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.. �F` APPLICpT14_1 FOR K:t�NSTRIJCT _ �P8 P�RilA1�' 1 <br /> � <br /> . <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT �r�`E'� <br /> HEATING SYSTEM: J GAS ❑ELECTRIC '�J ___ _ - ---- �_ . <br /> BUILDING DEPARTMENT <br /> 259-88�I0 <br /> DEMOLITION COMBINATIOIJ BUILDING `�iAECHANICAL PLUMBING SIGIJ <br /> Ol .y`9 l.IAiLADORE55 CRv ZiC P10N[ - <br /> � .��v� ��,�,-�.,K� ��� � ��,._t�� 32� - 3�� �, <br /> TE`N�A-'-����iE55 CRV Z�P ' !{"Ie'7 PHONE <br /> ARCHITECT OF�ESIGN[fl IdNL ADORE55 CiTY IIP PHONE <br /> H�pn�� _ <br /> L'1 C'7 y GENEPAL CONTRACT R N:Stt ADDRE55 GIiV 21P PHONE STATE LICENSE a <br /> .��H �g�-� 1�� -- <br /> I 9 y y MLGV�NiCAI COyIFAGTOR MNL AD.^E55 GiY ZIP PHONE Sil�E LICENSE n <br /> H � ��1',f��S r��2,�ccF: �.���:���o i o 1 �, F�,_�.lu.�. �`6�� ��E'�-{6�0 BD�s'�-cs2l�"i��� . <br /> y �'�-{ Vw'.'32lGGONTRACTOP ldARADUHESS ✓ CItY 2iP i'��ONF STAT[IICENS[e <br /> Fi'i n — . _.. <br />� H:[t <br />, �O H� CLASSOF WORK <br /> � ✓NEW ADDITION ALTERATION REPAIR DEMOLITION WOODSTOVE/FRPL INSERT BUILDING RELOCAI IOf 1 <br />, [n H <br /> LONTAGT PERSON ANU PNONE N0. <br /> I O COHTRAGT PP GE Oi WORK � � �� -- <br />� � z j, — <br />� � H� [lESCfiiBE WORN RNDSOUARE TAGE INVOLVED <br /> � �O <br /> 4]� � F�eo�osEouseoFaw�oir�� I HEREBY CERTIFY THAT I HAVE READ AND EXAMWED THIS <br /> H <br /> Sr p APPLICATION AND KNOW THE SAME TO BE TRUE AND GORRECT. ALL <br /> z H /�� pROVI510N5 OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br />� � y z LEGALOESCflIPT10NOFPBOPERT'ISHOYJK�ElOYlORATTACNFOIIRCOPIES) yyORK WILL BE COMPLETED WITFI WHETHER SPECIFIED HEaEIN OR <br />� H y �oT e�ocK oF NO7. TH� GRANTING OF A PERidIT DOES NOT PfiESUME TO GIVE <br /> i � �H AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> O C7 C/� OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORPdANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> �jx �[rz) OWhER OF THIS FROPERTY Tn PEFFORM THE WORK �OR WHICH <br /> y �� APPLICATION IS MADE AND I CO�dPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> x � ��'z-2(4 '� <br /> 5 G'1411'Pt �`�iE <br /> ano.iecrr,ocaess � . <br /> a � , �� s� �LA� �„��,�,=,Fu���rtis�,.� <br /> PLUMBING j� MECIIANICP.L ' <br /> NO. TYPE OF FIXTURE OR ITEM / FEE NC. TYPE OF E�UIPMENT FEE <br /> ri ' WATER CLOSET(TOILET) _ A�C—A�HN�LG UNITS—HP <br /> �"�` BATHTUB ' FORCED AIR SYSTEMS—B.T.U.S7M E.A. <br /> LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M <br /> �' � SHOWER CLOTHES DRYERS <br /> -- � KITCHEN SINK 8 DISP I VENTILATION FAN _ <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY NlATER HEATEH <br /> CLOTHES WASHER WOOD STOVE <br /> ' � URINAL METAL FIREPLACE&CHIMNEV <br /> DRINKING FOU AIN FIREPLACE INSERT ,_� <br /> �'-�'O�' PLOOR DRAI HEAT PUMP <br /> � � . BACKFLO REVENTERS '�j GAS PIPING <br /> ROOF D INS—RAINLEADERS EXHAUST FAN <br /> SINK ERVICE-9A(i.ETC.1 <br /> - s G� - s;�..,.lorc.lF � <br /> • � <br /> �_...7_.,�� SUB TOTAL S SUB TOTAL S p � I� <br /> PERAAIT $ PERMIT 5 ��� <br /> TOTAL FEE S TOTAL FEE 5 � J�f� <br /> FOR OFFICE USE ONLY: <br /> i'RONTSETpACK REARSETBACK SIDESEID4CK PLANG�L:K1lW�AklF.�l �EL RECBPINO <br /> /1 ) <br /> USFZONE LOTAREF VAGANTSITE ' FF.CS VALUATION FEE <br /> BUILDINC � ' <br /> i d'C OF COtl15.AIlOWA6lE IYPE Of COil9.PG10FL ocC r.v�Cr �N o�bxnuuc ci�5 --- � <br /> newv � PLUM3ING � <br /> 5¢[OF OLDG. NO OF STOPIES �ASEMENT MECHANICAL /�T— <br /> ADOITIONA�PLAN CHECK � • <br /> OGCUPRNLYLOAD FIRESPRNNtEFSFEO�� HEIGHTLIMiTATION � <br /> SPFINKIER � ' <br /> � <br /> REASON FOR SPfiINKLERS � , <br /> STATE Bl11LDING Sl1RCNAFiGE <br /> -- _ i i <br /> iNTAKEBV PLA�ISAPPROVED�Y CITYOFEVERETT PU�LICWORKS � � <br /> LOCALSALES � <br /> TAX CO�E IS 3105 TOTAL �)' ; ' <br />