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APPLICATIC'] FOR CONSTRUCT�N PERM17 � <br />TO BE COMPLETED IN BLACK INK-PLEASE PRINT <br />BUILDING DEPARTMENT HEATING SYSTEM: ❑ GAS i] ELECTRIC U _ <br />259-8810 <br />1 1 DEMOLITION 1� COMBINATION C I BUILDING i 1 MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MAILAODRESS CIN ZIP PHONE <br />, vFuu�c p�FQSsoN 2Q2s •`��CyNGr+rro ��c' EvCREiT lu,w �R1Di z58-Z1/8 <br />TENANT MqIL AODRESS CITY 21P PHONE <br />SM�iE <br />ARCHITECTORDESIGNER MRILADDRE55 CITY ZIP PHONE <br />.$Jji7�E <br />GENERRLCONTRACTOR MMLRDDRE55 CITY ZIP PHC�NE STATELICENSE• <br />S.4�r <br />MECHANICAL CONTRACTOR MAIL AUDRESS CITV ZIP PMONE STATE LICENSE t <br />3�y�+rE <br />PLUMBING CIXJTRRCTOR MAIL RDORESS CIN ZIP PMONE STATE IICENSE I <br />CONTHACT PRICE OF WORK <br />DESCRIBE WORK AND SOUARE FOOTqGE INVOLVEO <br />PROPOSEU USE OF BUILDING <br />LEGAL DESCRIPTION OF PqOPEBTY� �S�HO�W-N BELOW OR ATTRCM 7W0 COPIES� <br />LOT� BLOCK ��— OF m�`� `�� <br />.,__.e�....,_ ..nn.i r.. c�.T <br />PARCEITA%ID.NUMBER <br />.t/ SG — � S —UC) i — tXJO � <br />CONSTRIICTIONLOANLENDER.AUDRESS.TELEPNONENUMBER <br />CLOSET <br />LAVATORY�WASH BA: <br />SHOWER <br />KITCHEN SINK 8 DISP <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />ROOF <br />SINK 1 <br />FOR OFFICE USE ONLY: <br />FRONTSETBACK REAR; <br />tvPE or caNsr. <br />SIZE OF BLDG. <br />OCCUPANGYLOAD <br />REASON <br />INTpKE BV <br />TOTAL $ <br />l0T AREA <br />NO.OF STORIE$ <br />FIRE SPPINKLERS RE00 <br />FIRE ALARM REOD <br />PLANSAPPROVEDBV <br />DATE <br />FEE <br />CONTACT PERSON �.NO PHONE NO. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORHECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BF COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PFiESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br />OTHER STATE OR LOCAL lAW REGULATING CONSTRUCTION OR THE <br />PERFORA7ANCE 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 LAW 1827 RCW AND 29fi.200 WAC. <br />No <br />NC—/�'HNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />CLOTHESDRYERS <br />VENTILATION FAN <br />WATEFl HEATE <br />WOODSTOVE <br />FIREPLACE <br />HEAT PUMP <br />GAS PIPING <br />SIOc SETBACN PLAN CNECK <br />VACANT SITE F <br />❑ YES ri NO gU1LDING <br />OCCU�ANCY NO W pW[IIINGUH�15 <br />,aoun pLUMBING <br />BASEMENT <br />�-' YES . J NO <br />MEIGHT LIMITATION <br />CITY OF EYERETT <br />LOCALSALES <br />TAII CODE IS 3105 <br />MECHANICAL <br />AD�ITIONAL PLAN CHECK <br />OTHER <br />STATE BUILDING SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />- // -9f <br />SUB TOTAL $ ' <br />PERIdIT $ � <br />TOTAL FEE $ ' <br />fEE RECEIPTNO. <br />VALUATION FEF. <br />—� <br />—�� <br />i <br />� <br />_i <br />� <br />� <br />i <br />i <br />i <br />� <br />/� i <br />