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,D�x <br />>yyy <br />H x� <br />K' C] <br />H� <br />' 'i�'1 H "�9 <br />(n H <br />Ci1 O � <br />OH <br />��g <br />�H� <br />NH <br />g �' <br />C] t7 y <br />��M <br />HON <br />A�P�ICA,TiC ""'1 F�R CON�STRUCT�` ��1 PERMIT �� <br />TO BE COMPLETED IN BLACK INI<—PI_EASE PRINT � <br />---- ----- <br />' HEATWGSYSTEM: ._1GAS .$�ELECTRIC �.J ___- -- _ <br />BUILDING D[PARTMFNT -- — <br />259-8810 <br />�c DEMOLITION COMBINATION u BUILDING MECHANICAL PI.UMBING SIGN <br />OVJN[R I.IAiI A��RE55 GiY !iP P��O4E <br />3 � Il a- Ka1,�, , �r n 1 ( "? �=> ��a� �. �_�t `> � �i1s: << N�,,_.�`1 0.�:; �<; � zS z � ��, •[ �� �', <br />,crnr,r "� n+ni�FoonEss � GTY Z:P NIIOfiE <br />AHCHiiEGTOR0E5iG11ER lAfRADDFE55 GiY L� PHONE <br />V c 1� �� n '�,��C" i G <br />\�� vE� u l�ll5 C\ � rl-�t-�Si Ol�.�c�� ->� a- �i.r{ l 5-C'1 �< � <br />RALCONTqqpTpq � fdFll DDfiff56 CIiV � IP PXG�iE SiNTELICENJ/S°�< <br />� � � � !� � J 7 7C ] <br />��J��p �� �!l!!c,—� �� vn—�� –/0%i , �3 9 f�,Q� SL= c� �'�� .� 3 �'- ';' <br />i[LHAW M CONiH�CiO IANL D�RET 55 CiTY 2iP P��OrJE 5?.UE LICENSE a <br />7 ���.��'S�-.�V 7�1y.� _ <br />PWtABINGCOkiRACTOR fd�iLApD4iE5S CITY ZIP PHONE SIAiEUCENSEa <br />�' - — - — <br />NEW XADDITION <br />'<,�.`.c o.., ii 3�� S-. <br />CONTRACT PFICE OF \9D�✓ <br />_pg(jF3i8E WORH ANO SOUAPE i' <br />PPOPOSED <br />ALTERATION REPAIR K DEMOLITION 'JJOOOSTOVBFRPL INSERT BUILDING RELOCATION <br />- cor�rticr aeNso�: nno a�e�+e no \'� �-,. <br />�C�.`�-1��-T�0 i�lL �:�_c��l( z`>L'; <br />c:vo:veu L'tt.clt�l� JCt � qC(�� <br />Y�2�t1^� �LLLI•-[L � <br />- S�l �..i. J ` <br />IEGAL pESCRiPtIUtlGF PROPERTV ��✓OViN EY'.GY:O�� AiT��CH FCUR CO�IES� <br />�or S-L o:ocnCic��-PuycF <br />�, l: �Nn' ��C U l J \`�l ��,- � -- <br />��i ic lrlc`�`, �-G'O — <br />a) \anonncy`,y � ]` ! <br />PLUMBING <br />NO. TVPE OF FIXTURE OR <br />_� WATER GLOSET (TOILETI <br />- BATHTUB <br />LAVATORV(WASH BASIN) <br />SHG.NER <br />i KITCHEN SINK 8 DISP <br />LAUNDflYiNAY <br />i CLOTNES WASHEfi <br />- � URINAL <br />DRINKING FOl <br />- FLOOR DRAIN <br />BACKFLOW PF <br />ROOFDRAWS-R�WLEADERS <br />SUB TOTAL <br />PERMIT <br />TOTALFEE <br />FOR OFFICE USE ONLY: <br />FRONiS[ip4CN H[MSGIpACM. <br />1 1 <br />_��' 2�' - <br />USEZOtIE LOiARE� <br />� -I �l ILu <br />trr[orCor�tsnuov+aou rr-r[[orcunscFcwai <br />�_%� _' __�L N __ <br />Sli C OF OLDG NO OG STOfiIES <br />� <br />SiDE SE1PnCr[ <br />� ' <br />VACAN(SIiE �— <br />PJO <br />r��.0 �.irc.tc�..��ir.. <br />Lz �3� <br />E3ASELICNi <br />OCGl1PANLYLOAD FlRFSPRNNL[R511[pV HEIGII�IIlAITrqION <br />.'� - / ( I;Ov'lG <br />�L� <br />❑EASON � HSPRItINLERS '^ I � /��Fl��u <br />� <br />wrnneor ain�+snr����ow:onr CITYOFEVERETT <br />• 1 LOCAL SALES <br />,. � � i i�- ��. i,/�.. I TAX CODE IS 3705 <br />i HEFEBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOLV THE SA�dE TO BE TRUE AND COFRECT. ALL <br />PROVISfONS OF LlNJS AND ORDINANCFS GOVEPNW�i THIS TYPE OF <br />WORK VJILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THF. GRANTING OF A PERMIT UOES NOT PR[SUME TO GIVE <br />�UTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br />OTHER STATE OR LOCAL LAW REGULATIPIG CONSTRUCTION OR THE <br />PERFORh1ANC� OP CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTV 70 PERFORM THE WORK FOR WHICH <br />APPLICATION IS PdACE AND I COMPLY WITH THE STATE <br />CO�TRACTORS LAW 1827 RCW ANO 29620G WF:. <br />x..,-¢-1�t-�t==�-�`1-� ,r ,'L�%r 'f� _' �1. <br />��,: <br />(dECHANICAL <br />TVPE OF EOUIPMENT <br />A'C-A�HMDLG UNITS-H.P. <br />FORCED AIR SYSTEtdS-B.T.U. td E.A. <br />UNITHEATERS-BT.U. M <br />CLOTHES ORVERS _ _ <br />VENTILATION FAN _ _ <br />RANGEHOOD <br />WATER HEATER <br />WOOD SiOVE <br />IdETAL FIREPLACE 8 CHIPdNEY <br />FlREPLACEINSERT <br />GAS PIPING <br />EXIIAUST FAN <br />SUB TOTAL S <br />PERMIT 5 <br />TOTALFEE S <br />P�nrlLULCF.rluhluLP btF f1ECEIPINO <br />�� '" 1 �_' : % (� % �: �3. _� � % �t :! � "'J <br />«�c vni nennu FEE <br />BUILD��1G ?� <br />�, — _ _ _--- -- -- <br />� PLUME3ING _ _ <br />MECHANICAL <br />\ A�DITANALPLANCHECK -_ <br />i <br />SrRINKLER <br />` __ __ — <br />% STNE Bl1IlDING SUFCHARGE <br />PU�LIC IVORKS <br />TOTAL <br />.3�•7 , <br />