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o�x <br />>H[~i� <br />4 xy <br />yxH <br />� � � <br />��� <br />tiH <br />�zp <br />�3 Cl <br />OH <br />��g <br />�j] V (i <br />t"y� <br />HH <br />g�' <br />H <br />n d❑ N <br />[�U � <br />q <br />O� <br />fU <br />� <br />1 <br />I �� <br />� <br />� <br />APPLICATI� 1 FOR CONSTI�UC7_JN PERMIT �� <br />�'� TO BE COMPLETED IN BLACK INK—PLEASE PRINT ���% <br />�� <br />BUILDING DEPARTMENT �HEATING SYSTEM: �GAS LJ ELECTRIC J_ __ � <br />—_� <br />259-8810 <br />DEMOLITION COMBINATION <br />c�vn[r� r.�m�nooaEss <br />� n _ <br />n <br />_t% ,� ,yY������i��.i �l.'i� �L����t'�- <br />t�ypryi �i MRiL�ODRE55 <br />a��GuIECTORDESiGNEF M1IAILAODRE55 <br />GENERALCONTRPLIOR AIAILAODRE55 <br />� <br />1,�[CIIANICALCONTRRLi R MRR D R[55 <br />i ��,,:;,.,.., - 1� <br />�l�,�n��c�, '�c �f -„ ,, -�-1=/ <br />BUILDING <br />ciiti <br />)i� r�fC�' <br />�I diY <br />LITI <br />:IiY <br />��� <br />PLUM1IOINGCOHiRhf.i=R i��.ACOF�55 _ CITY ' <br />u,cs oF wonH <br />NEW ADDITION �� 4LTERATION FEPAIR DEAIOLITION <br />1 ~1 <br />CONtACT <br />CCNiMCiPRICEOFIVCRN`` L/L�, �'� <br />OFSC� 1YORh AND SOl'AP[ <br />�n��a II � <br />riaoroseo usE ov paaowc <br />LfIGAt p[SCRIPiIC N OF PFOPI <br />u�t __ OLOGN <br />i'ROJECIADOR[55 <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WAS <br />SHOWER <br />KITCHEN SINK 8 <br />DISHWASHER <br />LAUNDRVTRAV <br />CLOTHES WASH <br />URINAL <br />DRINKING FOIIN <br />FLOOR DRAIN <br />BACKFLOW PRE <br />ROOF DRAINS- <br />SINK (SERVICE- <br />FOR OFFICE USE ONLY: <br />PRONTSEI9ALN REARS <br />ll's[ZONE LOiRP <br />SVEOF <br />!1[ASON F <br />rt,rnKE o� <br />61Y <br />[7� <br />SUBTOTAL S <br />PERIAiT S <br />TOTAL FEE S <br />I`l M1N'. PP{'f101 CD OY <br />�MECHANICAL PLUMBING SIGN <br />2iP CHOf1E <br />��._,� -�1--� n..-'1 <br />1�^-���1 �).� °'�AL. <br />?iP PHONE <br />ZIP PHONE <br />TIP cMONE SiRiF UCENSE i <br />WOODSTOVEiFRPL INSERT BUILDING RELOCATION <br />RND i'HONE NO <br />��; 7�5 _ %�/(� <br />.����'' �, 1 <br />I HEREBY CERTIFV THAT I HAVE HEAD AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAh1E TO BE TRUE AND CORRECT ALI <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNIhG THIS TVPE OF <br />WORK WILL DE COMPL[7ED WITH NlHETHER SPECIRED HEREIN OR <br />NOT. THE GRANTING OF A PERA11i DOES NOT PRESUME TO GIVE <br />AU7HOAITV TO VIOL�TE OR CANCEL THE PROVISIONS Of ANV <br />OTHEF STATE OR LOCAL LAW REGULATING CONSTRUCTION OF TIIE <br />PERFOFM1fANCE OF CONSTRUCTION THAT I AM AUTHOflIZED OY THF <br />OWNEFi OF THIS PFOPERTV TO PERFOPAI THE WORK FOR WHICH <br />— APPLICAiION IS h1ADE AND 1 COAIPLV WITH THE STATE <br />CONTRACTORS LAW 182; RCIN AND 29620D WAC. <br />i <br />i -1 <br />�� �� �.^. i[,'! — <br />X. i,. !. i. � i: � i i <br />. � . �-� i; . ,�.. <br />MECHANICAL � � <br />NO. I TYPE OF EOUIPMENT FEE <br />A C-A HNDLG UNITS-HP. <br />FORCEDAIRSVSiEMS-BTU. A1 EA. <br />UNIT HEATERS-�.T.U. ht <br />EXHFUSTFAN <br />SIOESEipACN 'LANC�IECNtlU'd6[R <br />S�3S <br />MCRNT SITE FEES <br />BUILDING <br />ttarc,c. xoaca�r.'.�•.��� <br />�w�' PLU1.1131NG <br />BASEMENT MECMANICAI <br />NEiGNTUMItnTION ADDITIONALPLANLHECK <br />SPRINKL[R <br />STAT[ B�ILDMG SURCNARGE <br />CITY OF F.VERETT PU�LIC WORKS <br />LOCALSALES <br />TAX CODEIS 3105 TOTAL <br />K <br />SUB TOV L 5 ; - <br />PERMIT S ��';_ <br />TOTALFEE 5 , �iI'. <br />FEE <br />