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APPLICATIIrN FOR CONSTRUC7 ��N PERh11T <br /> ��<«�� <br /> ,.� �, ,� . e <br /> ��r�o <br /> ev�reit <br /> BUILDItJG DEPARTMENT <br /> 259-f3810 TO BE COMPLETED IN INK-PLEASE PRINT <br /> !7 DEMOLITION i I COMBINATION I ' BUILDING I 'MECHANICAL ! 'PLUMBING IJ SIGN <br /> _ owrven � rnni�nooness utt nr rHor+e <br /> S�N�=tifu,o�v/r�/ 2/S'O N io7�^` �37o Sc.-7fcc,/JG .�la.f-7$c0 <br /> r[rmr�r u itaooness crtr zm rHoee <br /> ANLIatEGTORDE5IGN[R M�M1ADDRE55 CIiY ZiP PIIONE <br /> x�"�� <br /> �7� � <br /> a�-3 GENElIAL CONiRACTOR MAR��DRE55 CITY ZIP PMONE UCENSE� <br /> C�H <br /> a y� M[CII�NICAL WNiR�CTOR MML��Dfl055 GI1Y Z�o PHONE IICENSE� <br /> rx9 <br /> Kzn ri�u/meinccor+tnncron Mnanooness arr z�r r�icve ucn�se� <br /> O S O >LF.....) (�isTSX£ �/02 S.r.7iV � '� � �✓�:,...�T ql c ZS2•25 2 Z �i�/�vVf /.f�AL <br /> '+J �-t'+J anssoFwoan <br /> y y��'-. I 1 NEW I_1 ADDITION Ll ALTERATION ❑ REPAIR I I DEMOLITION f I WOODSTOVE/FRPL INSERT ❑ BUILDRJG RELOCATION <br /> �' O� IENANiIAfPf10VG�IEN10111NtERIOPREMODELONIV CONTPCiP[RSON�NDPNONENO. <br /> y d comnncr vmtE ov woan� <br /> � ��y -oesc^n�oc wonK n!�o scunne roouce nrvaveo <br /> � 7Ll�aSi..�G F�u. �un.� tr�-TS/L Mf-�'"++t5 <br /> L)� C� <br /> H rnoroseous[oneunmNG I HEHE�V CERTIFV THAT I HAVE READ AND ExAMW[D THIS <br /> APPLICATIO�!AND KNOW TNE SA�AE TO BE TRUE AND CORRECT.ALL <br /> H <br /> r H y i[cn�Ai�r�or P�orEqrvlseom�oeiowonertectirour cories� PROVISIONS OF LAWS AND OR�INANCES GOVERNING THIS TVPE OF <br /> � � -- -- VJORK WIIL �E COMPLETED WITH WHBTHER SPECIRED HEREIN OR <br /> H ior B�ocK or 1JOT. THE GRAIJ7ING OF A PERfd1T DOES NOT PRESUME TO GIVE <br /> O C7N AU7HORIiY TO VIOLATE OR CANCEL 7HE PROVISIONS OF ANY <br /> � �� OTHER STATG OR LOCAI LAW REGULATING CONSTRUCTION OH THE <br /> PERFORIdANCE OF CONSTRUCTION.TNAT I Ald AUTHORIZED�V THE <br /> Z H ti OWN[R OF THIS PF70PER7Y TO PERFORM THE WORK FOR WHICH <br /> y0� —_ APPLICATION IS MADE AND I C061PLV WITH TNE STATE <br /> CONTRACTORSLAW1827RCW AND29G200WAC. <br /> sa��mncorr.o�unnciononnun�oaiz[onre�n onrc <br /> �I�'JJLGiI.DU11E55 . � ���"� — <br /> � �5- , � -i 1� , ,�� �i, �f,_ ��dru:.�msc�rruusiuossucer�sn�onNoouswcssnnrne <br /> c <br /> 'e � PLUMDING " MECH�NICAL <br /> �� NO. TYPE OF FIXTURE OR ITEM FEE NO. TYP[OF EOUIPMENT FEE <br /> __I VJATGR CLOSET�TOILET) _ _ A�C� A HNDLG UNITS—H,P. _ <br /> 9ATHTUD fOfiCEDAIRSYSTEMS--O.T.U. h1 [A. <br /> i��'' _ LAWTO�V IWASH�ASIN� �— _ UNIT HGATERS—B.T.U. M _ _ <br /> '� SHOWER CL01H[S�RYERS � <br /> KITCHtN SINK 3 DISP VEtJTILAT10N FAN � <br /> 'w � UISHWASHER _ RANG[HOOD � <br /> .�,,� LAUNDRY TRAY ' WAT[R HEAT[R <br /> CLOTHES WASHER --�— WOOD STOVE <br /> URWAL �dEIAL FlR[PLY�CE 8 CHIIdNEY <br /> ��' �� DFiINKING FOUIJTAIN _ _ FIREPLACE INSERT <br /> �" �"� f-LOOR DI7AIN II[AT PUIdP <br /> �_ <br /> �ACKFLOW PREVENTERS GAS PIPING <br /> � � ROOF URAINS—RAML[ADERS EXHAUST FAN <br /> �I � SINK(S[RV!CE—BAfl.ETC.) —r— _ <br /> / /� _—�—_ -- <br /> --1——t Q�� —/�lff_/ll __ _ <br /> 'ti'' —_ _ — - _�— <br /> SU�TOT�L $ �' ; — SUB TOTAL $ <br /> P[RMIT S /O P[R�dli $ <br /> � � TOTALfEE $ TOTALFE[ $ �— <br /> rnorllSEtoncK nEnns[toACN slp[SLienCK PInHc��[f,KNp1AI�Ln PC[ R[CEtr1No. <br /> useza�e �ornn[n vncnr+rsne FEES VALUATION FEE <br /> I I VES ! I N� _ oui�nrt+c <br /> 1vP[OfL0�I51�LlOwpOt[ IYPfOfC�NSI.nCIUAL occuru2r rvomnwwx.r,uwis —__ <br /> crx�e <br /> PLUMOING ��i[I'p <br /> ti4EOFpLDG NOAf51pfUE5 �ASEMENt M[GIIANICAL <br /> I 1 YES I 1 NO — <br /> occura�cv�oao rmesrnHrct[nsncoo ��Ea�rtuunnnor+ �T���� � <br /> I J YES I.I NO SIn7E OUltl]ING SURCHnRGB <br /> nr.nsor�ron saninrci�ns — �--- <br /> SIA7C ENGfiGV SUBp1ARGC <br /> nrrucntiouncc.or r��nr+.nrrnoarnnv CIiYOFEVERETT ruouCwonks Y <br /> LOCl�L SALES ' <br /> TAX CODE IS 3105 TOT�� /� �O� <br />