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APPLIC/�TIG _J FOR CONSTRUCT . �N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />HEATING SYSTEM: l�}GAS ❑ ELECTRIC ❑ <br />BUILDING DEPARTMENT <br />259-8810 �. <br />� n�..n� �mn� .� rnuaiueTinu ,ti piw nwr, X MECHANICAL ?FPLUMBING : I:iIGN <br />OWNER <br />m� <br />MAIL <br />MAIL ADDRESS <br />Mnn noog�ss <br />MAIL <br />cirv <br />crtv <br />c� <br />''X NEW i I ADDITION � I ALTERATION i� REPAIR <br />CONTRACT PRICE OF WORN /��/ Z <br />OESCRIBE WORK RND SOUARE FOOTAGE INVOLVED <br />,rl�� l��T� S N <br />PROPOSED U� OF BUIL�G�r�L I�% / �� <br />��.�. 0 3 <br />LEGAL C?�^_ IPTION OF PROPEPTY ISHO N BELOW OR ATfACN FOUR COPIES) <br />LOT � �_ BLOCK �F �/leof� <br />PRQIECT ADDRESS <br />71 �� � <br />PLUMBING <br />NO. TYPE OF FIXTi <br />WATER CLOSET (TOIL <br />, BATHTUB <br />LAVATORY�WASH BA: <br />SHOWER <br />KITCHEN SINK & OISP <br />DISHWASHER <br />LALINDRY TRAY <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVEN� <br />ROOF DRAINS—RAIN <br />SINK (SERVICE—BAF <br />SUB TOTAI S <br />PERMIT $ <br />FOR OFFICE USE ONLY: <br />PRONT SETBACK REAR SETBACK <br />Zo' 2� <br />USEZONE LOTA�RyEAy� <br />_ / %l.� <br />TVPEOFCONTS.ALIOWABIE i"PFOiCONSi.AC1 <br />�_./ _� <br />(3't�,5 - SI` -�' <br />4� r.F, Gi <br />OCCUPANCVLOAD <br />N//a <br />flEPSON FOR SPPINKLF <br />IIITANE BV <br />NO.OF STORIES <br />� <br />fIRE SPFNKLERS R <br />��� <br />PLANSAP ROVEDBY <br />� � <br />2 /� /95 <br />SIDE SETBACK <br />�jd- /O <br />� <br />ZIP PHONE <br />ZIP PHONE <br />� / �VT'Y—+ <br />ZIP PMON STFTELICENSEa <br />�r 9�?.03 3�8-3 �3 t +<E�.t�*?�� <br />21P PHONE STATE �ICE SE �I <br />Ud. 1�G2�3'i5o 12E-L1-AS rna_yS� <br />21P PMONE STATE LICENS[ • <br />��/�qG 793-�//3 <br />DEMOLITION I�� WOODSTOVElFRPL INSERT '�. ! BUILDING RELOCATION <br />CONTACT PERSON AND PHONE N0. <br />K.:., vv�� (,�ir,��o_ �L��3- �A�q <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />'� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORFlECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />� WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTF:ER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PEflFORMANCE 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 7827 RCW AND 296.200 WAC. <br />x�.� U\/� � l.� 40 �.�-. , 1— 3C7 - 9 S <br />PLAN <br />FORCED AIR SYSTEMS—B: <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGE HOO[1 <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPIACE 8 CHIMI <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUST FAN /�/ <br />�� BUILDING <br />acuvAuv xoorownuxeuxrts <br />°p°3 PLUMBING <br />BaSErnEr+r MECHANICAL <br />u J ADD!TIONAL PLAN CHECK <br />NEIGHT LIMITATIOJJ <br />STATE BUILDMC SURCHARGE <br />CITY OF EYERETT PUBLIC WORKS <br />LOCAL S.,LES <br />TAX CODE IS 310K Tora� <br />M E.A. <br />SUB TOTAL $ <br />PERMIT 5 <br />TOTAL FEE 5 <br />/ <br />FEE��In 7� RE <br />0 <br />�. <br />