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APPLICATIO".' FOR CONSTRUCT"'�N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: GAS ❑ELECTRIC ❑ � <br /> 259-8810 <br /> i DEMOLITION � COM8INATION BUILDING MECHANICAL I PLUMBING SIGN <br /> OWNER MAILADDPESS CITV ZIP PHONE <br /> 1-�Cc�.-� � Sarsc L 350�. Caa�:cs p�c 'Y2 ��u�ti� wasl,. � 8ao i Zs2-1�4 � <br /> 7ENANT MAIIAUURESS CITV ZIP PHONE <br /> ARCNITECTORDESIGNER M!ILAODRE55 CITY ZIP PHONE <br /> 7M'P2r�sto�v ��Sc�N 241� C-CoL F�n"''h �z C�2e�. 2$'Z RZOo <br /> GENERALCONTRACiOB LY�iLAUDRESS CRY ZIP PHONE STATEUCENSEt <br /> ��,,.� E(ec�i�,t CaxS�f. 1�0.3oX �4(o MUll�l��o ��/�. `lb'd7s` 355-23�l7 C C Z3Z DJ � <br /> MECHANICAICONTPACTOR MAILAODRESS CITV ZIP • PMONE STATELICENSE• <br /> PLUM9ING CQNTRACTOH M�IL ADDRESS CITY 21P PHONE STFTE UCENSE e <br /> CLASSC�-'NURK <br /> � � NEW i �� .4DDITION �, ALTERATION � REPAIR �. DEMOLITION . '�JODSTOVE/FRPL INSERT . BUILDING RELOCATION <br /> p �'J� � CONTACT PERSON AND PMONE NO. L-}. <br /> CONTRACTPRICEOFWORK � p � (�O S��J�a 1�L=C R` 3SS-2�91 <br /> DESCRIBE WORK AND SOl1ARE FOO?AGE I VOLVEO <br /> Woo� �t7,•�nE S � �,wH,l R�5 I SO� <br /> PPOPOSE�USEOFBUILOING I I HEREBY CERTIFV THAT 1 HAVE READ AND EXAM�PIED THIS <br /> S-1 N'� LC �,AM�Lti Z�=�Q�✓cL APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGRLDESCRIPTIONOFPROPERTV�SIIOWN ELOWORATTACHFOURCOPIES� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> WORK WILL BE COh1PLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or 3 eiocK �_ oF �d y �ZN� RDD NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> � � � y. AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> ��� OTHER STATE OR LOCAL LAW FEGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THhi I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> -- APPL�CATION IS MADE AND � COMPLY WITH THE STATE <br /> CONTiiACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> � 3a -a 9- �' �c�+ <br /> x ��--- (0-�-5'Z <br /> PRQIEC7AOURESS� 5 ntUnc oetE <br /> '3�y � �RtP'A A`�'G- cirreusmEss��ccr+sEno <br /> PLUMBING MECHANICAL <br /> N0. TVPE OF FIXTUHE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> 'a WATER CLOSET(TOILET) NC—FUHNDLG UNITS—H.P. <br /> 1, BATHTUB '- 1, FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) �Q �- (d UNIT HEATERS—B.T.U. M _ � <br /> j, SHOWER i " 1 CLOTHES DRYERS ' <br /> 1 KITCHEN SINK 8 DISP <" ' ,'Z VENTILATION FAN � <br /> DISHWASHER � ' - 1 RANGE HOOD <br /> 1 LAUNDRYTRAY � 1 WATER HEATER <br /> 1 CIOTHES WASHEP. � - CS WOOD STOVE <br /> 0� URINAL 1 METAL FIREPLACE 8 CHIMNEY GNS <br /> DRINKING FOUNTAIN � FIREPLACE INSERT <br /> QI FLOOR ORAIN �l HEAT PUMP <br /> d 8' :KFLOW PREVENTERS ; Z GAS PIPING � <br /> ROOF DRAINS—RAINLEADERS ',]. EXHAUST FAN � <br /> SINK(SERVICE—BAR.ETC.) � <br /> �' O � !!U <br /> i �� <br /> SUB TOTAL 5 U ' ' SU8 TOTAL 5 <br /> PERMIT 5 T PERMIT $ <br /> TOTAL FEE 5 SU� � TOTAL FEE S ' <br /> FOR OFFICE USE ONLY: �•��'' <br /> FRONT�C� REARSETBACN / SIDESETOAGK PLANGMECKNlIMBEF FEE AECEIPTljO/� <br /> ,� ��, <br /> USE ZON LOT RPEA VACpNi SITE FEES VALUATION FEE <br /> � BUILDING Qjg.� ' .)� <br /> TYPEO�LONiSRIIOWABIE TYPEOFLONSfACiURI sC�vtMGr 6oaIMIlUMGuxni --� � <br /> r.�wv � pLUMBI4G SO � � <br /> SRE oF BLOG 5 f �, NO.oF STOR�ES DaSEM_NT MECHANICAL Q ' � <br /> /7N6 S Z p � <br /> OCCUPrWCVIOAD FIRESPRNKLERSREOD NEIGNiUTAITATIqN ADDITIONALPLANCHECK ' <br /> / <br /> �O SPRINKLER � <br /> REASON ORSPRINKLERS <br /> STA7E�UILDING SURCHARGE (� <br /> IN7AKE BY PLANSAPPPOVEO BY CITY OF EYERETT PUDLIC WORNS � � �n% <br /> LOCALSALES <br /> ��-� TAX CODE IS 3105 rorn� /.�7 ; � <br />