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APPLICATIG_ J FOR CQl�ISTRUCT, JN PERMIT �� <br /> TO BE COMPLETED IN BLACK INK-PLEASE PRINT <br /> BUILDING DEPARTME.'JT �HEATING SYSTEM: U GAS '�' ELECTRIC ❑ <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING /rMECHANICAL PLUMBING SIGN <br /> ONTlER MULADUFESS GITV iP PMONE <br /> ���-u����s_.E ���a 3 33y-o9�s <br /> Ei'ANi IA�IL AODRE55 GITY 21P PHONE <br /> y Plex ��oy i'�rmrP �r. �uere+l- EUe�i-� <br /> RRCHITECTORDESIGNER MAIL�DDRESS CITV 21P PMONE <br /> GEAtK'LGdJTRFCTOR M/ILADORE55 CITV ZIP PNONE STATELICENSE� <br /> 6A5 F1eL�1M Sc� E.rYla'�n mo,-�r�. 98��� ��5'-!�.� �S�I�ACTy�J� <br /> AIECH[R'�Ni�CRL�,C.�O�NTR TOR MAILPDDRE55 CITY ZIP PHONE STATELICENSE� <br /> �l l le. <br /> PLUMBINGCONTR4CTOfl MI.ILADLRE55 CITY ZIP PHONE STAIELICENS[� <br /> LLR55OF WORK <br /> �( NEW � ADDITION ALTERATION REPAIR �. DEMOLITION WOODSTOVE/FRPL INSERT BUILDING RELOCATION <br /> WNTqLT PERSON AND/P�NO)N'EI NO. (]2' <br /> CONTRRCiPRICEOFWORK */4 90 °`—' � - ' %7y__��/`�]/�_ <br /> UESCRIBE WORN AND SOUARE F00T GE INVOLVED <br /> � <br /> PROPOSEDUSEOFBWLOING i HEREBY CERT� THAT I HAVE READ AND EXAMINED THIS <br /> — APPLICATION AND KNOW THE SAME TO BE TRUE AND CORFIECT ALL <br /> IEGRLDESGRIPTIONOFPROPERTY�SHOWNBELOWORATTACHFOURGOPIES) PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> WORK WILL BE COAIPLETEO WITH N'i1ETHER SPEGIFIED HEREIN OR <br /> tor etocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CGiJSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND ! COMPLY WITH THE STATE <br /> CONTRA RS W 18.27 CW ND 29620�WAC. <br /> X V �� (� <br /> FROJECTRODRE55 � Scrv�iun[ D�*[ <br /> KVl/ (f(/(/���� C t�✓ f.ItVAlI5�Nf55liCEN5Eu0 <br /> PLUMBING �1 �dECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILET) � A/C—A�HNDLG UNITS—H.P. <br /> BATHTUB FORCED AIR SVSTEMS—B.T.0 M E.A. <br /> LAVATORV(WASH 9ASM) UNIT HEATERS—B.T.U. M <br /> SHOWER CLOTHE:i DRYERS <br /> KITCHEN SINK 8 DISP VENTILATION FAN <br /> DISHWASHER RANGE HOOD T <br /> LAUNDRV TRAY WATER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEV � <br /> DRINKING FOUNTAIN FIREPLACE INSERT ' <br /> FLOOR DRAIN � HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING ; <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN � <br /> SINK(SF(iVICE—BAR,ETC.) ; <br /> I <br /> i <br /> T <br /> I <br /> _ SUB TOTAL $ SUB TOTAL $ �2�= <br /> PERMIT $ PERMIT 5 �! � <br /> TOTALFEE $ TOTALFEE 5 , /,�T' ��� <br /> FOR OFFICE USE ONLY: <br /> FRONTBETBACN REARSETBACN SIOESEiBFCK PLRNCHEGNNUMtlER FEE RECEIPTNO. <br /> 9� � <br /> use zoae ior naea VRCAKT SITE FEES VALUATION FEE <br /> BUILDING <br /> ttPE0LC01liS.AIIOWABLE 1YPEOiCON57ALipAL oceu�4u;r �:oorewFuw=uxns — <br /> neovv ?�UMBING <br /> SIZE OP BLDG. NO.OF STORIES BASEMENT MECHANICAL <br /> OCCUPANCVLOA� FlqESPPNNLER5RE00 HEIGHTLIMITAiION ADDITIONALPLANCHECM. <br /> SfqINKLER � <br /> RERSON FOR SPRINNLERS —i— <br /> 3i?TE BUILDING SURCHARGE <br /> iMTAKEBY YlANSAPPROVE�BY CITYOFEVERETT PUBLICWOflKS <br /> � � LOCAL S11LES - ( <br /> � TAX COUEIS 3105 TOTAL <br />