Laserfiche WebLink
APPLICATIC ^1 FOR CONSTRUCT' 1N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />BUILDING DEPARTMENT HEATING SYSTEM: j�GAS ❑ ELECTAIC ❑ <br />259-8810 <br />❑ DEMOLITION f 7 COMBINATION ❑ BUILDING �MECHANICAL ❑ PLUMBING ❑ SIGN <br />ARCHITECT <br />MAIL A�DRE55 <br />T�- c <br />MAIL NUUHtOJ <br />GENERAL� ��C�1 � I <br />MECHANI � . R ES <br />�EATTLE WA 98199 <br />PWMBINGCONTRACTOR AfAILA0DRE55 <br />CONTPACTPfiICEOFIVORK .�/ ^ ,' � � <br />,(, XL <br />DESCRIBE WORK AND SOUARE FOOTAGE INVOLVE� <br />/ /'//v, <br />� <br />cn� <br />cin <br />cin <br />CITV <br />CITV <br />PROPOSED USE OF BUILOING <br />LEGAL OESCRIPTICY OF PROPERTV �SHOWN BELOW OR ATTACN TWO LOPIES� <br />LOT BLOCK OF <br />PARCELTA% ➢ <br />CONSTRUCTION <br />110. TVPE OF FIXTURE OR 1' <br />INATER CLOS[T (TOILET) <br />BATHTUB <br />LAVATORV (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEADERS <br />SINK (SERVICE—BAR. ETC.) <br />FOR OFFICE USE ONLY: <br />FRONTSETBACK REARSETBACN <br />IISE ZONE LOT AREA <br />7VPE OF L�NST. <br />SIZE OF BLUG. <br />OCCUPANCYLOAD <br />REASON <br />INTAKE BV <br />0 <br />SUBTOTAL S <br />PERMIT S <br />TOTAL FEE S <br />FIRE SPRINKLERS REO'0 <br />FIRE ALARM REO'D <br />PLANS APPROVED BY <br />OATE <br />SIDE SETBACK <br />ziv _ <br />Z�L <br />21P <br />2IP <br />ZIP <br />Z�P <br />PERSON <br />✓MVrvC <br />PHONE <br />P�MONE <br />PMONE <br />}j � �� <br />5TATE UCENSE e <br />��7 �'�l,'i��3.�� <br />STATE LI�ENSE P <br />STATE LICENSE • <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILI 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 />OTHER STATE OR Lf�CAL 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 ��1dADE A� I COMPLY WITH THE STATE <br />CONTRACTORS�LAW 18.27 EC�O/AND 296.200 WAC. <br />N0. TVPE OF EOUIPMENT <br />NC—A/HNDLG UNITS—H.R � <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />CLOTHESORYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE (WOOD BURNING) <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUST FAN <br />❑ YES ❑ NO eui�o�NG <br />acuPexcr eoamvEu�xcu4ns — <br />cwouv p�UMBING <br />BASEMENT MECHANICAL <br />Cl YES ❑ NO <br />HEIGHT LIMITATION ADDITIONAL PLAN CHECK <br />OTNER <br />STATE BUILDINJ SURCHARGE <br />CITY OF EUERETT PUBLIC WORKS <br />LOCALSALES <br />TAX CODEIS 3105 rorn� <br />TOTAL 5 <br />dIT 5 <br />RECEIPT NO. <br />FEE <br />� <br />� <br />i <br />