4727 W GLENHAVEN DR 2016-01-01 MF Import

APPLICATIC'�I FOR CONSTRU� �"")N PERMIT � TO BE COMPLETED IN BLACK INK—PLEAs;E PRINT BUILDING DEPARTMENT HEATING SYSTEM: GAS ❑ELECTRIC [� � 259-8610 ;7 DEMOLITION i7 COMBINATION ❑ BUILDING f iMECHANICAL �PLUMBING ❑ SIGN ONMER MAIL ADDRE55 CILY ZIP PNONE �ON1� _ S IM PSDn� �7a7 W. 6LEwNpV�rJpr � ��h2�iT��.JW qfi>o3� Clob) 1SJ, a.314 1ENANT AIAIL ADD 55 CITV ZIP PHONE � 11 ARCHITECTOFDESIGNER MAILADDRESS CIiV ZIP PHONE GENERRL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE UCENSE■ MECHANICALCONTRACTOR MAILADDRESS GITV ZIP PNpNE $TATEIICENSE• IZtJIQ�(uQtiiiN StaTtz $N�a— --wL . PWMBING LONTRACTOR MRIL pDDRE55 CITY ZIP PHONE STATE LICENSE/ CONTRACT PRICE OF WORK "7 o c o5� �= i 6u2�L UESG'16E WORK AND SOURRE OOTAGE INVOLVED CONTACT PCqSON AND PHONE NO. Q � i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS raoroseo usEQF B 0.0 NG qppLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL . '—� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF LEGALDESCFIPTIONOFPROPERTV�SHOWNBELOWORATTACHTVJOCOPIES� WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR � �or BLOCK oF NOL THE GRANTING OF A PEFMIT DOES NOT PRESUME TO GIVE � AUTHORITY TO VIOLATE OR CANCEL THE PflOVI510NS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORA7ANCE OF CONSTRUCTION,THAT I AM AUTHORIZED BY THE OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH PARCEL7AkIA.NUMBER APPLICATION I MADE Ai;D I OMPLY WITH THE STATE CO RS AW 1827 RCW A 296.200 WAC. CONSTRUCTION IORN LENDER,ADCRESS,TELEPHONE NUMBER � /� ��7� � PROJECT DDRESS {/�7 s�cn�ruac o,re � ��/ � CITY6USINESSLICENSENO PLUMBING MECHANICAL � N0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE WATER CLOSET(TOILET) � NC—A/HNULG UNITS—H.P. , BATHTUB ; � FORCED�IR SYSTEMS—B.T.U. M E.A. � - LAVATORY(WASH BASIN) I UNIT HE.�TERS—B.T.U. M ; SHOWER � CLOTHES DRYERS , � KITCHEN SINK 8 DISP ; VENTILATION FAN � DISHWASHER � RANGE HOOD , � LAUNDRY TRAY ; VIATER HEATER � � CLOTHES WASHER � N'OOD STOVE ' � URINAL ; METAL FIREPLACE(WOOD BURNING) � DRINKING FOUNTAIN � FIREPLACE INSERT _ � FLOOR DRAIN � HEAT PUMP , BACKFLOW PREVENTERS ; GAS PIPING � ROOF DRAINS—RAINLEADERS � EXHAUST FAN , SINK(SERVICE—BAR,ETC.) ; , � � I � � SUB TOTAL $ SUB TOTAL $ Q � — PERMIT $ � PERMIT g ; � TOTAL FEE $ ' TOTAL FEE $ � � � FOR OFFICE USE ONLY: FRONTSETBACN REARSETBRCK SIOESEIBACK PLRNCM��NUMBF.R FEE RECEIPTNO. y usezor+e LOTARE� vacnqisrte FEES VALUATION FEE ❑ YES ❑ NO iiUILDING ' i iYPEOFCONST NO.OFSTORIES Octuv�hcv xOwowtwHcuNrtS �p0°' PWMBING � SIZEOFBLDG. FIRESPRINKLEPSFEO'D BASEMENT MECHANICAL � ❑ YES ❑ NO �� OCCUPANCYLOAD FIRE qLARM REO'� HEIGHi LIMITqTION ADDITIONAL PLAN CHECK � OTHER i REASON i STATE BUILDING SURCHARGE � INTAKE BY PLANS APPROVED BY CITY OF EYERETT PUBLIC WORKS i LOCALSALES ' DATE TAX CODE IS 3105 TOTAL ;