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APP�l�/�Tlt,�J FI�R C'.U[�sTF�I��'� .�N IPE�91R97' �''�" <br /> TO BE COMPLETED IN DLACK INK—PLEASE PRINT <br /> I� HEATING SYSTEM: i�I GAS [J ELECTRIC U ______-� l <br /> BUIL�iIPIu DEPARTMENT - -- <br /> 259-C810 <br /> DEMOLITION COiNBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> ��•,hER �nnanoor+ess cirv zv� P�+or+e <br /> il'1�1�� ��G�Ic�.�,�.\ � "?,�13 I�f,b �5�= F'rr,/f 35�7- I i}���' <br /> �� � iENANI MpILAUDFE55 — CIiY IIP PHONE — <br /> 'yL� y 40.C��ITELTORDESIGNEF M4ILADOPE55 GIIY ZIP PHONE <br /> q ^ �' ..— _- _ <br /> 9 H V) GlNER4LCONTflACTOfi MAIL�L��RE55 CITY ZIP PHONE STAtELIGENSEr I <br /> C <br /> y � Id[CHANiCAICONiRACTOR MAILADDfiESS CITV ZIP PNON[ StAiELiCENSEs . <br /> � '3 � `_�r=A 1�:�_t,] �-lr«f,�.. . c L,t QG, ���/��Av,:���.s'- �%k�75� _ I <br /> �H � BlUMf31NGCONTRACTOR MNL �RE_5 Cltt ZIP PNONE Si�TELICENSE> i <br /> !/� H <br /> H t' <br /> � S"'u anssnFwoaK <br /> y d NEV! ��. '. A�D1710N �,' ALTERATION � REPAIR DEMOLITION � WOODSTOVBFRPL INSERT . BUILDING RELOCATION <br /> O f� CONTACT F EP5011 ANp PHONE tl0. <br /> � �� CONTIiACT PFICE OF WOPK ��v��' �� ..— ' <br /> �'•' n <br /> «�. � C[S/CBiEEN'ORKANOSOUAPEi(K1T�GEINVOWEO I � <br /> '��sH / r�rK�c /�:,� ��JC[S f'/r'� /�lCL' — <br /> Hy rnoeoseouseoFa DING i HEREBY CERTIFY THAT I HAVE READ ANU EXAMINED THIS <br /> u APPLICATICN AND KNOW THE SAME TO BE TFiUE AND CORRECT.ALL , <br /> H �e�n�oescAivnoNOFanoaearv�seowrvee�owoanrrncNFouacoPies� PROVISIOtJ50FLAWSANDORDINANCESGOVERNINGTHISTVPEOF <br /> � t7� — WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR � <br /> '� �or e�ocK oF NOT. THE GRANTWG JF A PEFiM1T DO[S NOT PRESUME TO GIVE , <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY ' <br /> H �y OTHER STATE OR LOCAL LAW FiEGULATING CONSTRUCTION OR THE ' <br /> " PERFOAMANCE OF CONSTRUCTION.TIiAT I AM AUTHORIZEO BY THE � <br /> � OWNER OF Ti15 PROPERTY TO PERFORM THE WORK FOR WHICH ! � <br /> _ APPLICATION IS MADE AND I COtdPLY WITH TH[ ST,4TE '�. <br /> CONTRACTOFIS LAW 18.27 RCW AND 296.200 WAC. � <br /> � � L C <br /> ^ X � ���i l� I� <br /> PROJEGT ADDRE55 �'������� ni I <br /> L '� � <br /> � a3� s� �� �,rii �.,.o��,�,�u�,«.�sE�,o � <br /> � PLUMBING MECHANICAL <br /> ,, �Iw�.�,�� NO. TYPE OF FIX7URE OR ITEM FEE NO. TYPE OF EOUIPP.fENT FEE � <br /> w,�� WATER CLOSET(TOILET) AiC—AiHNDLG UNITS—H.P <br /> BATHTUB FORCED AIR SYSTEMS—B.T.U. Id E.A �, � <br /> � � LAVATORY(WASH BASIIJ) UNIT HEATERS-6.T.U. M _ I � <br /> ! .`` SHOWER :.LOTHES DNYERS � <br /> �_� KITCHEN SINK 8 DISP _ VENTILATION FAN ' �� <br /> i DISHWASHER RANGE HOOD _—� : <br /> � LAUNDRY TRAY WATEfi HEATEN ' II ��� <br /> CLO i HES WASHER WOOD STOVE � I <br /> URINAL METAL FIREPL�CE 8 CHIMNEY i_ <br /> ( �� DRINKWG FOUNTAIN FIREPLACE INSERT __I_ I, <br /> FLOOR DRAIN � HEAT PUMP I . <br /> � BACY.FLOW PREVFNTERS '✓ GAS PIPING � j �� <br /> � ' ROOFDRAINS—RAINLEADERS EXHAUFi FAN '� <br /> . SINK ISERVICE—BAR,ETC.) . <br /> � ' ��� � <br /> I SUB TOTAL 5 SUB TOTAL S , <br /> PERMIT 5 PERMIT 5 ' <br /> '�� TOTALFEE S TOTALFEE $ , <br /> �� — <br /> FOR OFFICE USE ONLY: <br /> fllONTS[TB4CN RE�FSEI��CR SiDESETB�CN PLAHCHECKNUfA�EB �[E 4iEGEIPTNO. <br /> ,�i(�'.�lJ/ . <br /> wezorvE �oinaen vncAuisire � FEES VALUATION FEE � - <br /> eui�oiNc <br /> lYPEOFCONIS.FLLOWABLE iYPE0fC0115CFCiUAL nccera•�cr rvo0vm'i4u'.eu�.as — <br /> 090°P � PLUh181NG <br /> 512EOFBLOG. NO.OFSTORIES BASEMENT MECHANICAL <br /> OCCUPANCY LOA� FlRE SPFNKlERS REOD N[IGNi LIMiTAiION ADDITIONAI.PLAN CHECN <br /> SPNINKLER <br /> REASONFOFSPRRIKLERS —_T— � � <br /> STATE BUILDING SURCFIAFiGE <br /> iurnve�r r�nr+snrPno�eoov CITYOFEVERETT PUBL�.CwOnKs ' � <br /> LOCAL SRLES —T— <br /> 7RX COOEIS 3105 rorn� <br />