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APPLICA,TIOl�FOR CaNSTRUCTI�I PERMIT �✓� <br /> ��1 TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT � HEATING SYSTEM: U GAS ❑ELECTRIG J ____ � <br /> 259-8810 <br /> � i DEMOLITION I l COMBINATION _��BUILDING MECHANICAL I I PLUMBING L 1 SIGN <br /> ONTlGR M�II�DDFE55 Cltv Iio vrpNE <br /> Tff� BoEI�ly Go. � 1� o. 60X 3707 M s OF-'1 y,fERTL�, �✓A. 9SiZ4 266-3sG3 <br /> tFNANT M�M1�ODRESS GITY 2iP PHONE <br /> S A-n7C AY O L�+N67L <br /> �PCHi7ECTORDESiaNER MAII�DORE55 pTY iiP CHpNE <br /> $E�c eNa r,�Eet2s <br /> Gf.NER�ILONiB�CTOR MMLRODRE55 f,itv IiP PMM1l ST�TEIIGENSEI <br /> ��NGlL ��`/.DUSTKiA�- <br /> MEGM�N�C�I CONTRACTOF M�II�D'JRESfi :iiv zlo vHpNE ST�TE LICENSE� <br /> PLUMBINO CONTR�CTOR MeIL�ODAE55 Crtv zn' PMOHE Si�TE LICENSE r <br /> CONTR�CT PRIGE OF WpRK <br /> Z D� 000 <br /> DESCRIBE WO�It I.ND SOU�RE�OOT110E�NVIXVFD CONT�GI PERSON�ND PNONE NO <br /> --s�.'-tc` "L-- LF��Ngn.D f}57'�1(30R$K I-- 'LGL—?SL3 <br /> —_ i HERFBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSED USE OF BU�ID�NG qppl �ATION AND HNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> C2(W S��T�� PROVISIOVS OF LAWS AND OROINANCES GOVERNING TH�S TVPE OF <br /> LEOAIDESCqIPipNpFPppPFRiV�SHOWNBElOW0�4}TqGMTWOLOPlE51 wOiiK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN Oq <br /> NOT THE GRANTING OF A PERMIT DOES NOI� PRESUME TO GIVE <br /> ���— fl��'" � ` AU�40RIiV TO VIOIATE OF CAIJCcL THE PROVISIONS Of ANV <br /> i OTH�R STAiF OR IDf.AI LAW REGULATING CONSTRUCTION OR THE <br /> '--"— "------ --"" "'�'---------"---- PERFORMANGc OF CONSTRUCTION. THA7 1 AM AUTHOFIZED BV THE <br /> OWNER OF THIS Pf10PERTV TO PERFORM THE WOHH FOR WHICH <br /> �-- ------------------ �--- �---��------- --- A?PLICATION IS MADE AND I COMPLV WITH iHE STATE <br /> ��ACFL TAY 1 D NUMBEp CONTRACTORS LAW IB 27 qCW AND 2P6200 WAC <br /> LONS�RUCTqNLO�NLENDER.�DFNES$ TELCPNONENIIMIiFR � f��( �� / ; ��'/C� � /� ///C�� <br /> .. 'F . � PiM�.%—�' <br /> PHOJECTAUDRES/S� /��+ /f 5.,""•""' � n•�� <br /> 3��� �• {//Sy�I�� �r y� C�iYBII[i415[12[MSfMI <br /> PI.UMBINO MECHANICAL <br /> HO. i VF�OF FIXTURF.OR ITEM FEE N0. TVPE OF EOUIPMENT FEE <br /> WAfER!,9.OSET(TOII FT) AiC—AiHNDLG UNITS—HP. —T <br /> BATHTU? FORGED AIR SVSTEMS—P.TU M E A <br /> LAVA1pF I(�VASF'BASINI UNIT HEATERS—O.TL. M <br /> SH0INEF CLOTHES DRVERS <br /> KI7C�IEN,iINK 6 OISP VENTILATION FAN <br /> DISHWASHER FANGE HOOD T— <br /> LAIINDRV TRAV WATER HEATE�� <br /> CLOTHES WASHER WOOD STGJE <br /> URINAL METAL FIREPIACE�V.00D BUR�JING� <br /> DqINKl4r POUNTAIN FIFEPLACF INiFFT <br /> fLOpR ORAIN HEAi PUMF � <br /> BACKFLOW PREVENTERS GAS P'PING <br /> FlIX1F DfiAINS—FAINLEADERS EXHAUST Pl.�' <br /> I _ 5'4K(SFRVICE—BAq,ETC.) _ <br /> — — -- +— <br /> SUB TOTAL E SU6 TOTAL S <br /> PERMiT E PERMIT S <br /> IOTAL FEE E TOTAL FEE 5 <br />� FOR OFFICE USE ONLY: <br /> FRONiSETB�CN RE�pSETfl�CN SIDESETB�CN NUNCHECMNIIMBEP FEE RECEIPTNO <br /> use zew� ioi�eee vee�Ni srte FEES VALUATION FEE <br /> __ � � VES �� i NO BUILDING �J/ °�' �]07 ;� <br /> (YP!B CONSI NO OF STOHIES occuo�xr. Mu n owlmw an��s --- — �� <br /> wwo p�UM81NG <br /> ✓-�✓ � 11-1 — <br /> Si2FfYAlf%� ��16°�YNINNtFASPpq'D O�SF.MENI MECHANICAL �— <br /> 7�ty' � fu) � ,:,� vES � ------------- — <br /> � --'--'— ADDIiIONAI.PLAN f.HECH 9 <br /> OCf,I1P�NCYI.OAD iIREA.�Rs'nE011 111'Jf1111iMiIAnrN1 � ' S <br /> __��_N� _ _ _ OTHER—'______'—_.._—_ i <br /> 9E�Sd/ ---____ ' '_ _"__�_ <br /> SiATE BWLDING SUR�NARGE (� ;5(7 <br /> �N1�NE BY P�,1N5 PAOVEO BY �j CITY OF EYERETT PUBLIC WORRS <br /> �� LOCAL SALES <br /> o�,F ��_ ��_ !j TAX CODE IS 3105 tor�► <br />