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APPLI�ATIC 1 FOR CONSTRl1CT 7N PERMiT �� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT �E'T <br /> i — ---- — ' -- <br /> . — --- -- --- <br /> HEATWG SYSTEM. -�AS J ELEGTRIC J ___ ___ I <br /> BUILDING �EPR 'TM1IENT -�-- <br /> 259-8810 <br /> DEMOLITION COMBINATION �^ BUILDING _ �'MECHANICAL �PLUMBING SIGN <br /> c.vucn r�n��.y��n,;s __.._ c����� �ia r��or�c <br /> fJp�✓EaJ�(_/2� Ciwsi, Tic . 2ZQz�-$7�`��5•� GJa�/w�,i��J wa 5/d���3SS <br /> �n•+wr� N Nlt$ r.mn .�c�ss � _, ci*v zu, w�ouE <br /> �i �[�vic,�±• <br /> d9;l�liEGi,�OHU[�S�f,N6R 61NL40D�iE55 CitY ZIP PMONE <br /> GC�CORif�' In�OR �nRaO[�V�C55 C�iv Z�P PNONE STATEUCENSE� <br /> F] o H �CEtY2��� �xd L�/Cua� <br /> `� � �sJ 'fp iCA�COMRACIOR nil fiDnE55 ';rtv ZiP PMONE STRTELtGENSE• <br /> t�� � y _y���__�_ ,�'_t���i,i,� �wldtJC�, �0.� — <br /> � N FLL:u�o0Gu19AGtOR 'IARAi�DfiL'ti ��t�' ZIP PNONE STATELICENSE� <br /> � Hf/� � <br /> �..� '� CONTRACiP OFWORR -� <br /> �•- � ��f ,P. ;���s�:>( G�9 o y�� /]. — <br /> O r�1i O D[SCRiBE\YOnrc qND SOUna[FOOtAGE INVO�VED ����i���N��":�="�I�S2�� L[/l/�, ''3-r/'S= <br /> /�! /��_ rU••�• <br /> �+d N �+d <br /> x z� /S.$S � r'j.F�P — — <br /> � � e SF�.. <br /> I HER[BY CERTIFY T��AT I HAVE READ AND EXAM1IINED THIS <br /> � n �.y rn �os i nr nuno•� Q �' ^ APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> H� [+1 a _ � �(,�Gt'�'.Q�..,rql� iUc• �U.�1 PROVISIONS OF LAIVS AND ORDINANCES GOVERNING THIS TYPE OF <br /> p.� iEcn�oescn�r-ioHocraoaeervisHowr�ee�owoan**ncNtr:ocoPiEsi WORK WILL BE COMPLET[D WITH WHETHER SPECIFIED HEREIN OF <br /> x H <br /> NOT. THE GRAN7ING OF A PERId1T �O[5 NOT PRESUME TO GIVG <br /> y y z iot o�a:K or qUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> . <br /> �„� y OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR TN[ <br /> C7 U1 � PERFORMANCE OF CONSTRUCTION.THAT I Atd AUTHORIZEO BY THE <br /> n d� OWNER OF THIS PROf'ERTY TO PERFORM THE WORK FOR WHICH <br /> ❑ APPLICATION IS tdADE AND I COMPLV WITH THE STATE <br /> � C+J t'� vnn¢�in*i o r+un�Aer, CON ACTORS LA4Y 1827 RCVJ D 296.200 WAC <br /> x� y - %�i� .' ������x� _ <br /> H � [CNSiqUCliOr��onNLL'rCER nC���E55.iEICeNOrvENUA1BER <br /> �,oa -��- �3_ <br /> PROJ' D SS �••�� <br /> ��17r, 5•�' . ., .:.: .--- _ <br /> PLUMBING MECHANICAL <br /> t NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> � �� WATEF CLOSET(TOILET) /I __ A C-�HN�LG UNITS-N.P. __ <br /> / BA7HTUB / / FORCED NH SVSiEh1S-B.T.U. M EA. � <br /> LhVATOP�IVV4SH BASIN) UNIT HEATERS-B:i.U. M Y' <br /> / SHOWER � CLOTHES DRVERS � —_ <br /> � � / KITCHEN SINK 8 DISP � VENTILATION FAN � <br /> ' `� / RANGEHOOD --� <br /> i _L DISHWASHER <br /> I w - LAUNDRVTr7�Y / WATER HEATEF / <br /> l� CLOTHES WASHER I WOOD STOVE _ <br /> - URINAI. METAL FIREPLACE(WOOD BURNING) AS __ <br /> '_ _ —`--� <br /> DRINKING FOUNTAW FIREPLACE INSERT <br /> � � fLOOR DRAIN HEAT PUMP __ <br /> - BACKFLOW PREVENTERS GAS PiPING <br /> _ - ROOF DRAWS-RAI�'JLEADERS ,`L EXHAUST FAN _ <br /> � SINK(SERVICE-BAR,ETC.) <br /> �•= _ <br /> _ � _ <br /> ��' SUB TOTAL 5 > SUB TOTAL 5 � !' - <br /> - � PERMIT 5 PERAIIT S _ <br /> TOTALFEE 5 TOTALFEE 5 <br /> FOR OFFICE USE ONLY: <br /> �POtUSEIDAGN REARS[1�AGH $IDESETfl � FLAtlGl1['KtlUAlpFfl �F[ RECbP�TNO <br /> �� 7� � � 0_�zS 3��� `_3 ��G-�'� <br /> � <br /> usezcvc iorne[n vncnr�Tsrta FEES �ALUATION FEE <br /> � �itd� �-� YES ❑ NO pUIL�ING Li c � �� <br /> .J � _ <br /> _ 7 L� �� =�.L_' <br /> rmeottxst noocsior+its oK����c. uowowu��n;o"��s � <br /> �ll� � -na�� I PLUMDING � ��� <br /> n�� <br /> 5¢EOFBLDG fiPESPPiNnlCRSR[oo BASE61ENi / MECNANICAL G�O ' <br /> �tbG df G��/4: o � � YES .VNO -- -'_,' <br /> OCCUPPNCr LOAD imE ALnaM n[O� i�Bc�tt LiMiiA�/ A�DITIONAL PLAN CHECK 2�� c_- <br /> ti�v � �NFr'-' ��/X'l�,� --- ��' <br /> R[ASON �- <br /> STATEBWLDINGSURCHAFGE � �5t) <br /> inrnntnr n�nnsnrrnpvcoov CITYOPEVERETT puoLiClvoHHS ZL� <br /> �J Id LOCRL SALES � <br /> °A1 S /B 93 TAX CODE IS 3105 TOTA� 07� �'�'� <br />