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APPLICATIG J FOR C�NSTRUC'�N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />HEATING SYSTEM: U GAS ❑ ELECTRIC ❑ <br />BUILDING DEPARTMENT <br />259•8810 <br />I 7 DEMOLITION I I COMBINATION !�=QpILDING I I MECHANICAL I I PLUMBING L I SIQN <br />pWNEP t MAILADORE55 CITY 21P PHO•iE <br />�c,�i2 Y`1�NNE O L5�^.�( 7f�7y �-�—vestc� C� .✓ �Zd 3 _, U 7 7i `� z <br />.'.....� u�u nnnccc GTV . ' ZIP PMONE <br />ARCIIITECTORDESIGNER M�I�ADORE55 CITY 21P PHONE <br />� //i� � <br />O ERAI.CONTRACTOR MAII ADDRE55 CITY ZIP PMONE STQE �ICENSE � <br />✓ �lC%iL��-/P <br />MECHANIGKCONTA�GTOR M�ILADURE55 CITY ZIP PHONE STATELICENSEI <br />PLUMBINOCONTRAGTOR MAILADDRESS CITY ZIP PHONE STATEIICENSEI <br />�},1fEW LI ADDITION i I ALTEiiATION I! REPAIR I I DEMOLITION I- I WOODSTOVFJFRPL INSERT i I BUILDING RELOCATION <br />�A�,�J /.(I CONTACT PERSOI. AND PHONE NO. <br />J/ �'.�e�u 9 �� �r_ .. 2���.r� <br />DESGRIBE WORN AND Sd1ARE FOC tAGE INVOWED <br />PRO USEOFBUILDIN/G <br />a[/�/Q�'(iAON l� .i�L'TA/w%i <br />LEdLL DESCNIPTION OF PROPERN ISNOWN BEIOW <br />LOT BLOCN OF <br />CAPIES� <br />/ PROJECTADDRESS <br />�� � ��3 m1�, �,�7�-U � �v_ �_� <br />PLUMBINO <br />►p, TYPE OF flxTURE OR ITEM FEE <br />WATER CLOSET (TOILEn <br />BATHTUB � <br />LAVATORY(WASH BASIN) <br />SHOWER <br />KITCHEN SINK 6 DISP <br />DISHWASHEH <br />LAUNDRYTRAY <br />CIOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />HOOF DRAINS-RAINL ERS <br />SINK (SERVICE-BAR, C.) <br />SUB TOTAL S <br />PERMIT E <br />FOR OFFICE U$E ONLY: <br />FHONTSETBIICK REAfl: <br />TIPE O�F( jCONT�S. ��lLOY <br />_�lSL_ <br />SIZE OF B�DG. <br />�6 St f <br />OCCUPANC LOAD <br />� <br />pEA$ON FOfi SPPII <br />INTANE BY <br />h �� i <br />TYPE Of CONST. �CTUAL <br />FIRE SPRNKLERS REO'D <br />�� <br />PLANS APPROVEO BY <br />1 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 WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTIN� OF A PERMIT DOES NOT PRESIIME TO GIVE <br />AUTHORITY TO VIO�ATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL lAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER UF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTOFiS LAW 18.27 RCW AND 296.200 WAC. <br />UNITS-H.P. <br />UNIT HEATERS-B. <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATEF HEATER <br />METAL FIRE <br />FIREPLACE <br />GAS PIPI� <br />EXHAUST <br />0 <br />i.U. M <br />8 CHIMNEY <br />BUILDING <br />uvu�cr W aowtwxGuxns <br />9WP ' PLUMBING <br />C <br />SEMEN7 MECHANICAL <br />iGHT uM1Tn7iON ADDITIONAL PLAN CHECK <br />SPRINKLEP <br />STATE BUILDING SURCHARGE <br />CITY OF EYERETT PUBLIC WORKS <br />LOCALSALES <br />TAX CODE IS 3105 TOT�� <br />PERMIT <br />TOTAL FEE <br />i <br />i <br />i <br />ysa ; <br />� <br />