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�., <br /> u" � � APPLICATIOI�OFi CONST'RUCT1�1 PERNt�T everelt <br /> � TO BE COMPLETED IN INK—PLEASE PRINT � <br /> ie��e��„n,������ <br /> ciiv or <br /> everett I HEATING S1'STEM: I:i1 GAS U ELECTRIC U � <br /> u BUILDING DEPARTI�IENT <br /> ��� 259-8810 <br /> � � , I I UEMOLITION i\ COM:aiNATION_ BUILDING MECHANICAL I I PLUMBING I I SIGN <br /> OWNER FIARRIlUfi55 CIIY ZiP PNONE <br /> �HVi . <br /> tcy GEa,i£�_cc� I9iN n�. 5,�,.. 57. s.;•i�c� yhiC3 .SN7-S,L/3 <br /> �t�G IENRNT MAILAODFE55 CIIY 21F PHONE <br /> kiz �. <br /> ��� RRCIIITECTOFO[SIGN[R MMLA�OIiE55 CIIY ZIN P1101lE <br /> y��--II (JfSt r/ L�r-�c 5 z Pr c 15"'' ST_f-"L'��L'-LTl <br /> F3x� GENEPMCONTR�CTOfi MMLAO�f1E55 CIIY Z�P PHON'c ULENSEf <br /> �� GcvNe/ � 173rzL <br /> o qy� CEo.-/r.�c c� — <br /> I.IECHANICRLCONTRACTOR M11pII.ADDf1ESS CItY ZIP PHOUE LICENSEI <br /> F-i b�a O FNe�Lr, �'FC!/+�i-L�S`;T__ 13nir?cC(t�r_r c„r, '`"_ -_-rncr[»n_--- -�i E,."-9SCG` �02010l00�_ <br /> �y � PIUMpINfCONlll�f.lull MMi �Pulil6:{ Cuv /iP... PIION[ LICENSE/ <br /> �H PE�n2ri���cr_ r�tc'i�dii�l. �.'QC'��17i L,��N�..ct'/� 33R �Sit/ Pt�1�o;� 137c3 <br /> Y H C1�S50F WORK <br /> r�..� ,G NEW I I ADDITION � � ALTERATION ' REPhiR DEMOLITION WOODSTOVE/FRPL INSERT I I BUILDING RELOCATION <br /> gy - ------. _._.__--- - �----------- - <br /> �„� cuuinct r�nsun nim n�rouc uo <br /> n�y CON(RRCT PI110E OF WOIIH � <br /> 11r��t�r_�i�,= �s-5-:tvrG . _��.•�-ezi3 <br /> R� � U[SCRIBEWORKPNp50U4pEFOO1RGEINVOIV[U��,,,," <br /> H fn I-1 E� �+w 5G d'Y- (.�il U <br /> HOC/� rnovoseouseoi�nminuir, : IIEFL�V CERTiFY 7FtAT I Ft=,VE READ A�!D EXAMINED THIS <br /> ��//�L^LE L/d%'UL f %��.'+. APPLICATION AND Kf!�W THE SP.A1E TO BE TRUE AND CORRECL ALL <br /> LEGAlDESCRIPTIONOFPf10PENTYIS1101VN0ELO�VORnt1ALNF0u(iGOVIE51 PROVISIONSOFLAWSANDOFDINANCESQOVERNINGTHISTYPEOF <br /> . � ��2�� � WORK WILI B[ COMPI.ETED WITH WHETHER SPEC�FIED HEREIN Ofl <br /> ioi oi.ocK or NOT, TIIE GRANTING OF A PERMIT DOES NOT PRESUMF TO GIVE <br /> P.UTIIORITY TO VIOL.4TE OR CANCEL THE PROVISIONS OF ANY <br /> 07HER STATE OR LOCAL LAW REGULATING CONSTRUCTION OA THE <br /> PERFORMANCE OF CONSTqUCTION.THAT I AM AUTHOHIZED BY T11E <br /> �"'SL�O�.LI'�nIL 5��-- OPPLIQOIONISISRMADE A�DPE COMP YH WITOHKT ER STATE <br /> COMRACiORS LAW 18.27 RCW AND 296200 WAC. <br /> SiGNAIUI� ff.nilif CI(211JRAUIIIORIZEOAGENT yATE <br /> -- X �/�%�tyiw' �/��il6 <br /> POOJEC1AD�flESS / ��//�� <br /> ----- -- ___ _ .._ _ - �Co,�Pl�co ��6e <br /> � n� �'lY� / / 1� � APPIIC�NISCIIVOIISIN[SSIICEN5EN0 �NOpU5�NE55NAME ' <br /> 1/ �1 �J ..J <br /> � '�t PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM fEE 1�0. TYPE OF EOUIPMENT FEE <br /> 11 WAIEfiCLOSflI (IOILEI) _ _ —T NC �AtlINDLGUNRS—H.P. � <br /> � 1, BATHTU[3 _!_ FONCEDAIRSYSTEMS—B.T.U. M E.A. �— <br /> '�1 � LAVATORY(WASH BASIN) ;_ _ UNIT HEATERS—B.T.U. M i <br /> SHOWER �_ CLO7HESDRYERS � <br /> __._._ <br /> 1 ' �_ KITCHEN SINK 8 UISP _ _� VENTILATION FAN � <br /> � DISHWASHER RANGE HOOD � <br /> �1 LAUNDRY TRAY _� _i, WATER HEATER � <br /> '� _ CL6THES WASHER � _ WOOD STOVE � <br /> � URINAL MEIAL FIREPLACE 8 CHIMNEY � <br /> DRINKING FOUNTAIN ; _'_ FIREPLACE INSERT ; <br /> ' FLOOR DRi�IN —�— H[AT PUMP � <br /> - --".—._"___'......_ . __ ..___.. __ . ____ _ _.� ___ .__— . . __._.. __._ <br /> ' �ACKf-IOWP(IfVENIBHti ; GASPIPWG ; <br /> _ —._'__... . _ _'__ .. .. -_�.___ .__ ___.__.__'___ <br /> ROOF[7RAINS—FlAINLEAUERS � EXHAUST FAN i <br /> — — '— — <br /> SINK(SERVICE—B�R.ETC.) ; ; <br /> — —--r— — -' ' � <br /> ' —� �� <br /> ' ... .. .. . . .. ' .. _._. , <br /> . . ._. ..__.. .. . � . .._ . _ .._.. <br /> I_e . . I ..._ ' <br /> SI1B TOl'AL $ ; SUB TOTAL $ ' <br /> ' — —__.—____—_.__ _. _... . _ _ _ . ._ _ _ ._ . _ .—_ ._ _._ _' <br /> 1'1"HMII $ i PERMIT E i <br /> ..__' _ _.. . . . � . . ___ <br /> IUTALI-EG $ TOTALFEE $ � <br /> ` FOR OFFICE USE ONLY: <br /> FRONISE104CH flf�11SBIpTf.H $IUf:5F111Af.N PIN CN[CKtlUl.11)ffi F[E RECEIPTNO. <br /> 2v ' Zv' S' 9/ �l 7la 3/0 3� c%5's.SO <br /> USE208E lOLR(I[A vnr.anr�ai� FEES VALUATION FEE <br /> R-i 8,2� � ���«>���� 3 4oZ 5 a a ;so <br /> IYFEOFCONISAIIOWABIE IVPFIIff.111I51Af,IVPI ix'wrAr¢r immunm�nyrv�ns --- -- � <br /> 1d11X1�• PLUTAUING � <br /> ---�=^� —�=��— -R=3- —� � ' - <br /> SRE OF OLDG. NO OF SIORIES OnSNAEIII � <br /> �(.Z2 5�` + �J 2G/ 1.1ECHAllICAL 1.//1 � n`/l <br /> 46o Sf Gl12 Z a --- 1�'-� <br /> oCCUPANGY}}}OnD finftiPN�HII'IISIiCqn I�f.lr�nln.nlnll�w ADUIiIGNALPlA1JQ1[CK aq �aS <br /> , ' /I` Ji <br /> '� N� OfIILR ${ � . <br /> IIEASON FOR SPRINKlE115 ------- —rl /� <br /> . SlAr6(3UIlUttlG SU9p1AliGE L,�'S(/ <br /> ___'_'_'_'._. _ _... . . _ . . . ... . . . __ .__...___ ...—____ <br /> mink�nr rinm:n�runviunv CITYOFEUEfIETT runu�:wonHs � <br /> ,M� !�� �/y� �ocn� sn�Es ' <br /> 73 �, �5 <br />