Laserfiche WebLink
APPLICATIC-1 FOR CONSTRUCT' 1,N PERMIT �✓� <br />TO BE COMPLETED IN BLACK INK-PLEASE PRINS' <br />BUILDING DEPARTMENT F+EA7ING SYS7EM: J GAS ,� ELEC7R�C J ___ ___ <br />259-8810 <br />�( DEMOUTION COMBINA'fION BUILDING MECHANICAL PLUMBING <br />OWNEN MRI�RU�HES: CITY ZIP PHONE �7s <br />/1%r• �,� ar/i 6.3U'� E �i«� � ''._.�L.a_�J�l�o 3 <br />TENFNT MAILAD E55 CIiV ZiP �MONE <br />FRCMREC�ORDESIGNER M�ILA�DNE55 (:ITV zl? PHONE <br />GENERALCONTqALTOR MAIL4DORE55 n CITV (IP PNONE�y��dSf�fEIICENSE� <br />erw� E.,k�J�•xs f' i�• �,r 3�s/ Sno��n.i.(_9ff�jc r S ��r� , <br />MGGM�NI AICONTq�CTOR I RAODPE55 � piv ZiW PHONE �LICENSE� <br />PIUMBINGCONTRACTOR MRIlA0�RE55 CITV IiP PNONE STQEIICENSE� <br />CONiR�CT PPICE OF VNRN /, <br />O� <br />/-! �f ,U <br />DESCRINE WORR oND SOUANE FOOUGE INVOLVED <br />Z� —o �'F /cv�o�.r/ � / <br />7�.«+r7 //n �5�.-y ' -2,/� <br />PRJPOSEO USE OF BUILDING <br />LEG�L DESCRIPT•ON OF VROPEh'Y �SMOWN BELOW OR ATTRCN TWO COPIE51 <br />LOT--- BLOCN — OF — <br />P�RLELTANI.O NIIM9ER <br />C JNTAC7 PERSON AND PNONf: NO <br />SIGN <br />� <br />I HEREBV CERTIFV THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND OF�INANCES GOVEFNING THIS TVPE OF <br />WORK WILL BE COMPLETEO WITH WHETHER SPECIF�cD HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PFlESl1ME TO GIVE <br />AUTHORITV TO VIOIATE OR CANCEL THE PROVISIONS OF ANV <br />OTHER STATE OR LOCAL LAW REGULATING CQNS7RUCTION OR THE <br />PERFOF67ANCE OF CONSTRUCTION. THAT � AM AUTHORI2ED BY THE <br />OWNEFi OF THIS PROPERTV TO PERFORM THE YVORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY Yl'ITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND ^86200 WAC. <br />ADDRESS. TELEPNONE NUMBER <br />c�-. �'/3� <br />//��l //�� sa r - o�*t <br />/ Y/LL�iiO //I' LIlYBUSM[ASIILlNSfM) <br />WATER CLOSET (TOIL <br />BA'fHTUB <br />LAYATORV(WASH BA! <br />ShOWF.R <br />KffCHEN SINK 8 DISP <br />DISHWASHEH <br />V�UNDRY THAV <br />CLOTHES WASHER <br />DRINKING FOUNTAIN <br />FLOOR ORAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEADERS <br />FOR OFf'ICE USE ONLY: <br />FRq1i5ETB�CR RE/RSELBACN <br />❑SEIONE lOT ARF.� <br />rrac a coxsr <br />OCCUP�NCYIO�D <br />FE�SON <br />INiANE BV <br />SUB TOTAI S <br />PERMIT S <br />FlHI[ SPPIfINLERS HEOD <br />FIRE �LANM REO D <br />PI.ANS ��PROVED BY <br />DR1E <br />NC—NHNDLG UN1TS—H.P. � <br />FORCED AIR SVSTEMS—B. i.U. M E.A. <br />UNIT HEATEFiS—B.T.U. M <br />CIO:HES nRVERS � <br />�':.NTILATION FAN <br />RANGEHOOD —� <br />WATER HEATEfl <br />WOODSTOVE <br />METAL FIREPLACE (WOOD BURNIMG) � <br />FIREPLACE INSERT ' <br />HEAT PUMP <br />GAS PIPING ; <br />E%HAUSTFAN � <br />SIDESETBACN PIPNCHFCF.NUMtl i n ^ <br />ua �� <br />wcnN* :rtE FEES <br />` � VES �� . NO BUILDING <br />OCCUC�Mfv NOqpMILiNGUMi15 — <br />cnnuv p�UMBING <br />B�SEMENf MECHANICAL <br />" �, VES � �. NO — <br />HEIGMTLIMIiATION ADOITIUNALPLANCHECN <br />OTHER <br />STATE BUILDING SURCHARGE <br />CITY OF EYERETT PUBIIC WORNS <br />LOCAL SALES <br />TAX COaE IS 3105 10TAL <br />fEE � RECFFiNO <br />