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APPLICATI� FOR CONSTRUCTiaiN PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: 'J GAS J ELECTRIC J <br /> 259-8810 <br /> i � DEMOLITION ! I COMBINATION X BUILDING I I MECHANICAL I_I PLUMBING I 1 SIGN <br /> O\YNEF MAIL�DDRESS CITY 21P PHONE <br /> ,��4T 'T�'`iN"K IAA12ou��""`�Auc �-r.cr�. yt//t 98Z01 �zHOG) 339- 13[g <br /> � ZZZD (?ra�/�✓L F1/cr Wr4- 0/ � 33�I—OB70 <br /> ARGHITECTOR�ESiGNER MAILAODRE55 CITY T ZIP PMONE <br /> GENERAICONiqACTOR MFIIADDRE55 CIiV 21P PMONE STATEUGENSE� <br /> MECNANICALCONiRAC10R MAILq�DRE55 GTV ZIP PHONE STATELICENSE• <br /> PLUMBING GONTFqCTO� MAIL�DOPESS CIT� ZIP PHONE ST�TE JCENSF R <br /> CONTRACT PRIG�Of WORK /��� <br /> =-1 S� <br /> DESCRIB WORK ND SOUAPE FOOTAGE INVOLVED CON7ACT PERSON AIJD PHONE N . <br /> �„�,� b.�.,t�,;, 1� �ic��3�q-o�7n <br /> d«� <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSED USE OF BUIIDING APPLICATION AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL <br /> � PROVISIONS OF LAWS AND ORDINANCES GOVERNING TH�S TYPE OF <br /> LEGALOESCRIPTIONOPPROPEPTVISHOWNOELOWORATTACHTWOCOPIESI WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> .�.�p�.��/ un7 �'�OO NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or�i]�L e�ocrc–3�.Z— oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS GP ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORRIANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> Paace�Tnxio.r+ur.ioea $�+i' Y ax � i`' - APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> y � � '�O�Z �'OOOU CONTRACTORS lAW 1827 RCW AND 296.200 WAC. <br /> LONSTRUCTION LOAN LENDER.��OFE55.TELEPMONE NUM9ER ' , � <br /> �. p�?a�s rB y <br /> PROJECT ADCRESS scns ne ' oe*e <br /> 22?.0 r�Nc� �v �� a�s�NEss���E�s<<�o <br /> PLUMBING ECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATE9 CLOSET(TOILET) � A�C—A/HNDLG UNITS—H.P. � <br /> BAT�iTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> LAVATORV(WASH BASIN) UNIT HEATERS--B.T.U. M � <br /> SHOWER ' CLOTHESDRYERS � <br /> KITC.HEN SINK 8 DISP VENTILATION FAN ; <br /> DI: ;WASHER RANGE HOOD <br /> L'UNDRY TRAY ; WATER HEATER ' <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL METAL FIREPLACE(WOOD BUFiNING) ' <br /> DRINKING FOUNTAIN � FIREPLACE INSERT � <br /> FLOOR DRAIN � HEAT PUMP � <br /> BACKFL05N PREVENTERS GAS PIPING ; <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) ; ' <br /> � <br /> � <br /> � <br /> � <br /> — � <br /> SUB TOTAL 5 ; SUB TOTAL S <br /> PERMIT $ � PERMIT 3 � <br /> TOTAL FEE $ ; TOTAL FEE $ ' <br /> FOR OFFICE USE ONLY: <br /> FRONi. SETBAC� RE�R SETBACK / SIDE SET�N PLAN CNECK��Efy/ FE � NECEIPT NO. <br /> �i �i, 'r� � S <br /> USE ZON[ LOi ARE4 VACANT SITE FEES ,VALUATION FEE <br /> ��� _-� YES �l NO � N� <br /> BUILDING �-f50 /j � (�/ <br /> TYPEOFCONST. NO.OFSTORIES ocm^Fxw xoo��WnlixGuw.is <br /> _ I °p� PLUMBING <br /> J <br /> SIZEOFBLDG FIFESPRINNLERSREOD BASEMENT �,�ECH�NICAL <br /> i <br /> C YES ��. NO , <br /> OCCUVANCv�onD FIRE�LAqMREO'D HEicHrurdiiniiorv ADDITIONALPLANCNECK � <br /> Z� / ' <br /> OTHER ' <br /> flEA50N j r—� <br /> STATE BUILDING SURCHARGE y�s <br /> INTAKE BV PL�NS APPROVED BY CITY OF EYERETT PUBLIC WORKS � <br /> ���d LOCAL SALES � <br /> onre 5�� TAX CODE IS 3105 TOTAL �J_ ] <br />