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APPLICATIC�1 FOR CONSTRUCT'^1N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />HEATMG SYSTEb; '.J GAS J ELECTR�C 'J — J <br />dUILDING DEPARTMENT <br />259-8870 <br />DEMOLITION COMBINATION <br />r�EN D� i �..� �h � T„U <��S ��C <br />MAIL AD�FE55 <br />GENEF�LGONTRACIOR �AIAILADDRESS <br />fiN�RE�.r %�us?iN C�, -ZN�- <br />IdECHANIGALCONTR�CTCA MAILADOfiESS <br />rUoRTttc,�iv C�v�st��- 31 $�., �e <br />PLUR7�WGCONTR�r,� MAIL�DDRE55 <br />N�2f (.+�k'Sr�a�;cl�lEcLw..ica� riuc_ <br />CONTR�CT FriICE OF WORK <br />�� ��Z�- <br />DESCR'dE WORK ANO SOUARE FOOTAGE INVO! y[� <br />�U1�M ��l'�i5Ga.0"r ��.$C_� <br />I gJILDING I MECHANICAL <br />C�TY ZIP <br />� � sr �?� S� - <br />CItV ZIP <br />QTY ZIP <br />CITY <br />`7GYi4 - r ry! P/,y <br />GITV <br />�E,�� ���II wRh <br />C� <br />��� I,ll�l�� <br />PROPOSE� USE OF BUIl01NG <br />l'�d/,�� <br />LEGAL OESCRIPiION OF PROPERTV �SHOWN BELOW OR ATT�CH iW0 COPIESi <br />� � �� <br />LOT 1 BLOCK OF � � —� <br />PARCELTA%IA.NUM1IBEfl <br />CONSTqUC�IONLOANLEN�ER,�DURESS. <br />NO. TYPE OF FIXTI <br />WATER CLOSET (TOILI <br />y_ BATHTUB <br />'1 LAVATORY�WASH BA; <br />SHOWER <br />\ KITCHEN SINK 8 DISP <br />� DISHWASHER <br />LAUNORYTRAY <br />l CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENT <br />� ROGF DRAINS—RAINI <br />� SINK ISERVICE—BAR, <br />ITEM <br />/ <br />� <br />� <br />FEE <br />SUB TOTAL 5 <br />PERMIT 5 <br />TOTAL FEE S <br />FOR OFFICE USE ONLY: <br />FRONTSETDACN REAR SETBACK <br />� / �' <br />LSEZONE IOTARtA <br />ivP�EOF-C•ONSf. NO JPSiONIES <br />Y .l � <br />52E OF BLDG F FiE SP9INKlERS REO'D <br />��y.� .S/�' {- � <br />3v .f. Gn�c <br />OCCUPANCYLOAD FREaL4fiM1IRE00 <br />R[ASON <br />iNrnK� ov <br />onte <br />ov <br />SIDE <br />0 <br />E <br />E <br />PHONL <br />bP qFj-p� PMONE <br />��cs ��i— <br />ZIP PHONE <br />T 4' ZoSr -353- 55 <br />ZIP PMONE <br />. $(lr f 6 Z(d �747 • <br />COt1iACT PERSON AND PHONE NO. <br />i/�V� f—/'lli}1.'11%� <br />I I pLUMBING SIGN <br />� o Z6 7�l{'3% <br />SiATE LIGLNSE n <br />s^�r,g ,�Nf�RG-!�C InS�a <br />SiAIE LICENSE a <br />5 STATELICENSEM <br />xy9' <br />�� i - 3q�� <br />I HEREBY CERTIFY THAT I FiAVE READ AND EXAMINED THIS <br />APPLICATI01 1ND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OH <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OF CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORAIANCE 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 WITN THE STATE <br />CQNTRACTORS LAW 78.27 RCW AND 286.200 WAC. <br />v �y�ZS-4`I <br />7 wrz <br />MECHANICAL <br />NO. TYPE OF EOUIPMENT <br />NC—ArHND�G UNITS—H.P. <br />� FURCED AIR SYSTEMS—B.T.U. <br />UNIT HEATERS—B.T.U. M <br />� CLOTHES DRYERS / <br />3 VENTILATION FAN <br />� RANGEHOOD � <br />� WATER NEATER — <br />WOOD STOVE <br />METAL fIHEPLAC[ (WOOD BUR <br />i FIREPLACE INSERT <br />HEAT PUMP <br />1 G�S PIPING <br />YES '. NO BUILDING <br />occ;:v.�,cv reou�mcEu�'.cuvns — <br />r"'�" ' pLUA1EING <br />R-3 - <br />BASEh1ENT MECHANICAL <br />:YES NO <br />MEIGNTCMITFTION ADDITIONALPLANCHECK <br />__ Z�' OTHER � <br />STATE l3UILDING SURCHARGE <br />CITY OF EUERETT PUBLIC WORNS <br />LOCAL SALES <br />TAX COOEIS 3105 TOTAL <br />E.A. <br />SUB TO�(AL 5 <br />PERMIT S <br />TOTALFEE 5 <br />9 <br />� <br />