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APPLIC/4i'IOId FOR CC�n1aTR:�C'Tf`..N! PE,�{MIT �•�"�',' <br /> u��e���n����� TO BE COMPLETED IN INK—PLEASE PRINT • � <br /> a rv or <br /> everetf i_ HEATING SYSTEM: ❑GAS J ELECTRIC J _ —� <br /> BUILDING DEPARTMENT <br /> 259-F1810 <br /> DEMOLITION XCOMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> owr�ea �.mi�nooaess a�v zia v�ioue <br /> Gtc%i�c,���> 12/�l N. �y�-`- �5;. <;r,-.a�ry�_ `7`sic3 s�i7 -�1/3 <br /> i[NANT 1.1ALLADDP[SS Cii` 26' PNONE <br /> �� <br /> nRGHITECi0RDE51GNER !dAiLnODR[55 CItV ZiP i'HUNE <br /> 1 � <br /> a l�� GENER�,ONiRAGTOR M1IAII AJ�RE55 CiT'/ ZIP PHONE / �UCERSc e � <br /> [Tli7 — l.Y�[-�N�=� JE�`'� I�)'��.. <br /> 'jaF3 k.P]IRNICALWNTRACTOR biAILA0pFE55 GTY ZIP PHONE LICBlSEP <br /> c�'H ���E�Uo;' 2 '�CAi,,.� ��sl ��'ilker�::2T . �'�eE���it �/A�I�C_-� t=Neav2Nl �Ti-1 <br /> >Hti cwrsoinumrnr�ncna �.�m�nooRess ciTv zu- r�ron= ucervse. <br /> r x n ,- , �o. zi7� cy_H,��� �=�N� �jVc=�� �eKr- �c ,� � �e 5 <br /> HZH 1=���-�OLNj�rIL� I�WIIF/fJG � � �_ I� <br /> CLA55 OF YtORN <br /> � �-7 77 lC NEW ADDITION ALTERATION REPAIR OEMOLITION WOO�STOVE�FRPL INSERT BUILDWG RELOCATION <br /> � H� CO'liACTPER50tlANOPNONENO <br /> �H /� ° �5`i-zdsc <br /> � x[� CONTiiACTPRICEOFVlORK __�C%C'/2 !/S!i���5 l�/� <br /> O(n pE5CFi19E WORK ANp SOU/RE FOOTAG'c VNOWED L�S�/L <br /> o �?d Fl�w _ Gnr-/57-R�;�--rr ��; I �6 2 _ <br /> � ,�� r��,ovoseouseoFeuaoiuc I HEREBY CERTIFV THAT I HAVE R[AD AND EXAMINED THIS <br /> y�n _ (LcSI DE r�Tl/�� _ APPLICATION AND KNOW THE SAME TO 6E TRUE AND CORRECT.ALL <br /> xHq ��cn�oe5caivnorioFrao�earv�.S�owNoeicwoanrmer.our+��s��rs� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> 3 WORK WILL BE COMPLETED WITH WHETHcR SPECIFIED HEREIN OR <br /> > y z �or�_ o�ocrc or L UTH fzlE .r _ NOT. THE GRANTING OF A PERId1T DOES NOT PRESUME TO GIVE <br /> t-� AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> � y y �E',�� �5"-rH �(` c - OTHER SiAT[OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> H 'L --- PERFOFitdANCE OF CONSTRUCTION.THAT I AM AUTHORiZED BV THE <br /> n d y OWNER OF fHIS PHOPERTY TO PERFOfiPA THE WORK FOP WHICH <br /> APPLICATION IS 1dADE AND I COMPLY �VITH TdE STATE <br /> Ci] CONTRACTORS LA�V 7827 RCW AND 296200 WAC. <br /> `Ii H� iC�fntlin�OFG0u10.AC�ORO��At1D�ORRED�GENi OAiE <br /> y o ti _ „� a�C i�v c����� � <br /> X / ' � <br /> �J ,, , , <br /> i�no.�[:r.r nolo/aepss �) - ----�-- ! ` LL L/ � `l� _ ti`. <br /> � J ,�� - � S� � c11�'v r.s'c' n � ,r.� ,r�.r Eu�.. s i�cerisEr.o �Noeusrt�estir�n�ne <br /> PLUMBING MECHANICAL <br /> NG TYPE OF GI%TURE OR ITEM FEE NU. TYPE OF EOUIPMENT FE[ <br /> IVATERCLOSET(TOILET) �p_,'� A�C-hHNDLGLINITS-HP. <br /> ��� I BATHTUB _ _ /d � �_ FORCEDAIRSYSTE6IS-�.T.U. M E.A. �~— <br /> z LAVATORY(WASH BASINi �0 �� _ __ UNIT HEATEflS--B.TU. M <br /> SHpVJER ' / CLO7HE5 DRVFRS <br /> '��'' � KITCHEN SINK 8 DISP __ y� JENTILATION FAN — <br /> ""�"o DISHWASHEFi �'-� _�_ RANGE HOOD <br /> .�• LAUNDRY TRAY _ WATER HEATER <br /> _� CLOTHES WASHER _ $'� ___ WOOD STOVE <br /> �� URINAL METAL PIREPLACE R CHIMNEY , ; <br /> DRINKING FOUNTAIN FIRFPlACE INSERT .J O I - <br /> _ _ �— <br /> FLOOH DRAIN HEAT PU�dP <br /> BACKFLOW PREVENTERS _ �_ GAS PIPING <br /> " '� ROOF DRAINS-RA W LEADERS EXHAUST FAN <br /> SINK(SERVICE-BAF,ETC.) ___ ,.�tc�i�... % i�., ,. 1 acr �d ' _ <br /> a .a� — — , <br /> (� ! _-- <br /> � ''� SU6 TOTAL S _=�f � - SUB TOTAL 3 q p ; <br /> !' ' PERMIT S --� PERM1IIT S <br /> TOTAI FEE $ y S ; TOTAL FEE 5 �/.J ' <br /> , FOR OFFICE USE 7NLY: <br /> fqOHTSEtOnCH fiEAflSETBACrc SIDESET�4CN PIANCHLCnN' ���Ef1 f[C �ECEIPTNO. <br /> �� � �� ! I ' /`�/ J G . 7 ` ;� �i ��S"t S a <br /> us[zorve �or nnen vncnrrt srte FEES VALUATION FEE <br /> �E'- / '7 � Y ouaoiNG :' 3 4o i �/7z ' SG <br /> IVPCOf1:0'16PllOWABIF lYPEOFL�NS1AGlllRl tardu,_r riu0�ow¢unc�•dn —�-- <br /> ✓- � ✓� lj °"0v' � PLUldBING ySl; O� <br /> /L-3 <br /> Si2f�f U�Di�� ��0 OF STOPICS �ASEMENI Id[CHANICAL _ <br /> l8 I �U � o� <br /> .v.,y J�r t ai // �— <br /> AD�IiIONAL PLAN CHECK(/����� <br /> uccunnuev�ono riaesrnNK�enseeo-o HEic��rurnrtario�+ �_ ��,., �, , 30 � <<> <br /> . . ' <br /> ,�/r ,�, �_J o,�E� G � <br /> RE4SOIlFOHSPPINHLERS - �— <br /> STATE BUILOING SURCHARGE � i$3 <br /> imnHcor � r���+sar'rnovconv CITYOFEVERETT PUBLiCwoeKs �p ;oA y <br /> LOCALSALES <br /> TAX COOE IS 3105 rorn� �G 7 ; O a <br />