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APPLICATIQ ' FOR CONSTRUGT! `N PERMIT �� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT '�`�"Ez'� <br /> ;---- - - - -- � <br /> L HEATING SYSTEM: � GAS J ELECTRIC J _ __ ___. _ _ , <br /> EUILDItJG DEPARTI.IENT —� <br /> 259-8810 _ / <br /> DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGtJ <br /> u �.a L n;l �.t c r _ _ ZiP - PH iC ��� �� `� '. <br /> � �,_�,�,� t� �.��+ ��_� « :,i � �. ;� ��Y � r1� � ��, ` lb ��., .-, -�:�: <br /> -i�.r., �; n+ai�nooatss a,r ni� r�wHe <br /> 1 �� 1 �� _ _ <br /> . �>��r(.CTORpESIGNER MAItADDFE55 GRV ZIP PNONE <br /> L� � <br /> 6.1!S�:nL CDNTqACTOR AUIL AODRE55 tlTY IIP PMONE SiAiE LICENSE� <br /> I t( N <br /> -.:,,,iJl�A�a�,��,oA Ma��>11C� �1, 1 � ���C �t- ���a:�c�l �,`����rz33� rl�Er�lt�;��.lu ��,_� <br /> � OH —_ <br /> � i�!•.b�YG LONLqACTOR MAIL A�OR[SS GITY 21P �HONE STAiE LICENSE� <br /> D �x __._ �CiV�'t d�� 1�A'CC�VIGLV���C. � — <br /> r.��rnn.taaiCFOFW H �^� <br /> a H t~i+ _ l '. ���LJ <br /> 1 <br /> p.� '3 LE Scia!IE WORN AND SOU�RE FOOTAGE INVdVEO CONTAGT PERSON AN�PHONE N0� <br /> y hi __ <br /> � H� _ �C��\�' C a C CC. -- <br /> y y H �1�.��1 — <br /> � HEREBY CERTIFV THAT I HAVE READ AND EXAMWEU THIS <br /> � `r,�»� rn�-�- c��ov i�owc APPLICATION AND KNOW THE SAME TO BE iRUE AND COFRECT ALL <br /> y ty PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> llyy -,n�cescnivncHorvaorEnrvis�wwnoE�owoaannc��Twocoaiesi WOPK WILI 8E COMPLETED WITH WH[THER SPECIFIED HEREIN OF <br /> NOL THE GRANTING OF A PERh11T DOES NOT PRESUTAE 70 GIVE <br /> �� � �r., — o�ocK oF AUTHORITY i0 VIOLATE OR CANCEL THE PFiOVIS10NS OF 4NV <br /> �"'� OTHER STATE OR LOCAL LAW RFGULATING CONSTFiUCTION OR THE <br /> 7a' y� PERFOFMANCE OF CONSiRUCTION.THAT I AM AUTHORIZED BV THE <br /> t" `C OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> � �"� y _ ___ APP�_ICATION IS MADE AND I COMPLY WITH THE STAT[ <br /> y p.� r��:._u inK io muueEa CONTRACTORS LAW�B.2i FCW AND 296200 WAC. <br /> C] t7 N , <br /> � �.s�nucnou io+rv iervoen.nooness.ieiev�ror�e r�cr.in�a % <br /> � ' x i'_ (t1�,�,?(:2 ��'�-,..i- r: �� � ��7/'i-� <br /> H O N Pt70JECj��Q E S .._ .1 _. � T�� � -- _ . _ ___ I•��_. <br /> � PWMBING MECHAl11CAL , ... <br /> NO. TVPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET ITOILETI A C—A HNOLG UNITS—HP _ __ <br /> I �ATHTU� � FORCED AIR SVSTEMS—B.T.U. M E.A. _ <br /> � �� _ LAVATORY�WASH OASIN� _ UNIT HEATE(i5—B.T,U. M �_ <br /> SHOWER CLOIHESDRYERS <br /> HITCHEN SINK R DISP VENTILATION FAN _ <br /> DISHWASHER RANGE HOOD __ <br /> • LAUNDFY TRAY WATER HEATER �__ <br /> i _ CLOTHES WASHER �NOODSTOVE <br /> � h1ETAL P�REPLACE(WOOD BURNING) <br /> URINAL <br /> DRIIJKING POUNTAIN FIREPLACE INSERT _�_ <br /> FLOOR DRAIN HEA��PUMP <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ' � ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> SINK(SERVICE-6AA.ETC.) <br /> '�1 � _ — <br /> _ —i— <br /> SJB TOTAL S SUB TOTAL 5 <br /> L1� PERMIT 5 PERMIT 5 <br /> �1 TOTALFEE 5 TOTALFEL 5 <br /> FOR OFFICE USE ONLY: <br /> PPO'li5E1P,�Cx �1CAR5[704CK S�O[SLIORfI! �'LANR��CKNUI.�pLR �CL RLC[iPiNO <br /> Z <br /> nv_zoN[ �otaatn vncnrvrsne FEES VALUATION FEE <br /> !-- VES � �. NO OWLDIIJG <br /> I.rl er roNs[ No oF stoRlEs o.unanev e.o o:Orv[i�r,cu�.as --- --—_ �i <br /> °R0"` PWtd13MG <br /> �;Gf.OPBL00 FIRESPRiNNlERSNEOD AASEMENL MEGHANICAL <br /> '�� YES �... ryp .� _ _ <br /> t,+.:(�.UFANCYlOAO FIREAURMREOD HEIGHTl1A11iAilON ADUITIONALPLANCHECK _ <br /> OTHEfi <br /> Hf ASON <br /> STATE BUILDING SU�CHARGE <br /> ��r�inee or i��aus nvrnov�oov �ITY OF EUERETT pU�IIC WORKS <br /> LOCALSALES <br /> „�,; TAX CO�E IS 3105 TOTAL <br />