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APPLICATIC � 1 FOR C�NSTRUCTr1N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />BUILDING DEPARTMENT HEATING SYSTEM: GAS ,j�ELECTRIC Cl <br />259-8810 <br />❑ DEMOLITION ❑ COMBINATION C� BUILDING x MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER h1AILA0DRE5S CITV ZIP PHONE <br />Tn,O G,..Tc �ini tl,,._._... l�.,ll,,._I.,..__ co��t— 7�-a_a��„ <br />TENnNT MFILAODRE55 GTY " ZIP PMONE <br />Ll. S�/•1h Ic I la OS 5�' . L= v,e.✓e N- yV�a t I l,va.•, L <br />ARLHITECTORDESIGNER IAAILAODFlESS CITY ZIP �ONE <br />GENERALCONTRACTOR IAAILADDRESS CIiV ZIP PHONE STATELICENSEa <br />MEGHANICAL GONTRACTOR MAIL ADDRE55 CITV ZIP PNONE STATE LICENSE a <br />�Uerl0.lc` Sti.ee�.Q�-�Q �ta4.z -�Sl� ac-/1l: �PcQwtand 4bAsz BSS—/3a�{ <br />PLUMBING CONTRACTOR MAIL ADDRESS CI7V ZIP PMONE $TAT�L��y$�� � O�fr� <br />r� 1/ ic <br />CONTflACT PRICE OF WORK O D <br />��531— <br />�ESCRIBE WORK AN� SOUARE FOOTAGE <br />PROPOSEDUSEOFOUI�DING J <br />�A.n�.{� A-recL <br />LEGAL DESCRIPTION OF PflOPEFTV �SHOWN BEIOW OR AiT�CH TWO GOPIES� <br />�or eiaK oF <br />PAFCEITA%ID.NUMBER <br />CONSTRIICTION LO�N LENDER. A�URESS. TELEPHONE NUMBER <br />PLUMBING <br />NO. TYPE OF FIXTURE OR <br />WATER CLOSET (TOILET) <br />SHOWER <br />KITCH[N SINK & DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER _ <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFIOW PREVENTERS <br />ROOF DRAINS—RAINLEADERS <br />FOR OFFICE USE ONLY: <br />FRONTSET�ACK REARSETBACK <br />USEZONE <br />TYPE OF CONST. <br />SIZE OF BLOG. <br />OCCUPANCYLOAD <br />REASON <br />INTANE BY <br />FEE <br />SUB TOTAL 3 <br />PERMIT $ <br />TOTALFEE $ <br />LOT AnEA <br />NO.OF STOpIES <br />FIflE SPRINKLEFS REO'� <br />FIRE ALAR61 pE00 <br />P�ANS APPROVED BY <br />onre <br />SIDE SETBACK <br />NO, <br />I HEREBY CERTIFY THAT I HAVF. READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL 8E COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATI!JG CONSTRUCTION OR THE <br />PERFORA4ANCE OF CONSTRUCTION. TNAT I AM AUTHORIZED BY THE <br />OWNEF OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br />cirveusincssucer�ser+o. U„Z[a��•s� <br />MECHANICAL <br />N0. TYPE OF EOUIPMENT <br />A/C—A/HNDLG UNITS—H.P. v, <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE (WOOD BURNING) <br />FIREPLACE INSERT <br />HEAT PURhP <br />GASPIPWG /Q� �-}- <br />EXHAIUT FAN <br />NUAI6ER <br />�/ <br />❑ YES ❑ NO OUILDING <br />OLLOiANLY 1'A�ipY![LU!lGU�1115 � <br />cnouv PWMBING <br />9ASEMENT MECHANICAL <br />❑ ves ❑ No <br />HEIGHTIIMITAT10N ADDITIONAL PLAN CHECK <br />OTHER <br />STATE BUILDING SURCHARGE <br />CITY OF EUERETf PUBLIC WORKS <br />LOCALSALES <br />TAX COUE IS 3105 I TOTAL <br />� <br />SUB TOTAL $ /(/U ; ' <br />PERMIT $ � � � <br />'fOTAL FEE S ' � <br />RECEIPT NO. <br />i <br />1 <br />� <br />� <br />� <br />� <br />