917 COLBY AVE 2016-01-01 MF Import

APPLICATIO�' FOR CONSTRUCTC,N PERMIT � TO BE COMPLETED IN BLACK INK—PLEASE PRINT HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ BUILDING DEPARTMENT 259-8810 C] DEMOLITION �"] COMBINATION �� /�%��X ooa�/% C�O�C BUILDING iENANT MRIL ADURE55 �� ARCNITECT OF DESIGNER M�IL �DDRE55 ��TY L' MECHANICAL �J PLUMBING ZIP PNONE �tv/ 3� 6 —7'r/7.f :�P PHONE GENEPALCON ACTOR MAILA�DRE55 GTV ZIP PHONE STATELICENSE� �si� /��,�,� �yoz -6�'�uF �!E. �yA�ys✓��[F f�z7a 33y-Ob�f [AKEtN,eo96fS3 MEGMANIULCONTRRCTOP M�ILAD�RE55 GiY 21P PHONE STATELICENSE� PLUMBMGCONTR�CTOR MARADDRE55 CITY 21P PHONE STATELICENSEI ❑ SIGN CONTR T PRICE OF WORK �22 0 � DESCRIBE WONK AND Sd1ANE FOOT�GE INVOLVED PROPOSE�SE,QF BUILOING S C� LEGAL DESCRIPTION OF PROPERTY ISMONM BEIOW OR ATTACH TWO COPIES) LOT BLOCK OF PARGELiRXI.D.NUMBER CONSTPUCTION LOAN lENOER. ADORE55, TELEPNONE T�/pE OF flXTURE OR ITEM WATER CLOSET (TOILET) BATHTUB LAVATORY�WASH BASIN) SHOWER KI?CHEN SINK & DISP DISHWASHER UUNDRV THAY CLOTHES WASHER URINAL DRINKING FOUNTAIN FLOOR DRAIN BACKFLOW PREVENTERS ROOF DRAINS--RAINLEADEHS FOR OFFICE USE ONLY: FRONTSETBAGN AEAflSETBRCK USEZONE LOTANEA tYPE OF CONST. S2EOFBLDG FE450N TOTAL $ NIT S FIRE SPRINKLEN$ REO'D PLANS APPROVEU BV DATE WNTIICT PERSON RND PHONE NO. I HEREBV CERTIFV THAT I HAVE READ AND E%AMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND OHDINANCES GOVERNING THIS TYPE OF WORK WILI BE COMPLETED WITH WHETHEfl SPECIFIED HEHEIN OP. NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON�TRUCTION OR THE PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I COMPLY WITH THE STATE CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. � A/�AIHNDLG UNITS--H.P. FORCED AIR SYSTEMS-9.T.U. UNIT HEATERS—B.T.U. M CLOTHES DRYERS VENTILATION FAN RANGEHOOD WATER HEATEF WOODSTOVE METAL FIREPLACE (WOOD BUF FIREPLACE INSERT GAS P�PI� EXHAUST SIDESETB�CK PUNCHE NNUMBEF FEE 3 0� VRCRNT SITE FEES ❑ YES ❑ NO BUILDING pCcuvexcr xoaowElOxcuxrts �P°�v PLUMBING BnSernErvT MECHANICAL u YES ❑ NO MEiGNi uMiTArior� ADOITIONAL PLAN CHECK OTHER STATE BUILDING SURCHARGE CITY OF EYERETT PUBLIC WORKS LOCAL SALES TAX COOEIS 3105 TOTAL �� Yi SUBTOTAL S PERMIT $ TOTALFEE $ ' RECEIPT NO. VA UA710N FEE �lo a 3 '� a� � ;