r si*e FEES VALUATION FEE <br /> IZ' S /� C�Jo N� ovaoirvc $�0837 _ -,--= <br /> �.�IOfC�t11541I0WPBlC iVPFOiCOH5IRG1UAl �ccuo�yq x0o�o'n!.�^n�.�•nt _� ,� � . <br /> °"n' pWM�ING :� <br /> 7-ti� '3 -- �- <br /> 0.i.'E oF8lIX3 NOAi S1oNIE5 BPSCMENL MECHANICAL �� .% <br /> ,I L_- - <br /> Z�ISJ SP �YJ AD�ITIONALPLANCHEGK <br /> O:;COPRNLYLOAD fIRESPRNY.LElISREOD ��EIGNLUMIiAiIOy �(��� <br /> J,YI(' ^(� � OTHER — � <br /> rr nsor�`Oa evnn�n�Eas STATE BUILDING SURGHAHGE <br /> :.]������ %ANSAPPROvfO�v CITYOFLVERETT ruoLiCwor�Hs -. � <br /> j� LOCAL SALES _ <br /> v/� TAX COOE IS 3105 roia� �' J �' ��, '- <br />