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APPLICATIC J FOR GONSTRUC7 .JN PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT � <br /> BUILDING DEPARTMENT HEATING SYSTEA4: ❑GAS ❑ELECTRIC ❑ . <br /> 259-8810 <br /> f_l DEMOLITION Li COMBINATION i I BUILDING ;_IMECHANICAL I_1PLUMBING � SIGN <br /> OWNER MAIL AOURE55 ��n. <br /> TE NT ��M'CS �� � WA. =IP PHONE , <br /> �° 4s3- o3iy <br /> MAIL ADDRES$ ��T� <br /> �nllGO 6/2,Os t/�✓Girv��'y'��I"4z3 E�/�al/OKCP�IA��VONE6s�� -���� <br /> ARCHITECTORDESIGNER MAILAOORE55 ��n, ZiP <br /> `f PNONE <br /> GENERALCONTRACTOR MAILADDRESS CITV <br /> SI I,n/]C/ � Z�P PHONE STATELICEMSEs <br /> YY(/F�Qi�.��l� �N� �7�3�' ��i� /�/ S eq- S�f2 8 7 3 7 <br /> MELHANICALGpryTRAGTOfl MAILADDRESS ��n. Z�P <br /> `� PHONE STATE UCENSE e <br /> PLUMAINGCnNTRACTOR Mr11LADDRESS CITY <br /> Z�P PHONE STATE�ICEIlS[t <br /> CUSS OF WORK � <br /> fJ NEW I 1 /,DD:7'IpN f I ALTERATION , I REPAIR I � DEMOLITION '.�� WpODSTOVFJFRPL INSERT I�1 BUILDING RELOCATION <br /> CONTACT PERSON AND PHONE NO. <br /> CONTflACTPRICEOPHOF, . /�/� w� �., _ i � � /� � <br /> DESCFIBE WORK AND SO'.ARE FOOTAGE INVOLVED � e IL .�=4�i�'�� � <br /> _''' <br /> �ti� <br /> PRO OSEDU OFN ILDIN6 � <br /> i HEREBY CERT�FY THAT I IiAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRl1E AND CORRECT.ALL <br /> LEGALDESCflIPT10 OFPROPERTV(;.40WNBELOWORATTACHFOl1RCOPIES� PROVIS�ONSOFLAWS.4NDORDINANCESGOVERNINGTHISTYPEOF <br /> �or B�p�K oF WORK WILL 8E COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHEH STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTNORI2ED BY THE <br /> OWNER OF THIS PROPERTY TO PEFFORM THE 1NORK FOR WHICH <br /> AP?LICATION IS MAC� AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 7827 RCW AND 296.200 WAC. <br /> PR0.1E TADDRESS sc tU E I�I �A�I /�—�. <br /> 3 ����� ��� CItYBUS�H[SSIICFN5EN0 <br /> PLU BING MECHANICAL <br /> NO. TYPE OF fl%TURE OR REM FEE NO. TYPE OF EOUIPMENT <br /> � WATER CLOSET(TOILET) FEE <br /> ' A/C—A/HNDLG UNITS—H.P. � <br /> BATHTUB ' FORCED AIR SYSTEMS—B.T.U, M E.A. � <br /> LAVATORY(WA5H BASIN) � UNIT HEATERS—B.T.U. M � <br /> SHOWER � CIOTHES DRYERS � <br /> KITCHEN SINK 8 DISP ' VENTILATION FAN � <br /> DISHWqSHER � RANGE HOOD � <br /> LAUNDRYTRAY ' WqTERHEATER , <br /> �. CLOTHES WASHER � WOOD STOVE <br /> URINAL ' METAL FIREPLACE&CHIMNEY , <br /> DRINKING FOUNTAIN � FIREPLACE INSERT i <br /> FLOOR DRAIN � HEAT PUMP � <br /> BACKFLOW PREVENTERS � GAS PIPING <br /> ROOF DRAINS—RpINLEADERS � EXHAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) � ' <br /> � , <br /> � , <br /> � <br /> � T <br /> SU8 TOTAL $ ' SUB TOTAL $ � <br /> PERMIT $ � PERMIT g ' <br /> TOTAL FEE $ ' TOTAL FEE $ �— <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBACK REAR SETBACK SI�E SETBRCK PLAN CHEC NUMOER FEE RECEIPT NO�{�J <br /> USEZONE � ��� ���� O�/S� <br /> AREA VACANTSITE FEES VALUATION FEE <br /> � � ' 3a � <br /> BUILDING n � <br /> TYPEOFCONiS.RIIOWABtE TYPEOfCONSt,AC10AL xcurexcr xoorrnvFuiuGuxits y(J 'On <br /> GpWP � PLUMBWG T ' <br /> SIZEOFBLDG. NO.OFSTORIES BASEMENT '�—�- <br /> MECHANICAL � <br /> OCCUPANCVLOAD FIRESPRNNLERSREO'D HEIGHTLIMITATION A�DITIONALPLANGHECK i <br /> i <br /> Ll C SPRINKLER ' <br /> REASON FOR SPfI1NNLERS <br /> i <br /> STATE BUILDING SURCHARGE � <br /> 'S�� <br /> INTAKE BY PL NS APPROVEDOV CITY OF EYERETT � <br /> M" LOCALSALES PUBUCWORKS , <br /> S _Z2 �14 TAX CODE IS 3105 TOTAL <br />