Laserfiche WebLink
APPLICATIC� FOR CONSTFiUCT'iN PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: f,J GAS IJ ELECTRIC U <br /> 259-8810 <br /> CI DEMOLITION f7 COMBINATION I 1 BUILDING �ECHANICAL I l PLUMBING I-I SIGN <br /> ��s�m �� ��c�,���� ���, � .�,�e��� , z„����y �,.oN� - <br /> r� i ra �nn nE s �����I�I�L�CII �N CI+L�L� IU�P�"� <br /> ABCNIT C JflDESIGNER IAMlA0DRE55 I7Y ZIP PIIONE <br /> GEN 'A�NiRnCTOR ���All A�RES C��1 p,� ��� „^ C� I.,,r�) „�� ��� q�a��ONG STATE UCCNSE� <br /> �; _'.. � �bJ � <br /> E H4NICAlCONTR�CiOR Ml.ILADORESS �� '�CITY IP PHO�fE � /ST�IE ��IE II A � <br /> � �� U { <br /> PLUM91 GC RRCTOR M�IL�O�RE55 CITV ZIP PNONE ST4TEU ENS a <br /> LONTPACT PFiICE OF WORK �� �� � � <br /> OESGRIBE WORK ANO SOUARE FOOT�GE INV E� �ONTACT PERSOPI�ND PHONE NO. <br /> -r. s _ a �� s Zl � �- �1�� 1 <br /> �o �����J�_SVS .� I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSED USE OF OUILDING APPIICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF , <br /> LEG�LOESCRIPTIONOFPROPEfi7Y�5HOWNBELOWORATi�C1iTlVOGOPIES� WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEfiEIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or BLOCK oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> � OTHER STATE OR IOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORM1IANCE OF CON:�TRUCTION.THAT I AM AUTHORIZED BY THF <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHIC <br /> APPLICATION IS MADE AND I COMPLY WITH THE STAI._ , <br /> PAflCEL TA%1.0 NUMBEfl CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> CONSTRUCTION LOAN LENOER.40DRE55,TELEPHONE NUMOEfl � p� %{ I// //+// <br /> �ti �,r i���%Y <br /> ; PROJECT ADDRESS =K�n nE ���� / / <br /> e�rvouswcssucirvser . <br /> � PLUMBING MECHANICAI <br /> � NO. TYPE OF FI%TURE OR ITEM FEE N0. TYPE OF EQUIPMENT FEE <br /> ' WATER CLOSET(TOILET) � AiC—A/HNDLG UNITS—FI,P. � <br /> BATHTUB ; FORCED AIR SYSTEMS—L�.T.U. M E.A. y_ <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M <br /> SHOWER CLOTHES DRYERS <br /> KITCHEN SINK 8 DISP � VENTILATION FAN <br /> DISHWASHER � RANGE HOOD ' <br /> LAUNORYTRAY ; WATER HEATER ' <br /> � <br /> � CLOTHES WASHER � WOODSTOVE � <br /> � URINAL ' METAL FIREPLACE(WOOD BURNING) ; <br /> ORINKING FOUNTAIN � FIREPLACE INSERT _� <br /> FLOOR DRAIN HEAT PUMP ' <br /> BACKFLOW PREVENTERS ; GAS PIPING � <br /> ROOF ORAINS—RAINLEADERS � EXHAUST FAN ' <br /> SINK(SERVICE—BAR,ETC.) � <br /> � <br /> — � <br /> � ---T— <br /> SUBTOTAL S ' SUBTOTAL 5 _ U ' <br /> PERMIT $ � PERMIT S L <br /> TOTALFEE 5 ' TOTALFEE S <br /> FOR OFFICE USE ONLY: ' <br /> FRONTSETB�CK REARSETO�CK SIOF.SETO�CN PLAIJCHEGRNUMO[Il FEE IIECE��'iN0 <br /> y,s�J <br /> usezone �ornnen VAC�NTSITE FEES VALUATION FEE <br /> i� YES ❑ NO BwLDwG <br /> nr¢or coxs�. r+o.or sTonies oca,�,�c� Ho or oxuu�+r m���s — ; <br /> tnwv PLU6I�ING � <br /> i <br /> SIZ[OFOL�G. FNESCBINKLERSREOD 6ASEMEN� MECHANICAL � <br /> n vEs n No � <br /> � <br /> OCCUPANCYLO�O FIREAIARMREOD HEIGHTLRAITATION ADDITIONALPLANCHECK � <br /> � <br /> OTHLR � <br /> -�i— <br /> REASON � <br /> STATE BUILDING SURCHARGE � <br /> i <br /> INTAKE DV PLANS��PROVGO BV CITY OF EUERETT PU�LIC WOIiKS i <br /> LOCAL SALES � <br /> p�,� ThX CODE IS 3105 TOTAL ' <br />