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APPLICATIL � FOR CONSTRUC7 JN PERMIT � <br />TO BE COMPLETED IN BLACK INK-PLEASE PRINT <br />BUILDING DEPARTMENT HEATING SYSTEM: U GAS ❑ ELECTRIC ❑ <br />259-8810 � <br />I I DEMOLITION I 1 COMBINATION I � BUILDCJG I i MECHANICAL I�LUMBING I I SIGN <br />OTWNER {� / MAIL,ADDPESS ,[� CITV ZIP PH/ON`E ) � <br />/� �\Ir'i � W' ��'4h /r�P� l�/Q./`C�1 /T�Q�i �7J_��PTO� <br />TENANT MAILADDPESS CITV ZIP PNONE <br />ARCNITECTOflOESIGNER MAILAOORESS <br />CITV <br />GENERALCONTRACTOR MAI�AODRESS CITY ZIP PMONE STATELICENSEt <br />MECHANICRLCONTRACTOR M�ILADDRESS <br />cin <br />STATE UCENSE t <br />PLUMBINGCONTR�CTOR MAIL�OORE55 CITY IIP PHONE `'j� STATEUCENSEII <br />C`Tr�„�� _C.�.! ¢rN.,,,�J RRUR li_S�,r��c..U� La 5�.,,.,e Gsy� �Rl�l-rcr_ /n,�l�s <br />f-I NEW i! ADDITION i; ALTERATION �, �. REPAIR I' DEMOLITION <br />�ND SOUARE FOOTAGE <br />BUILDING <br />LE WL DESCRIPjION OF PROPERTY �SHOWN BE�OY <br />T <br />l0T O' �L BLOCK VIODA�.aF <br />PRQIECTAODRE55 <br />� W Mart 1 <br />NO. I TYPE OF flIfTURE OR <br />al LAVATORY (WASH BASIN) <br />SHOWEH <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />. LAUNORYTRAY <br />� CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />� FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEADERS <br />SINK (SERVICE—BAR. ETC.I <br />FOR OFFICE USE ONLY: <br />FRONTSETBACK PEARSETBnCK <br />USEZONE <br />TV7E OF CONTS. �LLUWABLE <br />SIZE OF BLD^u. <br />OCCUPANCYLOAD <br />flEA50N FOR SPflINKLERS <br />INTANE BY <br />LOTiREA <br />/Y '� <br />SUB TOTAL $ ; — <br />PERMIT $ ,� � <br />TOTAL FEE $ ' <br />SIDE SETBACK <br />VRCANT SITE <br />fUAL ottUv4Ytv Na ormv[WUGUNns <br />GNW> <br />NO. OF STORIES <br />REO'D I HEIGHTLIMITATION <br />BY CITY OF EYERETT <br />LOCAL SO! ES <br />TAX COUE t;, 3105 <br />WOODSTOVE/FRPL INSERT ✓�UIIDING RELOCATION <br />AND PHONE NO. <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 WILL BE COMPLETED WITH WHETl1ER 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 LOCAL 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 IS MADE AND I CO;IPLY WITH THE STATE <br />CONTAACTORS LAW 18.27 RCW AND 296.200 WAC. <br />X R�.a...� ��,�.,. ��-z5-9� <br />SiGN�iIIP � DAIE <br />FORCED AIR SYSTEMS--B.T.U. M E.A. <br />UNI7 HEATERS—B.T.U. M ; <br />VENTILATION FAN <br />RANGEHOOD <br />WOOD STOVE <br />METAL FIREPLACE & <br />FIREPLACE INSERT <br />GAS PIPING <br />EXHAUST FAN <br />SUB TOTAL $ <br />PERMIT $ <br />TOTAL FEE S <br />:=ECKNUM��G� I FEE I RECEIPTNO. <br />� J / <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />ADDITIONAL PLAN CHECH <br />SPRINHLER <br />STATE BUILDING SURCHARGE <br />PUBLIC WORNS <br />TOTAL <br />� <br />i <br />