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APPLICATIC _J FOR CONSTRUC7vJN PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />BUILDING DEPARTMENT '— <br />259-8810 <br />� DEMOLITION COMBINATION <br />OWNER MAIIADORESS <br />.a� 3��us-rAD a�►o� t�t��K;� <br />rcueut MAILAOORE55 <br />HEATING SYSTEM: `� GAS ❑ ELECTRfC ❑ <br />BUILDING MECHANICAL <br />CITV ZIP PRONE <br />vd �ver�l- u�a q82o� <br />GN ZIP PNONE <br />.�mpr .s�,r;�l ��L•I <br />ARCHITE TORDESIGNER MAILAOORE55 CITV 21P PHONE <br />PLUMBING ' SIGN <br />GENEHALCONTRACTOfl MAILA�OflESS CITY 21P �'HONE STRTELICENSEt <br />M�HANIGALCWITRACTOR MAIL/DORESS CIN ZIP PHONE STATEUCENSEt <br />PLUMBINGCONTRACTOR MAILAf1DRE5S CITY ZIP PHONE STRTELICENSEt <br />CUSS OF WORK <br />I I NEW !X� ADDITION ���, 1 ALTERATION i REPAIR � DEMOLITION .� WOODSTOVE/FRPL INSERT �. . BUILDING RELOCATION <br />PROPOSEtI USE <br />LOT <br />FOOTAGEINVOLVED <br />' PROPERTY �SHOWN BELOW <br />BLOCN _ OF <br />TYPE OF PIXTURE <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAI <br />FLOOR DRAIN <br />;�• <br />Foua cories� <br />0 <br />SUBTOTAI $ <br />PERMIT S <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />FRONTSETBACI(I RERRSET��CK' <br />USE ZQ� LOT AR;A . <br />� S i,$ %C �eo <br />..,.,���.�.�.e ennweaic ttPEOFCONSt.AC7VAl <br />SREO�BLDG _ NO.OFSTORIES <br />633 sv ,�oi.1 r Z <br />�� A <br />OCCUPANCV LOAD FIRE SPRNKLEFS REO'D <br />u A t�- <br />REASON ORSPRINKLERS <br />INTANEBY PLr1NSAPPROVED6Y <br />11� ►t/3i <br />SIUE SETBACK <br />�..i � <br />CONTACTP�iruS�Mq�ENO. O/ `r'_ �ZC � <br />1�� {� U (b J <br />/Cl.i� V (l\ <br />Gw�. ��^�s`(�� c�SS—o997 <br />i HEREBY CERTIFY THAT I HAVE HEAD 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 GRANTING OF A PERMIT DOES NOT PRESIIME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCT�ON OF THE <br />PERFOfiMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THF <br />OWNER OF THIS PFiOPERTV TO PERFOflM THE WORK FOR WHICH <br />APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.2? RCW AND 296.200 WAC. <br />X _ —� �� �2 /' Jo� <br />ISIGNAlUl1l DAtE <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS <br />� VENTILATION FAN <br />RANGEHOOD <br />� WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIMNEY Af' <br />FIREPLACE INSERT <br />HEAT PUMP <br />SUB TOTAL S <br />TOTALfEE � I � � <br />. �- } 2 . �1� <br />PLANCHE N IB R FEE RECEIPTN <br />���"�� �� a�� �3� � .�si <br />1 � BUILDING <br />acuru+cr xamownuxcuxns <br />�"013 �' PLUAIBING <br />B.�SEMENr MECHANICAL <br />NO pODITIONAL PLAN CHECK <br />HEIGH/T� L�IMITRiION <br />L�J , <br />SPRINKLER <br />STATE BUII.DING SURCHARGE <br />CITY OF EYERETT rueuc woaKs <br />LOCALSALES <br />TAX CODEIS 3105 rorn� <br />� � � �o <br />,; <br />� <br />r <br />ii i. r— <br />;,S—o <br />Y'i G � � a- <br />.'� <br />