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APPLICATI�rI FS�R CONSTRUCT�ON PERMIT <br /> CITY OF�VERET�• BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVEFETT, WA 98201 •25�•8810 I <br /> f� DEMOU710N f l COMBINATION � BUILDING f"I MECHANICAL fl PLUMBING fl SIGN <br /> PROJECT ADDRESS <br /> �'����� ',� � % / J <br /> ONMER M�ILADp1E55 CITv 11P PnqNE <br /> ��O�L�V}1%�Y�C. Ci^../G-��r��eS 9'�S.Sf�i Kl.. Il�d �.Q kE�4-uR,�S 33��' �)(n ST� <br /> TEN�N= M.VLIIDIX1.55 Ci)Y 71P PIIONE <br /> AfiCHITf.CTOR0E51GNEf1 M�IL11D[ME55 GIIY 7m PHONE - <br /> 6ENEf1ALCONiMC1011 M�I1110M1E5S Cilv ZIP P110NE Si�TELICENSE� <br /> �-�olC�m Ct.+-k F�{e-.'nr;�n� �Is.SI-i IC� Pd�La�2.s uJ�s 9�156 .�3�1-� 9G•�Z► <br /> MECIIANIC�I CONTR�CTOR M�IL�0 f1F55 CITY )IP PIIONE STATE UCENSE r <br /> �' o(drna*oq�RP <br /> �WMBINOCONTMCTOR MML�ODRESS CIfY TIP PHONE ST�TELICENSE� <br /> �q, U00 � W <br /> coNrn�cr rnice cv wonK <br /> �15� B �Ft �1 lo � G�Qq� HEATING SYSTEM: - GAS ❑ ELECTRIC ❑ <br /> DE9CRIBENORK�NOSW�REFOOUGEINVOLVEq,J� CON1ACiPEASON�NUPpq\ry�NO / <br /> --�_ �F��S U r V-L�iV��I��Q (� Y1S� 6� <br /> TTT a3� - o�c, <br /> � I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> rnoros o use oF r,uaonro �PPLICA7ION AND KNOW THF SAME TO BE TRl1E AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNINO THIS TVPE OF <br /> LEO�LDESG ���CNOFPROPENTY�SNOWNBElOW011 �c tvro oci W�RK WILL @E COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> � NOT. THG ORANTINQ OF A PERMIT DOES NOl pRESUME TO OIVE <br /> iot _mocK or—� AUTHORITY TO VIOLAT� OR �ANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAv.���EOULATINO CONSTRUCTION OR THE <br /> _ PEFFORMANCE OF CQNF i'nJCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PI70PERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE ANU I CO�APLY WITFi THE STATE <br /> 7MCEl TiVI I D NVMBER CONTiIACTORS LAW 1827 RCW AND 296200 WAC. <br /> /� I <br /> CANSiRUCTIpN�O�N LENDER.ADORi 55.TELEPHONE 1NMBER ����J�a�fYl,M- . �''UI�G <br /> ,_ '^� [ ,� ^(-+� � I �'V�VW �J <br /> � r�WpS� .�L1�'I � LDS=J �v, i� SION�TURE O�TE <br /> CItY OUSiHE55lICE65E NO <br /> PLUMBINO MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TVPE OF FIl(TURE OR ITEM FEE <br /> �y WATER CLOSET(TOILET) i A/C—MiNDLO UNITS—H.P. � <br /> 9ATHTUB ' '�— FORCED AIF SYSTEMS—B.T.U. M E.A. � <br /> � LAVATORV(WASH BASIN) � HEAT PUMP � <br /> SHOWER � UNIiHEATERS—B,T.U. M � <br /> �— KITCHEN SINK 8 DISP ; CLOTHF.S ORYERS � <br /> OISHWASHER � VENTILATION FAN i <br /> LAUNORY TRAV ; RANOE H700 � <br /> �+ CLOTHES WASHEH � WA?ER HEATER , <br /> URINAL ' WOOD S70VE i <br /> DRINNINQ FOUNTAIN i METAL FIREPIACE(WOOD BUFNING) � <br /> FLOOFi DRAIN � � FIREPLACE INSERT(WOOD BUFNING) � <br /> BACKFLOW PREVENTERS ' � QASFIFEPLACE � <br /> i � <br /> SINK(SERVICE—BAR,ETC.) � OAS RANGE � <br /> _ ' QAS PIPINO � <br /> � EXHAUSTFAN i <br /> � �— <br /> � � <br /> � <br /> � � <br /> SUB TOTAI f ' SUB TOTAL 5 � <br /> PERMIT f � PEFMIT E � <br /> _ TOT�.L FEE S � TOTAL FEE S � <br /> FOR OFFICE USE ONLY: <br /> F{1bNT5F.TPALK pE�RSF.TBACN SIOESE78ACR P��NC��fCRN MOFR fFE PECEIPiNO. <br /> Z �' ? 0 - � - �C ' <br /> //�'7lCc'� <br /> USE 20N�{,'(J IOTMEA V�C�N�i SIiE S VALUATION FEE <br /> 1�_� � Z � IIYES (1 NO Bl111f11N(i <br /> NEIOHTLIMIT�TION NOOFDWELLINO $REOjBL /�I ' �� <br /> UNITS � ZZ S��� L./VP,/�I� pLUMBINO � <br /> /' <br /> OCCUP�NCY Iq ptgiq11E5 OCCUP�NiIOAD BASEMENf MECII�NIC�I <br /> onAu3 Z N nves � <br /> LI��URMRE00 qEA5pN ADDITION�LPLANCN I <br /> o,��E� ' la1 ' <br /> FIRESPIIINNLERREOD f1E�50N <br /> ST�TEBUIIDMOSUOCNMpE �- i/ <br /> TrreorcoNsr rinNsnrrn°�VEDBY CITVOFEVERETT �UPLICWORNS /)/}I <br /> �- ��/ V � LOCAL SALES —��L� <br /> ___ _ enre � 9 TAX CODE IS 3105 TOTAL /i j`� j — <br /> JC' <br />