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� W <br /> . � '' 1 � <br /> �►PPL��k�`�"90� �OR CONSTRUCTI.�N PEF�MIT eV1f''� <br /> mr t�����n«+•i� TO BE COM?LETED IN WK—PLEASE PRINT � <br /> cirv oF }} <br /> y n�+ I�j C�er�ll CEATING SYSTEM: ' GAS Ci ELECTRIC ❑ <br /> � py BUILDING DEPARTMENT <br /> �' y 259-8810 <br /> �C � H <br /> p�.yy y DEMOLITION COMBINATION �O BUILDING /�MECHANICAL �PLUMBING SIGN <br /> ` VNLR MAiL40DRE55 i/ CITY ZIP PHONE <br /> H � � ��C��vM �r Y � rc <br /> .� �aw�/ o � rE �. o�o� �'�zr�" 3�� S"�7 `/ <br /> �' � T[NANT MMLA�ORE55 CIiY ZIP Pl10NE <br /> oxo <br /> 'TJ N 'i9 <br /> (n n�iiE�TORDESIGNEA NAILAO��E55 CrtV LP PHONE <br /> � z � .��or�rt��. .'�Pr: .� <br /> � � GENEB LCO`RRAC� TOF dALLADDRESS CITY ZiP pHONE UCENSEn <br /> oH � � , �_ /aK�v r'A��C !� Evo-:� y'�'-� 7if'Q"S'7)y �/�QCuff�K/Iv,NO <br /> N � g MELHAIiiCALCONiRAGTOR MNLADORESS GITY ZIP PHONE UCENSEa <br /> 4]� C] <br /> H — <br /> � y PLU'AORIGCONTRALTOR M�ILAODRE55 CiTV ZiP PNON[ LICENSE� <br /> z <br /> H H ssorwoaK <br /> � H �NEW . . ADDITION ALTERATIQN � REPAIR DEMOLITION �. � WOODSTOVFIFRPL INSERT � . BUILDING RELOCATION <br /> ghy - <br /> I' � �� � ��y.._p�� � w �� CONtACT PERSON AND PHONE N0. <br /> ICONTPAQ PRiCE OF WORK <br />� � C � GESCRi9ElY0 NAND URREFOJT..�EiNVOLVE� <br /> r (b�.��,� �v�u� a�o� <br />� YR"�POSEDUSEOFBcw�r mNc I HEREBY CERTIFY THAT I HAVE READ AND EXA;'.11NFD THIS <br /> �� ��r�.li �('s APPLICATION AND KNOW THE SAME TO BE 7RUE 4ND CCHRECL ALL <br />` LEGA�DESGRIPiIONOFPRO ERTY�SHOWN�ELOYlO AiTACHF00liGOPIES� PROVISIONSOFIAWSANDORDINANCESGOVEF.NINGTHISTYPEOF <br /> WORK WILL BE COAIPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> i ioT,�_ e�ocK ' oF _ NOT. THE GRANTING OF A PERMIT DOES NOT PRESUMF TO GIVE <br /> � � ' ^ ' � �J� , � � AUTHGRITV TO VIOLATE OR CANCEL THE PROVISIOKS OF ANY <br />� /"orl,� p� Q�;�� � G� OTHEF STATE OR L�CAL LAVJ FiEGULATING CONSTRUCTION GR THE <br /> A PERFCRMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED I3Y THE <br /> ��t/rf�ON /'f OWNER OF TH'S PROPERTV TO PERFOfiM THE WORK FOR WHICH <br /> — APPLICATION IS MADE AND I COMPLY WITH THE ST�TE <br />. CONTRACTORS LAW 1827 RCW AND 296200 WAQ � <br /> Si UREOFGONTRACTORORAUiNOHREOAGENT �ATE U/�� I� <br /> X � <br /> PPQIEGTADDPESS � _ _ <br /> �i _ �� � S-� ,�� r1PVIIC NTSC�TYBUSRI SL �.NS[NO ANDOOS�NESSt!/ME <br />� I I PLUMBING M�CHANICAL <br />' � ' NO. � TYPE OF FIXTURE OR ITEM FEE NO. TYFE OF EOUIPMENT FEE <br />� � V�ATER CLOSET(TOILET) — CJC—NHNDLG UNITS—H.P. <br /> '�� 2 BATHTI�B � ; _ FORCED AIR SYSTE615—B.LUJ M E.A. <br /> LAVATORY(WASH BASIN) 7 t ; UNIT HEATERS—B.T.U. M <br />� 9�� � SHOWER - CLOTHES DRYERS <br /> KITCH[N SINK 8 DISP - — VENTIL�TIOIJ FAN <br /> � DISHWASHER � - RANGE HOOD <br />' ,�� LAUNDRV TRAV ; WATER HEATER <br /> o � CLOTHES WASHER T WOODSTOVE <br />' URWAL METAL FIREPLACE 8 CHIMNEV 7 .�'C� <br /> � DRINKING FOUNTAIN FIREPLACE INSERT <br />� �' FLOOR URAIN HEAT PUMP <br /> t� BACKFLOW PREVENTERS GAS Plf'ING <br /> ROOF DRAINS--RAINLEAOERS EXHAUST FAN <br /> SINK(SEFVICE—BAR,ETC.) <br /> i <br /> ''� l . ��/-U(i„ � . :i `72G�_ :, i�Gr'. <br /> /i <br /> I �— <br /> 1� SUBTOTAL $ ' l r�� SUBTOTAL $ / ' ;�f <br /> �' PERMIT $ PERMIT g <br /> �- - �� TOTAL FEE 5 � -- ) TOTAL FEE 5 � ""1 <br /> FOR OFFICE USE ONLY: � 5��.b1i� <br /> FR04i5ETEtAGK � RERNSETPACK SIDESETBRCK PLRNCNEGKNl11Af1[R FE[ � RELEIPTNO. <br /> 2iJ ZO � S� y/ :a �.� ? � 5`S'G. 70 S�3/,� / <br /> uSEzoNE LOTAREF vncn�rsiie FEES VALUATION F[E <br /> �J \ ` // <br /> �� � / �U� I�.�J BUILDWC. �' 1„�. 7.J ' ' Y�.J <br /> TVPEOFCONiSALLaWt�IE ttPEOFCOtlSIACiIIAL nccuaAxcv nao�owfwxcunn5 — <br /> _ ��� � PWMBING � � �'� <br /> SIZEO�j{3�'Q NOOFSTORiES 9ASEMENT ��EChIANICAL //�,� �L;�,� <br /> SF ' S � <br /> OLGUPAN�C�Y�L�OAD iIRESPRNNLEflSREO'� 4�EIGHT�L7IMiTAT10N ADDITIONAIPLANCHECK --j- <br /> _�((N �C� G / OTHER — <br /> BEASON F(JF SPqIANLEF: — — <br /> STATE 9WLDING SURCHARG[ I i���� <br /> INT�KEOY PL4N5FPPROVED�Y CTI YOFEVERETT FUBLICWORK$ LG iG i <br /> � • �� LOCAL SALES <br /> . . --1 . I T^." f.0�f1.: 7.in; rorni. i, ' I�i..- -.xF"..�+ �. <br /> --, - ---.___. . . . �,� , . <br /> �,,n'. ,.�. ' _ --._ . ._— ' . . .. ___ ' . :i.�:: <br />