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APPLICATIC�I FOR COMSTRUCT�)N PERMIT ���� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: U GAS ❑ ELECTRIC ❑ <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING x MECHANICAL PLUMBING SIGN <br /> ONRJER MAILIIDDRESS CITY Z? PHONE <br /> CNL-.t Rrx� v.�4. 3io� ��i��/�—S L�i-��__, ,— oJn. _ <br /> TENFNT MAIL AUDRE55 GITV ZIP PHONE <br /> . lM AL`IL �G�.�%C+=-t.� <br /> �EZyIUGdre>L�1G�,`. �-V-Ui�� . �� . , .. Z�Z.-`-t�ob ��..a 6u�i v�•4�*.� <br /> ARCHITECTOR�ESICaNER �ti�'lA�[]RE55 CITV 21P PHONE <br /> GENERAL CONTRACTOR MAIL ADDNE55 CITY ZIP PNONE STATE LICENSE� <br /> n._L . 5��.�S �i=-2 C:�'»Si. 123�3 c_�12�5 .,:f MUIGILTEO ,,aA 982�5 -142-454-� <br /> MEGHANIGAL CONTRACTOR M41L ADDRESS _ CITY 21P_ PMONE STATE LILENSE Y �_Z.'�k• <br /> /� ^-� • Pn.Hoh �[�4�5 <br /> /a1�V/�Y'-L�17 '�"�2� 'nZ�Ti�T�ot�+ ��D�N�/�W' `1Kr,-tZ 9'�j5-SG�-1 hD�lAr.�Fi' ��',46(c__ � <br /> PLl1MBING CdJTRALTOR MAIL ADDPESS CITY ZIP PHONE STATE LICENSC R <br /> GLASS OF WORK <br /> � NEW }C ADDITION ALTEFATION REPAIR DEMOLITION � WOODSTOVE/FRPL INSERT � BUILDING RELOCATION <br /> CONTACT PEFSON AND PHONE N0. <br /> �.� ����j <br /> CONTRALT PRICE OF Y/ORN � ����- �"�� �. - Y �TCJ3��JCO��� <br /> DESCRIBE WORN AND SOUARE FOOiAGE INVOLVEO <br /> iusrn�� G., o�.��E Jn� - r- z C,4,�.nn� <br /> PR/OP1OSEOUSEOFBUILDING � ��K�� � i HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> l>4� 'ST/-�i�o� �-��� eT APPLICATION AND KNOW THE SAME TO BE TRUE AND CORFECT.ALL <br /> LEGALDESCRIPTIONOFPROPERTV�SMOWNBELOWOfiATTACMFOUR wes� � PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTVPEOF <br /> . / WORK WILL BE COf�1PLETED WITH WHETHER SPECIFIED HEREIN OR <br /> LOT BLOCK OF �' NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> ��� �q���,.���� OTHER STATE OR LOCAI LAW REGULATING CONSTRUCTION OR THE <br /> PERFnRMANCE OF CONSTRUCTION.THAT I AM AU7HORIZED BY THE <br /> O'iJNER OF TfilS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APr^I.IC/�TION MADE AND I COMPLY WITH THE STATE <br /> CONTRACT W 18.27 RCW AND 296.20 WAC. <br /> �� / <br /> �05 a2ohs�...:r.-1 �nv G, X __--.. [- - f 3-�z�-`+S <br /> PR0.IECTADDRESS s ntUne onif <br /> DZ4�0� <br /> ;ur nus��+ess i¢cr�sr rva <br /> PLUMBING MECMANICAL <br /> N0. TYPE OF FI%TURE UR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � A/C-A/HNDLG UNITS-H.P. _�_ <br /> BATHTUB ; FORCED AIR SYSTEMS-B.T.U. M E.A. ' <br /> LAVATORV(WASH BASIN) � UNIT HEATERS-B.T.U. M � <br /> SHOWER CLOTHES DRVERS � <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN ; <br /> DISHWASHER RANGE HOOD � _ <br /> LAUNDRY TAAY ; WATER HEATER ' <br /> CLOTHES WASHER WOO�STOVE <br /> URINAL ' METAL FIREPLACE 8 CHIMNEY � <br /> DRINKING FOUNTAIN FIREPLA�E INSERT � <br /> T <br /> FLOOR DRAIN <br /> � 'tC'nf PUMP � <br /> BACKFLOW PREVENTERS ' GAS PIPMG ; <br /> ROOF DRAINS-RAINLEADERS �_ EXHAUST F�N � <br /> _�— <br /> SINK(SERVICE-BAR.ETC.) : <br /> � <br /> � —� <br /> � <br /> � <br /> � � <br /> � � <br /> SUB TOTAL $ � SUB TOT�L $ ' <br /> P'RMIT $ PERMIT $ � <br /> TOTAL FEE $ TOTAL FcE $ ' <br /> FOR OFFICE USE OI1LY: <br /> FRON75ETB�GN REAR SETBACK SI�E SE43ACK PLAN GHECK Nl/MBER FEE RECEIPT NO. <br /> � � [ ''' C :' <br /> USEIONE IOTpREA VAGANTSITE FEES VALUATION FEE <br /> BUILOING � <br /> tVCEO�CONiS.f.ILOWABLE tYPEOfGON57.ACtUAI xa�ex[r r,00�UwE'.u�icw:i�s i <br /> v c ouo pLUM81NG i <br /> S���FQLDCy` NO.OFSTORIES B SEMENi l MECHANIC4L � <br /> ��V 1` ' <br /> �,L a ' <br /> � A�DITIONALPLANCHECK ; <br /> OCGUPANCYIOAD FlRESPRNKLERSRWD ��.EI�NTCMITATION <br /> � 4�^ QEI.UGC ,�, — _ SPRINNLER <br /> � � <br /> REa$ON FOR SPPMKlERS �� � � O I' — I <br /> �� �V�PS � r��~ STA7E EUILDING SURCHARGE i <br /> i <br /> INiAKE BV �'LANS APPROVE�BY CITY OF EUERETT PUBLIC WORK$ � <br /> �� LflCAI.SALES <br /> 4I3 9 y TAY,CODE IS 3105 To'�A� ___ <br /> �..._�--����. <br />