Laserfiche WebLink
APPLICATIOPI .�OR CONSTRUCTIG _� PERMIT � <br /> TO BE COMPLETED IN BLACK INK-PLEASE PRINT �� <br /> �i <br /> HE�TIF..� '�STEM: J GAS yELECTRIC J -- - - -� <br /> BUILDING DEPARTMENT - <br /> 259-8810 <br /> DEMOLITION COMBINATION ✓BUILDING MECHANICAL PLUMBING SIGN <br /> ow�FA /,nim/�nuonecs crtv z�r �•�or�e <br /> IZ� � 1Jlle y�`����U r ��lfi2 �vG�'P� 02��drJf <br /> tENnrv'!� A�AaAO[lP[55 � C�iV ?iP PNONE <br /> �ne�.v.�_7ra.�f�u �fiv �s�'`Q--S/a..f��' f 335�-�,6 4 � <br /> pR� l"{EGi0R�E51G�:EP 1.1AIL�. 06C55 biV .iP PHONE <br /> �,L/ecve5 � �� SdtnP c s _ybe �, CpKe �l �7 <br /> GRlEROICONiRAC10R I�NLdDONL55 LI1V ]IP PNONE SLATELICENSEI <br /> S��n.G 4 S Q ulw2� — <br /> I.�fCINN�CALCONTRACiOfi M6i1 nD011E55 CI1Y ZIP FHONE SiATEIICENSE� <br /> � �� _�_��-��G� �y3s's3 � <br /> A�� FLUl.' P .WNiRI�CTOR 1lARADD SS Cliv ZIP PHONE STAiEIICENS[� <br /> G H <br /> � Hx p� anssorwonn <br /> ya H NEW �DDITION ALTERATION REPAIR DE1dOLITION WOODSTOVE�FFiPL INSERT BUILDING RELOCATION <br /> x / corvrncrrEnsor�nHonHorv[r�o <br /> Or�iQ CONLRRCTPRIClOFWORH (Q �OC� <br /> �F-i �{f CESCRI�E\VORF�NO SCUARE FCJIA(.[INVOIVE� <br /> y �� L/!�ln ,�a�Cl�fr iaq E-k'L,.._ �" _ <br /> �+`X� rnor�osEuus�uaort+a __ r I HEREBV CERTIFY THAT I HAVE READ AND EXAMMED THIS <br /> Qy � 5' G� - � �1��! '�"� � _ AP°LIf,ATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> 1 PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE(`F <br /> �n� �mn�oese�+mriev or rnoreerv is��o�vr+nE�owoi�nne.c���oim ca.�i�s�, <br /> ''l WORK WILL BE COMPLETED WITH WHEiHER SP[CIFIED HEREIN OR <br /> ��n i.or�y e�oc. _ �1 �� 1�-0120_�=6c�=-L'� NOT. 7HE GFANTING OF A PERM1tiT DOES NOT PRESUIdE TO G�VE <br /> �"� � SY�" „/� e He��hy->' AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> Z�-y � OTHER STATE OR LOCAL LAW FEGULATING CONSTRUC110N OR TH[ <br /> C" 7S 4 2 —a�0 ^ O/O^ 00O PEFFORb1ANCE OF CONSTRUCTION.THAT I Ah1 AUTHOR12ED BY 7HE <br /> H H � � OWNER OF THIS PROPERTV TO PERFORM THE WORH FOF WHICH <br /> gy _ — APPLICA710N IS I.fADE AND I COP.IPLY WITH 7HE STATE <br /> H <br /> O Cy fA CONTFAC70RS L,1\V 1827 RCl'J A __�200 WAC <br /> �� Cr�1 <br /> y o y _�gta `1`d Y/ S.,v�,-fP LAivQ - -- — — --. , — <br /> � -��..��rcrneoaess �deVe� �N � "..,-.--. -.- � -— <br /> PLUMBING ECHANICAL <br /> NO. TVPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> � WATER CLOSET�TOILETI yV�O oe ,S��� - _ �C-A HNDLG UNITS-H.P. <br /> I —�1 / BATHTUb _ � - = FORCEDAIRSYSTEMS-B.T.U. M E.A. <br /> L_ LAV�TORY�WASH BASIN� UNIT HEATERS-B.T.U. M <br /> SHOWER CLOTHES DRYERS <br /> KITCHEN SINK 8'JISP VENTILATION FAN __ _ <br /> � DISNWASHER RANGE HOOD _ <br /> i _ LAl1NDFiV T!7AV _ W�TER HEATER <br /> � WOODSTOVE <br /> CLOTHES WASHER <br /> URINAI h1ETAl.FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> , =, 1 � FLOOR DRAIN i" '- HEAT PUh1P <br /> � BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS-RAINLEADERS E%HAUST FAN <br /> SINK(SEfiVICE-BAR.ETQ) <br /> � ��I — — <br /> -�— <br /> �1� SUBTOTAL S " � SUBTOTAI 5 <br /> '- PERMIT S /S � PERMIT 5 <br /> � 70TAL FEE 5 TOTAL FEE 5 <br /> FOR OFFICE USE ONLY: - ?� � ` x <br /> FIiONiC{iOACN REAFSEtBACH SIpES°i9ACNl PI�NGHECKNUTABER 4CG PELEIPiNO <br /> o ' 2v' Sa-+�'�=� 3�.�Y. �oS��SU ! � �• ;_,S, <br /> usezor+e rnnt�nJf� ��Acnrvir,ne FEES VALUATION FEE <br /> 2- I � / "- �� AUILUING `�'qZZ) _ I/ � �'�_ <br /> tYl'E Of C .Y15 ALIOWAAI( 1 W[Of LOy51 ALiOAI _. �..... .�.. -- � <br /> PJ.Jcc�[r ' � <br /> —�_�( ��✓ = 3 / rwn�owc i� 'oc <br /> SREOF�I�G NOOFSi0RIE5 BASEIAENt MECNANICAL <br /> ZJ� Sr ADpi,/ G <br /> � ADOITIONPL PIAN CHEGK n <br /> OCCUPAN'VLOAD HRESi'RNNIEPSRWD HEIGMTL�4�,IiAliC4 � / � �'� � <br /> �,(-��-/� N7 Z�' SARINKLER <br /> REPSOt14pR SPRINNLERS � <br /> STATE DUiLDING SURCHARGE �/ 'S �' <br /> ir�tnKeev i��nusnrrnoveoov CITYOFEVERETT pUBUCWCFiKS —1-- <br /> . f� LOCALSALES <br /> �/ 6�/3 TAX COOE IS 3105 rorn� /S`� I vS <br />