Laserfiche WebLink
APPLIGATIC _J FOR CAN�TRUCT JN PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />HEATING SYSTEM: U GAS ❑ ELECTRIC U <br />BUILDING DEPARTMENT <br />259-8810 <br />r I DEM�LITION I I COMBINATION ' I BUILDING MECHANICAL ; l PLUMBING �IGN <br />MECHANICALCONTRAGTOR MAILADDRE55 CITV 21P PHONE STAIELICENSEp <br />PLUMBINGCONTflACTOR MAILADDRESS CITV ZIP PHONE STATELICENSEN <br />CONTRACT <br />LOT <br />(— <br />I�1 ADDITION I-.I ALTERATION ! I REPAIR '�. i DEMOLITION I�I WOODSTOVE/FRPL INSERT : I BUILDING RELOCATION <br />CONTACT PERSON AND PHONE NO <br />_ _ � N NM � /�Y"1 � � � % � � � � R�l <br />OF PROPE <br />BWCK <br />NO. TYPE 01� <br />WATER CLOSET i <br />BATHTUB <br />LAVATOR'V(WASI <br />SHOWER <br />KITCHEN SINit & <br />DISHWASHER <br />LALINDRY TRAY <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVEN' <br />ROOF DRAINS—RAI� <br />SINK ISERVICE—BAF <br />��� i HEREBY CERTIFY THAT I I�AVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />BELOW ORATiACH FOIIRCOPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WURK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />_ oF _ NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />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 />CONTRACTORS �AW 18.27 RCW AND 296.200 WAC. <br />PERMIT <br />TOTAL FEE <br />FOR OFFICE USE ONLY: <br />FRONTSETBACK REARSETBACK <br />i <br />USEZONE p QYrAREA <br />�,–�f� /5�� <br />7VPEOFCONTS.ALLOWaBLE TYPEOFCONSTPCIDAI <br />52EOFBLOG. NO.OFSTORIES <br />OCCUPANCVLOAD FIFESPRNKLERSRE�'D <br />INTAKE BV <br />� 1' <br />X <br />NO. — e auirrv <br />FVC—AIHNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS--B. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE 8 <br />FIREPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />$ <br />VACANT SITE FCCD <br />BUILDING <br />aaaexcr xoovowEwecuxrts <br />cxouv � pLUMBING <br />BASEMENT MECHANICAL <br />H iGHTLIhII7A7loN ADDITIONALPLANCHECK <br />SPRINKLER <br />STATE BUILDING SURCHARGE <br />CITY OF EUERETT PUBLIC WORKS <br />�oca� sa�es <br />TAX COOE IS 3105 TOTAL <br />M E.A. <br />SUB TOTAL 5 <br />PERMIT $ <br />TOTAL FEE S <br />/� PECEIPT N0. <br />"J/ VJ✓ <br />FEE <br />2 <br />