Laserfiche WebLink
. -. <br /> - -- APPLICATIOrV FOR CONSTRUCT�ON PERMIT �N� , <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT j <br /> HEATING SYSTEM: U GAS ❑ELECTRIC !J _ <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING XMECHANICAL PLUMBING SIGN <br /> . OW�R M1��R/DDR[SS CIiY ZIP PHONE <br /> ;cu,.�/a�r� �/��S yy�tl�r� f�/trr/t �52�-`t'y77 <br /> � TENANi AIAILRD�RE55 LITY 71P PHONE <br /> ARCHIT[CTOR�ESIGNEH h1AILADORESS CITY IIP PHONE <br /> GENERRICONiRACTOR FIRILADDRESS CIiV ZiP PHONE STATEUCENSE� ,' <br /> l'J�� I <br /> MECMrW:CRL CONTRACTOR MAIL�pppESS ��TY ZIP PHONE STATE LICE1lSE• <br /> ��x -" VF �IJ !{u•R' a- lU�(OCo C;"�A�U�W-� /Y�N,E I„� `!�'27S S��VHO�=bL- I <br /> �"� PlUM81NGCONTNnCTOR MRILADORESS GITV 21P PHONE STAiCLICENSE <br /> a�v� <br /> C1A55 OF WORN <br /> tyC C] NEW '�. � ADDITION ' ' ALTERATION ��. REPAIR DEMOLITION WOODSTOVEiFRPL INSERT BUILDING RELOCATION I�I <br /> y^� L WNt�Gt PEfi50N AND PIIONE NO � <br /> � N� CONiHACTPRICEOF\VOFK +' /� J V <br /> � x� OE�OEWORKANOSOUAREFOOT�G�INVOWED <br /> oHd yN Ji� Gu< Fu2��,�r,� 4c✓kT,E�/�s� <br /> PROPOSEDUSEO uaoiNc i HEFEBY CERTIFY THAT I HAVE READ AND EXAMWED THIS <br /> �J APPLICIITION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> ��(� �EGALOESGRiPT10NOFFROPERtt�SHOWN0ELO1YOflATT�GHFOURCOPIES) PROVISIONSOFLAWSI.NDORDINANCESGOVERNINGTHISTYPEOF <br /> H WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> ay� ipT eiocK oc NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME i0 GIVE <br /> r X AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> �„�y OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> �y y H PERFORh1ANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> � �y OWNER OF THIS PROPERTY TO PERFORM THE VJORK fOR WHICH <br /> C^, �^ APPLICATION IS MA�E AND I COMPLY WITH THE STATE <br /> 3, [iJ� CONTRACTORS LA 1827 RCW AND 296200 WAC. <br /> C+1 <br /> H O[Ni� � <br /> x l <br /> FFQJCTADDRE55 ���,,//� � � �� e�� � �� �J< <br /> ���%C'W�.a/� rxvv�n55�¢i:s.•. � _ <br /> PWMBING MECHANICAL ^ <br /> � NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILET) A�C—A�HNOLG UNITS--H.P. <br /> � � BATHTUB FORCED AIR SYSTEMS—B.T.U. A1 E.A✓ � <br /> ��'' LAVATORV(WASH BASIN) UNIT HEATERS—B.T.U. M <br /> SHOWER CLOTHES ORYERS <br /> !.� .� KITCHEN SINK 8 DISP VENTILATION FAN <br /> �,i� DISHWASHER RANGE HOOD <br /> LAUNDRV TRAY WATER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> !w � URINAL IdETAL FIREPLACE 8 CHIMNEV <br /> ! DRINKING fOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP <br /> ' � BACKFLOW PREVENTERS ; GAS PIPING <br /> .,�0 I ROOF DfiA1NS—RAINLEADERS � ExHAUST FAN <br /> SINK�SERVICE—BAR,ETC.) <br /> � — _ <br /> SUBTOTAL 5 � ;—' <br /> � SUBTOTAL 5 '� — <br /> �I I PERMIT 5 PERMIT 5 � — _ <br /> TOTAL FEE S TOTAL FEE S �.�'� <br /> FOR OFFICE USE ONLY: <br /> ��� Fi10NT5EtBACK REARSETBRCK Si0E5EtORCH PLANCMECRNU�IBER FEE RECEi�TkO <br /> .� , n _3 <br /> usezone �oinaEn WCANTSITE FEES VALUATION FEE _ <br /> BU�LDING <br /> tvCEO�CONiSUIOW�BIE LYPEOfC0851AL711AL O[cc�u[+ nacicniwsG�'.'s - <br /> LRp10 � PLUMBING <br /> SizEOFBtDG. NOAFSiORIES BTSEMENi MECMANICAL '�� <br /> oCCUPANGYIWD FipESPRNK�EaSREOU NEIGHIIIMITniIDN ADDITIONALPLANCHECK <br /> SPRINKLEH <br /> il[ASpN FOR SPRINNLERS T <br /> STATE BUILOING SUq'HAPGE <br /> it11AeC0Y PWISAPPpOVEDBY CITYOFE�ERETT PU�UCWORN$ <br /> LOCAL SRLES <br /> TAX COOE IS 3105 TOTA� <br />