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i r <br />APPLICATIOFr1FaR CONSTRUCTI�►�1 PERMIT CVe1�'� <br />��Erero��� TO BE COMPLETED IN INK—PLEASE PRiNT � <br />f,ITV OF <br />everetfi HEATING SYSiEM: GAS ❑ ELECTRIC U__ -� <br />BUILDING DEPARTMENT <br />� 259•8810 <br />� f"1 DEMOLITION ' COMBINATION <br />� �Eq MAi Ul,.�p RfSS <br />� .. "�� <br />\1�l_Y—� <br />BUILDING i' MECHANICAL '� PLUMBING � i SIGN <br />���r. (� 9.r��G o„��y- �'c�/�� <br />�ln✓u <br />I TEN11 MMLADDf1E55 CIIV � Z�P <br />� <br />� �PGNIIECTORDES!ONER IA�RADDRE55 CIIY 21P <br />. ......... . ................. uu� .nnnccc [rtv iil` <br />PHONE <br />,;. , <br />,..�-'n�/� G <br />MEGIIA IC�ILONTR�CTOH M�RADDflE55 C�1Y I�P P110NE L�CENSE/ <br />PLUMBIN6CONiR�GTOR MAILAOORE55 CIIY 21P PNONE LICENSE• <br />cuss oF vronK <br />l7 NEW I.I ADDITION '� ALTERATION �! REPAIR .'� D[MOLIiION � WOOOSTOVE/FRPL INSERT I i BUILDING AEIOCATION <br />LOMUCi PENSON �NO PIIONE NO <br />CtN1L11�CT PRICE Of WORN <br />�PR POSEUUSEOF'9WlDiN�a/ <br />� �l �i �-� /- /{ n <br />lEOALDE 11IPiqNOFPRp'F.NTV <br />LOT�� BLOCN _ <br />f� <br />FIXTURE <br />SHOWER <br />KITCHEN SINH <br />DISHWASHER <br />� I HERE�V CEFTIFY THAT I HAVE READ AND E%AMINED THIS <br />�u���� � APPLICATION AND HNUW THE SAME TO DE TRUE AND COHRECT. ALL <br />iowon��iecnwvn r��si PROVISIONS OF LAWS AND ORDINANCES GOVEFiNINd THIS TVPE OF <br />" � WORK WILL BE COMPLETED WITH WHETHER SPECIFIED ���(iEIN OF <br />o� �.t—{��'n'Q NOL THE GRANTING OF A PERMIT DOES NOT PR[SUMt TO GIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br />OTHER STATE OR LOCAL LAW REGULAiING CONSTRUCTION OR THE <br />— PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTV 70 PERFORM THE WORK FOR WHICH <br />. APPLICATION IS MADE AND I COMPLV WI7H TNE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br />5�6N�LUREOiC��AC1DIlOfl�lliNOBIZE��0EN7 O�^��f�/ <br />(� ❑� <br />1 1 �r� 3 e� <br />�� � �= <br />� �_ i � �N . CITY BUSRIFSS l ICENSE NO AND BUS�NE55 N�ME <br />�LOW PREVENiEHS <br />DRAINS—HAINLEADERS <br />FE[ <br />FOR OFFICE USE ONLY: <br />FRONiSET��Gk f1E�R5�El0�CM SiUEGE79�CM <br />U9E 20NE lOi A E/� a VAC�NT 611E <br />SIIE OF BLDO <br />loqa a 5�1 <br />OCCUP�NCYlO�U <br />RE�SON iOR SPRINNLERS <br />fMF,Oi`C0451 �(IWl <br />v � / <br />NO Of SiOR�E6 <br />f111E SPO� hlEf15 RE00 <br />INT�kEBY VLAN5APPOOVEOBV <br />r� � 4� <br />a <br />A1C—NHNDLG UNITS—H.P. <br />F�:RCEO AIR SYSTEMS—B.T.U. <br />UNIT H[ATERS—B.T.U. M <br />CLOTHES UHVERS <br />VENTILAf ION FAN <br />WATERlIEATEF� <br />WOODSiOVE t� <br />METAL FIREPLACE 8 CHIMNEV <br />FIflEPLACE INSEFT <br />HEA? PUMP <br />GAS PIPINC <br />EXIIAUST FAN <br />� <br />� <br />; ; R�� SUB TOiAI E ' <br />� l� PERMIT E <br />'�w TO1AlFEE E O'� <br />/O/rZ <br />PUHCHECNNUMO[R �[E RECEIPTNO <br />�i�sr,«3 L. YrZPi — <br />e J eu��oiNa <br />aamur.r rowovrtmrruxns — <br />°"�0 / PLUM(iING <br />B�SEMENT/✓� MECHAt11CAL <br />NEiO�rtl>iMil�pioN AD�ITIONALPI�NCHGCN <br />� d / OTNEIi <br />STAtF BUILDINO SURCNARGF. <br />CITY OF EYERETT PUBLIC WORKS <br />LOCAL SALES - <br />TAX CDDE IS 3105 Tor�� <br />_ . .. , . . . .�.., ,.. .. .,:-... .. . . <br />0 <br />