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RUCT �N PERMIT � <br />� TO BE COMPLETED IN BLACK INK—P!EASE PRINT <br /> BUlLDING DEPARTMENT HEATING SYSTEM: �GAS U ELECTRIC U <br /> ?.59-8810 <br /> 11 DEMOLITION I I COMBINATION � JUICDING I I MECHANICAL f I PLUMBING . I I SIGN <br /> OWNEfl M�ILADURE55 -� / CIiY IP PHONE <br /> G1.-��i CL/1 'Lh�/�GC�L�/ <br /> TENANT MAIL I1E55 � CIIY <br /> ZIP PFiONE <br /> ' �RCMITECTORDESIGNER MAIIADOf1ES5 (;IIY 21A PMONE <br /> OENcMLCONTMCTOH MAILAOURE55 �itY 21P PHONE STAfELICENSEI <br /> L�l�f- �i!/�E'� /Ov//�tc�6P�/u�.rf� Ft/-v.>-r-r 9SLo�1290-/?i�r LL✓ENZ� fJ/�1�5 <br /> MECHANIC�LCONTRACTOq MNL4UDIlESS CIiY ZIP PHONE SiATELICENSEI <br /> PIUMBINaCIXJTRACTOp M�IL�OORESS CIiY 21P PIIONE STA1 CENSEI � <br /> CyUSS OF WORN —�� <br /> � �•y NEW ( I ACDITIGN I I ALTERATION I I REPAIR I I GEMOLITION I I WOODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br /> n���� � CON7ACT PEflSON ANO PHONE NO. <br /> CON�BnCTPRIGLOFWW�K �j - <br /> DESCHIBE WORK ANO SOU�qE FOOT�GE INVOLVED � <br /> /'UN� .4 e�A /�SGSo Fr G�C, � D .au..Fr. r ;� <br /> PpCPO5EDU5rppBVILDINO �--� — ; µ�. <br />� � �, , I HEREBY CERTIFY THAT I HAVE HEAD ANU EXAMINED THIS � � +c)it <br />� �d/C�L.: �q,y���,�,�� APPLICATION AND KNOW THE SAME TO BE TRUE AND COFlRECL ALL `J�+ <br /> :EMLDESCPIPTIONOFPROPERfY�SHOWNBELOWOR�TT�CHFOURCOPIES) PROViSIONSOFLAWSANDORDINANCESGOVERNINGTH�S-''PEOF ' - <br />� . �or�_ niocK o�� S�f WORK WILL BE COMPLETED WITH WHETHER SPEGFIED HEREIN �R , •'�'s '�(y <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GI�. � � -x �°��'; <br /> }.y'i <br /> � �t � � AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY ��r„ t���� <br /> �. _ 7' ��'� J GiHE-R S�-�T�'+�R LOCAL LAW REGULATINii CONSTRUCTION OR THE � '-`.4.u�;'-y;fit;✓;Ha;";_ <br /> PERFORI� ' _OP CONSTRUCTION.THAT I AM AUTHORIZED BY THt - � <br /> ' �l� /Z 7 OWNE9 � � rIIS PROPERTY TO PERFORM THE WORK FOR WHICH � � �� <br />. APPL�.O ..iN IS MADE AND I COMPLY WITH THE STATE . . . ' :� <br />'� • / CONTRACTORS LAW 18.27 RCW AND 296200 WAQ . . � <br /> I — <br /> . 'ROJECT� UqESS 'L .qmm�E o��E ' I� <br /> I T/' <br /> CIIY BUSMESS IiCENSE H0. <br /> ; PLUMBING MECHANICAL <br /> � NO. TYPE OF FI%TURE OR ITEM FEE" NO. TYPE OF E�UIPMENT FEE <br /> s WATERCLOSEi TOILET � <br /> ( � A/C—A/HNDLG UNITS—H.P. , <br /> � BATHTUB ; FORCED AIR SY&TFMS—B.T.U. M E.A. � <br /> Z. LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M ; � <br /> � �9^ SHOWER � / CLOTHES DRYERS � � <br /> �, KITCHEN SINK&DISP ; VENTILATION FAN � <br /> � DISHWASHER • � RANGEHOOD � , <br /> LAUNDRYTRAY � WATER HEATER � <br /> CLOTHES WASHER � � -Q— WpOD STOVE ' '. <br /> � <br /> URINAL ' / METAL FIREPLACE 8 CHIMNEYG� biyp � '� <br /> .Q- DRINKING FOUNTAIN � FIREPLACE INSERT ; II <br /> FLOOR DRAIN � .�- HEAT PUMP i 'i <br /> BACKFLOW PREVENTERS ; GAS PIPING � '� <br /> . ROOF�RAINS—RAINLEADERS � EXHAUST FAN /// ' , '� <br /> $- SINK(SERVICE—BAR,ETC.) � — <br /> � � <br /> � <br /> — — i <br /> � T <br /> __ I <br /> 1 � <br /> SUB TOTAL $ ; SUB TOTAL $ � <br /> PERMIT $ � PERMIT $ ; <br /> TOTAL FEE $ ' TOTAL FEE $ � <br /> FOR OFFICE USE ONLY: � <br /> FHONiSETBACK REAqSEIBACK SIDESEIBACK PL4�JCNNC::BER FEE� RECEIP7N0. <br /> � S �/,, " <br /> � �usezor+ LOTAiIEA vncnNrsire FEES VALUATION FEE <br /> I /� BUILOING � � �8 ' � <br /> i <br /> TYPEOFCONIS.ALIOW�BLE 7vPE0�CON5��CIWI. acuruxr NOufmvF4�06UNi�5 <br /> — — �'3 U I P�UMBING � 7� i <br /> i <br /> SREOFBLDG. NO.OF5T0111E5 BAS MF.NT i <br /> MECHANICAL �D � <br /> 456 , o S,F, � o -- ; <br /> OCCUPANCVLOAD FlOESPRNNIEli5f1E0'D IIEIGIIiLIMIiNION AODITIONALPLANCHECK �T <br /> � SPRINKLER i <br /> REASON FOR SPIiINK�EFS � <br /> STA7E 6UILO��iG SURCHARGE ' � <br /> INi�REdV PLANSAPPROVEDBY CITYOFEVERETT PUBUCWOFKS � �� � <br /> LOCAL SALES ' <br /> I q� TAX CODE IS 3105 70TAL �Q �Q <br /> v <br />