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PtOM�EU�R'tTT uJiLDING DEP�. T0� 1 e2o <2� 5212 . �5� :99� :G���'9 «2�B P.�3 <br /> APPLICATION FOR CONSTRUCTION PERMIT <br /> TO BE COMPLETC•D IN BLACK INK—PLEASE PRINT � � <br /> HEATING SYS7EM: U GAS ❑ELECTRIC O__ �—] <br /> BUILDING DEPARTh4ENT � <br /> 259-6810 <br /> � I i pEMOLITION i COMBINATION I I BUILOING , i MECHANICAL i � PLUMBING �SIGI <br /> �� IAAR6D]RCS.• ...^ Cilv Z�n PIqNF <br /> y � oman ----• ... <br /> y ,- r-,,,•n•u- _���i._�9. <br /> � y S 1 n��i �arn��� a ]� P,�:cKer _._ �,Y :�� o������ <br /> unnia i,uit noon[s. <br /> .. � : S f3 m� o < o ho�� --- �Rv 2iu— PMONE.. <br /> ANGMI1tC1UNUGSi6NtM V�I BUUNhs� <br /> � � � _rneyer SiGN � ��u. /�,y NWY95sr, ��. ur.N `/8_273 . _. `/.��-�3a� _ <br /> ���� Z�p PnDNF SIREUCCN:C• <br /> y �. G[nCOALCIX1�MCi0� IANlMD0C5^+ � + <br /> � 4 �e lnrver :�_ ;�a�c_3 r..G. .. <br /> � � E 6 C ���-K��I C pHr�N: ciatE L�ClnSe r <br /> MlCNNIiC�L(:0`JINACILH I.1NiLAUUNt6S ' f.liV 71� <br /> O H _. <br /> N [tl S " "CRV 7�7 NNUNC 6TATEUP.6N'.CP <br /> � . j5 YWM9W4CIXI11UC101i MA4AWN[55 <br /> M _ . "' <br /> yy� M <br /> k+ Ny GIA55(%1YORK __..,_ <br /> y �NEW 1 I ADUITION i I ALTERATION I I REPAIR ,(�� DEMOUTION I I �y00DSTOVE/FRPLINSERT � '� bUIL01NGRELOCATIO� <br /> M 11 GONiAf.T VF.R604 PND GNO��E NO <br /> �GG o �, yn `l.��l- 13.;� <br /> �S W � CENITR1CTPPIGF(1fWOPR. . _..._-"�O�QQ��- . ._. _. . - . . .-- <br /> yy y DC`+CfUO[WOIIKAND•+OJA�Cf00TnG[�NVOLYED <br /> � 01 � S Fi� 5 — <br /> vR0 stUuSFc�BwlDivt. I NEREBY CERTIPV TNAT I NAVE HE�D AND CXA1dINED THI <br /> APPLICAI I0N ANb KNOW THE SAh7C TO BE TRUE AND COfiREGT.AL <br /> teo��nEscr+�HlauofPHovEN�vtSeavi+eEtowoRaiACNFouatoF�is� � PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHiS7Vf�E0 <br /> p WDRK YJILL BE C0��PLETED WI7H WHETHCR SPGCIFIED HERFIY Oi <br /> toi I 'IC� 6LOGK .S�o or RNi JC�f S NO7. THE GRANTING OF A PERAUT DOES N01 PRESU6IE TO GIVi <br /> AUl HORIIY 7D VIOLATE OR CANCEL THE PROVISIONS OF AN <br /> _IjT � � �����pd-__S i i,J � OTHER STATE OR LOCAL LAYJ REGULATWG CONSTRUCTION OR 7W <br /> _-_--�--q--- - I PEiiFOPIdANCE OF CONSTRUCTION.7H�T I AL1 AUTHORIZED BY T4' <br /> n ! 0\VNER OF THIS PROPERTY TO PERFOHM THE WORK FOR WIi1Cl <br /> O3�J JO _C�J.