Laserfiche WebLink
APPLI�ATIQ'�' FOR CONSTRUCT�N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEM: �J GAS ❑ELECTRIC J <br /> BUILDING DEPARTA9E_NT <br /> 259•8810 <br /> ! i DEMOLITION �7 COMBINATION ❑ BUILDING iJ MECHANICAL ', ;PLUMBING i=1 SIGN <br /> OWNER MAILAUDRESS GITV 21P PHONE <br /> y:,,�rir-zc� � /fi=/�i/ �/�.Cl �JiLli/L'CtlCi':� �f[.__ 1-LS=�I�%l �S'2(�7i l �C�� ZS<5'��� 7 <br /> TENFNT MqILA�DRE55 CITV ZIP PMONE <br /> ARCNITECTORDESIGNER MAILADDRE55 GTV IIP PHONE <br /> GENERALCONTRAGTOR MAILA�JRE55 GTV 21P PHONE STATELICENSE� <br /> MECHANICAL COYTRAGTOR MAIL ADDRESS GTV ZIP PHONE STATE UCENSG e <br /> PLUMBINGCONiRACTOR MMLADDRESS CITY IIP PHONE STATEIICENSEY <br /> , r_ <br /> CONTRALT PRICE OF WORK ' <br /> DESCRIBE WORK AND SOUARE FODTAGE INVOLVEU CONTACT PEFSON AND PHONE NO. <br /> _L�.ve�E !).;aln,� �}J�s Piicnl S._i°:��� 'nJ 'm F- 't (C��i ?CG - 87 <br /> �v Si�Wi=i� TiU'�TN[L �H���/' /'-c'F' S�.nr s✓s'r.�� <br /> Mn�.r W.9SHR L di cot i HEREBY CERTIFY THAT I HAVE READ AND EXAMII'ED THIS <br /> PROPOSEDUSEOFBUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND COHRECT.ALL <br /> RC�; - v��� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGALDESCRIPTIONOFPROPERN�SHOWNBELOWORATiACHTWOCOPIES� WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or e�ocK oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> � PARCEI iAX I D.NU'ABER CONTRQCTORS LAW 1827 9B.ZOO WAC. <br /> ' CONSTPUCTION LOAN LEN�EP.ADDRESS.TELEPHONE AUMHER �I ° <br /> 3 � <br /> PROJECT ADDRESS s n�ac oetc — <br /> � SI00 6��wNwecD 13J.i aivxusrt+essucervscr�o - <br /> PLUMB�NG MECHANICAL <br /> NO. TVPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � NC—FVHNDLG UNITS—H.P. , <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> ---�-- <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M ; <br /> SHOWER ' CLOTHES DRYERS � <br /> KITCHEN S�NK 8 DISP ; VENTILATION FAN ; <br /> � DISHWASHER � RANGE HOOD � <br /> LAUNDRY TRAY ; WATER HEATER � <br /> CLOTHES WASHER WOOD SiOVE � <br /> �— <br /> URINAL ; METAL FIREPLACE(WOOD BURNING) <br /> DRINKING FOUNTAIN � FIREPLACE INSERT ; <br /> FLOOR DRAIN � HEAT PUMP � <br /> BACKFLOW PREVENTERS � GAS PIPING <br /> ROOF DRAINS—FAINLEADERS � EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) ; <br /> � <br /> � <br /> SUB TOTAL $ ; SUB TOTAL S ' <br /> PERMIT 5 �C � PERMIT $ <br /> TOTAL FEE $ '� TOTAL FEE $ �— <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBACK REARSETBACK SIDESETB�CK PLFNCHECKNOMBER FEE RECEIPTNO. <br /> USEZONE LOTAREA VACANTS�TE FEES VALUATION FEE <br /> ��:� YES , NO BUILDIN6 � <br /> 1VPEOFCONST. NO.OFSTORIES ottuoqrytv 6aorprypiiNcu4u5 <br /> eeeuP pLUMBING ' <br /> SIZE OF BLDG. FIRE SPRINKLERS REO'D BASEMENT MECHANICAL � <br /> ❑ YES - NO , <br /> OCCUPANCV LOAD FIRE AURM REO'0 HEIGHT LIMITATION ADDITIONAL PLAN CHECK i <br /> I OTHER � <br /> REASON �- <br /> S1ATE BUILDING SURCHARGE i <br /> MTANE BV PLANSAPPROVEO BY CITY OF EVEHETT PUBLIC WORKS � <br /> LOCAL SALES ' <br /> or„E TAX CODE IS 3105 rorn� 9 � — <br />