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APPLICATIC .� FOR CONSYRUC7 _JN PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT ��r <br /> � � HEATING SYSTEM: �J GAS J EIECTRIC � J ..--- — —. - � <br /> BUILDING DEPARTMENT � — -- <br /> 259�8810 � , <br /> DEMOLITION 1 COtdBiNATION BUILDING MECHANICAL �C PLUMBING SIGN <br /> O':lt:CR IAAILADDNE55 CiiV ZIP V��CI:L <br /> J;..., !� .1�. �zo7 �l�lip�RI S.C. Ea.,e,c�;. w�+_9dUz4 472 --c,3�j-3 <br /> iRlANi � IAAILAOfJPBS 3 CI�Y DP ��'%•��. <br /> nnGwi[Ci0RDE5iGN[R I.NiInDpRESS Gav ZiP ���OG[ <br /> GR�EflALCONiIiFCTOR MPIL�DDRE55 LITY 21P PNON[ STAiELICENSEY <br /> �im� L.,:� �kLl-k».e,. �07 —lbi� 5� I SG Ev,-,�,�t, w4 7�'0'� 4�.?-os�3 -- <br /> 9H CI.CIIAN�ALCONiRAGTOfi I.InILAO�R[55 CILV IIP PN011[ SiATELICElISE• <br /> .��� — <br /> �--1 <br /> ay�/J �Pt.UBINuCONiFACTOfl IAAILAD�RE55 � CRV ZIP PIIO�lE SiPi[UCRJS[n <br /> H 3 1\A��eJicr Cuyz« (��_3 Q.U. h�F (724 (�,�cx.�.n�:llL 4.a �v7t �(�`S:�Yb� RAiN��Q II�G <br /> H ��-+ anssorwonK <br /> � NEW ADDITION AL7ERATION flEPAIR DEMOLITION WOODSTOVEFRPL INSERT BUILDING RELOCPTI!.l'I <br /> � y�y _. <br /> � H O CONLAGT PERSON AND PMONE NO <br /> �� z� CON*RaCTPPiCEOFWORK _ -� <br /> OF.SCl11pE WOHK AND SOUAFE FOOiAGE INVOIVED <br /> � <br /> �3 C <br /> O HC� ruoroseouseoFew�owc i HEREBV CERTIFV THAT I HAVE READ AN� EXAMINED iHIS <br /> H C+7 O S:���C �7ti.�ti tC5�d�+c�• �PPLICATION AND KNOW THE SAME TO BE TFlUE AND COFRECT ALL <br /> �" n iecn�oescaivr � oFanocenrvis NUEiawoanr*ncNFouacoPies� PROVISIONSOFLAWSANDORDI�ANCESGOVERNWGTHISTYPEOF <br /> H WORK WILL BE COMPLETED VJITH WHETHER SFFr,IFIED HERERI OR <br /> zy y� �or e�ocK �F NOT THE GRANTING OF A PERPAIT DOES NGT PRESUME TO GIv[ <br /> r+ z AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF- Al:�i <br /> H y OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR Ti!E <br /> � � <br /> �y PERFORtdANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY i iif <br /> C] v U1 OWNER OF THIS PROPERTV TO PERFORM THE WORK FOA �'�F{ICI! <br /> � �ty APPLICATION IS MADE AND I COMPLV VIITH 7HE STf<iC <br /> C+7 CONTRACTORS LAW 1827 RCW AND 296200 WAC <br /> H O(Nii � �y / <br /> �cb�.�"1. Yh.i G. y_��.`/:—_ <br /> PliO:iGl ADORESS /� oAt� <br /> ��Z .��-�^44S'/L_ �rnv5':r", :�,tr.o __- <br /> PLUMBING MECHANICAL � <br /> NO. TVPE OF FIXTURE Ofl ITEM FEE NO. 7YPE OF E�UIPMENT FEE <br /> �C—A�HND�G UNITS—H.P. <br /> !,.>„�I BATHTUgLOSET�TOILETI — , — FORCED AIR SYSTEMS-8 TU. M E.A. <br /> _ a _ <br /> � LAVATORV IWASH BASIN) _ UNIT HEATERS—B.T.U. M <br /> SHOWER CLOTHESDRVERS <br /> i,"`° � ' VENT!LATION FAN <br /> ' KITCHEN SI�K 8 DISP <br /> `'' � DISHWASHER RANGE HOOD <br /> LAl1NDflY TRAY WATER HEATER <br /> � CLOTHES WASHER WOODSTOVE . <br /> .,�� URINAL METAL FIREPLACE 8 CHIMNEV <br /> DRINKING FOUNTAIN FIREPlACE1N5ERT <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPINCa <br /> ! ROOF�RAINS—RAINLEADERS EXIiAUST FAN . <br /> SINK�SERVICE—BAR,ETC.) --- <br /> � ; <br /> —'r- <br /> '+r w — SUBTOTAL S <br /> SUBTOTAL 5 <br /> ��' PERMIT 5 PERMIT S <br /> TOTAL FEE 5 TOTAL FEE 5 <br /> �_,' FOR OFFICE USE ONLY: __ <br /> IIJHiS[iB/CK fiEAti5C1�ACN SI�ESLiBACH PLAl1��CKl�ll'.If?Lfi (EE AEGEIPiNO <br /> IIULZONE IOiAVEA VACANTSITE FEES VALUATION FEE <br /> EIUILDING <br /> IrvEOFCON15ALlOWABIE tYCE0FWN51AL1VAL ccc;%�tu uawNvnu•r,i'.•+ — ---— — - � <br /> ceouv PWId01NG � <br /> l¢EOFeLDG MOAFSWni[5 BASEMENT MECIIANICAL <br /> o�CIIPANCYLOAO FlNESPRNKLEHSREO'U ��HGNTLiMIIPiiON — AUDITIONALPLANCMECK <br /> ___ ___ , SPfiINKLER <br /> REASONFORSPPINNLERS � � <br /> S7ATE OUILDING SURCMARGE <br /> irvrnneor numsnrrnuvenuv 'I CITYOFEVERETT pUI3uCwORKS <br /> �ocn�sn�Es , <br /> � rnx cooE is 3ios TOT�� <br />