-�(J.__� ------- APPLICATION IS IdAbE AND I COM1IPLV WITH THfl S7ATi <br /> ' CONTiil�CTOF L 18.27 RCW AND 2 200 W�G. <br /> X `-.''� � a's �/� <br /> / , <br /> / �, <br /> . � . <br /> �� >> v��l���'.. _ __ R�...�,,, _ - „�„ <br /> � �... FRUJECTFDDRE65 ,._ �_._._ _ .._ —'. ... .. <br /> � cnv e.n�vas vcr.er re� <br /> PLUMBING MECHANICAL <br /> i FEE N0. TYPEOFEOUIPMENT FEE <br /> I ryp, TYP[OF FIXTURE OR ITEM - - <br /> '�� WATE.R CLOSFT(TOILET) __. i WC--fvHNDLG UNITS-H.P. <br /> �J FORCEDA�RSVSTEM$-B_7.U. M EA. <br /> ��' BhTHTUB -_ .......- ' UNITHEATEFiS-U.T.U. M ' <br /> LAVATORY(WASH @ASIN) _ - -- - �—r <br /> CLOTHES DRYERS ._ . <br /> . SNOWER '� � VENTILATIONFAN � <br /> KIl CHEId S'NK 6 UISP _ ._ ' ` �— <br /> I �� DISHWASHER � RANGEHOOD __. _ <br /> , . . . WATER HEATER � <br /> ' ___ ' <br /> . LAUNDRY TRAY ..._... y yl00�S70VE ' <br /> �_ -... ....._. _.._. . . <br /> CLOTIi[S VJASH[R , � �h�ETAL FIR[PLACE&CHI6INEY ' <br /> URINAL ' — ��� � � �' <br /> �� � FIREPLACEINSL-RT <br /> �r DIiINKING FOUNTAVJ �_ '__ -.- - - --- -'�" — -r <br /> FLOOR DRAIN __. � HEAT PUI.1P _ <br /> BACKFLOWPREVENTERS GASPIPING ,..___ �— <br /> �' �� ROOF�RAINS-RA��JLEADERS � EXH�UST FAN -- <br /> i I I � SINKISfHVICE-BAR.ETC.) �_ � ��� � ' <br /> —_ __ . .. , <br /> i � _... . . ... , <br /> . i _.. <br /> i <br /> � <br /> � �' _ _ �. _- SUBTOTAL S SU�TOTAL R . .i,- _ <br /> � — PERMIT S � , PERtd1T S � <br /> TOTALFEE 5 � ' TOTALFEE S <br /> FOR OFFICE USE ONLY: <br /> GPpNTNFlPF(;K NtA�SE18ACl( '+i0C5Cit1ACN PIFKCNFGNNpA1PGR FFF RECEIPiNp <br /> �/� ' nSS <br /> ��..+ �, i C� � FEES VALUATION FEE <br /> usczor+c �-- - �;crnacn )�j v.cu+*s�TF . �/� . � <br /> �_� Z '_ iOT � C) flU110t4C�_ �v,'�� .._ . _ �J�� <br /> iYPiGFt0951.�:IWL 0..['vu�Cr nuu�c�um�:nnn � <br /> tYW Of G7H15�110WFBlF n�An ' PLUMOIN� <br /> /. � <br /> .__ �._.. ... . _.__�__ <br /> . ."___'_— � i <br /> SVF OF PIM+. <br /> HU Of GtOn�ES �ASFMENT 1dECHANICAL � <br /> ADDIIIONAL PIAN CHECK !_ <br /> OCCIII'NIGYLUAD flp[:VPYHICaSBCDD � NEIf.NT11MiTATIUV � <br /> ___ $PRINKLEB .,T <br /> P4ASONFOFFGRiNKIFP.S � ����(�UIIDINGSURCHAROF � 1�[v <br /> --�/�-J� JM _ _---- . <br /> INUMFBV �f 1'iO:SAPPF VFfIBY CITYOFEVERETT pUPI�CWORKS <br />