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APpLICAT►►N FOR CONSTRU� . ION PERlIff.l'i' '°`°�`'" - _ <br /> ., _ _.,. , TO BE COMPLETED IN INK–�PLEASE PRINT � _ <br /> r.rtv or }} <br /> eVerell HE�TINGSYSTEM: JGAS JELEGTRIC J _ _ - _. J <br /> BUILDING DEPARTMENT �--- <br /> 259�8810 <br /> DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> - ,��.��� SJnow�sj 93 �Srl�xSllY �-uP.Ne!/��o 9�a�� P�,��,E3.S3 f �-� 7 <br /> +e I�Fti� U U <br /> i[NAN NNLRDORE55 IVr ZIP ���ONE��� � / w� /: <br /> �o<is /�esiy�� .S3/s 3�'`�/Jues'C�,J/UO, �: �: <br /> ARLMiI[C10ROES�G4Ef1 RIARApOR[55 OtV Z�P VUG�iE <br /> GLNERPLCONiRAGTOR MAILADDRE55 CIIY IIP PNONE IICENSE• , <br /> lV�� � �� . <br /> aH MEG�ANiCALCON1nACtOP �AARAD��E55 CiiV 2iP PHONE lCENSE <br /> ,a�x <br /> ay�/J PIIiMBiNGCONLR�L10li MAILRDORE55 CIl'� Z�P PHONE IIGEFSE• <br /> H �� ci or wo�arc — - - <br /> � y� �W A�DITION ALTERATION REPAiR UEMOLITION WOODSTOVEIFRPLINSERT BUILDINGRELOCAT���,�N <br /> � H� x�-J COtdACT PEP40�1 AND PIIONE HO <br /> y H l0!IiNAGT PRICE OF WOPN � S V D __ <br /> � �� DESCIUB[WORNANDSOUnqE�001AGE�NVOLVEDI — <br /> °�o �7�. St -- — <br /> O H�y rr�or�o useorounomc I HGREi3V CERTIFV THAT I HAVE REAO AND ERAMWED THIS <br /> H �1 O _��_lL� APPUCA710N AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> �` n ircm,rescaivi,or+ aovenmis�nwr+e[�owoenruc��vouaccriEsi PROVISICNS OF LAWS AND ORDIIJANCES GOVERNING THIS TVPE OP <br /> I-i WOFiK\YILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> z �"��` �ot �1"'I e�oc:n oF NOT. THE GRANTING OF A PERIdIT DOES NOT PRESUME TO GIVE <br /> �1 � AUTHORITV TO VIOLATE OR CA!JCEL THE PROVISIONS OF ANY <br /> � y y ��R� S /J��( IO1�l v U�U YI P I S OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> H PERFORMANCE OP CONSTRUCTION.Th1AT I AIA AUTHORIZED BY THE <br /> � �y ��� L� � OWNER OF THIS PROPERTV TO PERFOFiM THE WORK FOR WHICN <br /> r "I APPUCATION IS MADE AND I GOMPLY vlITH TME STATE <br /> CONTRACTORS LAW 1827 RCW AND Y96 20C�'IAC. <br /> Zyy SIGNFiURE0�C0!RRPGICqORAVi110HQE�AGE�it CAiG <br /> H O f/� <br /> b�:n. c• ,ne.i�: �� .�// ���✓ --- — <br /> ����C �s��� s� �F�.e� ACCII�AI "QiYt1U51NE$Sll�[q5EN0AN0�U51pE5iN4!'C <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIJ(TUFlE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET ITOILETI A'C—�.�HNDLG UNITS—H.P. <br /> ' ; FURCED AIR 5`!STEMS—B.TU. M E A. <br /> BATHTUB <br /> w.� UNIT HEATERS—B.T.U. M <br /> LAVATORVIWASHBASIN� <br /> SHOWER CLOTHESORVERS <br /> ... KiTCHEN SINK�DISP _ VENTILATION FAN <br /> (a , DISHWASHER RANGE HOOD <br /> LAUNDRVTRAY WATER HEATER <br /> CL�)THES WASHER WOOD STOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEY <br /> � � — FIREPLACEINSERT <br /> DFINKING FOUNTAIN <br /> FLOOR�RAIN HEAT PUMP <br /> � BACKPLOW PREVENTERS GAS PIPING <br /> �.',� ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> SIWK ISERVICE—BAR.ETC.) � <br /> --r— <br /> t,,..'q""j - __ - <br /> --�- <br /> SUB TOTAL 5 SUBTOTAL 3 __ <br /> � � PERMIT 5 PEFAIIT S _ <br /> TOTAL FEE 5 TOTF.L FEE 3 �, <br /> FOR OFFICE USE ONLY: <br /> � •' iHpt115CiBPCv fiLAllSUpALK $IUESETPCK CiANCH( �tlUlipE� kEE nf��/^O� , <br /> S � � <br /> �� �i 9 `7L� �.St�PU+�— �O� �L �r <br /> ii.,i.;��,•ry, � ioi nn[n ��cnHt siID FEES VALUATION FEE <br /> �C.'I /O� � AI� pU1LDING �$tiSJ fQ d'" � ac <br /> ��b�o�rr,nsnuowFou irrsa�cnr�sincnw �..w, ti��rnn�•.�cr� — — — <br /> n:: <br /> °�"° � PLUMDING <br /> �Z_�� _ �� - <br /> SVL Urb�oG No OFStoPrts OASEMENi MEGHANICA� <br /> 572 5r ( Nu -- — <br /> nccuI�'nINc/v��onD iinFSnnunLLn5Rf0'G nEioelLUAii�nON �DDITIONALPIANCNECN <br /> __�l/Ii—_ NJ — /S�_ 07HER_ — —_— ' <br /> iu�:,� , �o�uvnmvuvis —��� <br /> SIATEBUIL�INGSURCH4RGE �/ �$7J <br /> ,;�:, n� � � I �•ur+ssern�.�Gu�- CITYOFEVERETT auoucwo��Ks <br /> 91 LOCALSALES <br /> �' p�i2 TAX CODE IS 3105 TOTA� j/,2 � $D <br />