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APPLICATIC � i FOR CONSTRUCT"�N PERMIT � <br />TO BE COMPLETED IN BLACK INK-PLEASE PRINT <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ <br />BUILDING DEPARTMENT <br />259-8810 <br />❑ DEMOLITION ❑ COMBIMATION ❑ BUILDING �MECHANICAL ❑ PLUMBING ❑ SIGN <br />ONMEF M�ILAUDRE55 CITV ZIP PMONE <br />'E !I,%�, ��/D0.�,4-L/3 �d.rc� 9f?o/ ��(-(3/� <br />�ESCRIBE WORI! AND SOUARE FOOTAGE INVOLVE[ <br />� � //1�'!� <br />� <br />G <br />PR�D USE BUIl01NG y <br />���YY-- ,�1/li7l //Ls <br />LEOAL DE RIPTION OF PROPEPTV (SHON?! L01 <br />LOT BIOCK OF <br />VARCELTA%IA.NUMBER <br />CONSTRUCTIONIOANLENDER,ADDRE55.TELEVHONE <br />TYPE OF FlXT <br />WATER CLOSET (TOIL <br />BATHTUB <br />LAVATORY(WASH BA: <br />SHOWER <br />KITCHEN SINK & DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CL(' � ES WASHER <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEAC <br />SINK ISERVICE—BAR, ETC <br />OR <br />CONTAG7 PERSON AND PNONE NO. <br />i HEREBY CERTIFV THAT I HAVE REAO 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 />AfT�CHTYOCOPIES) WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GFANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br />OTHER STATE OR LOCAL LAW flEGULATIN(i CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF TNIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />� APPLICATION IS MADE AND i COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />iuMoea ����� �/!/� — <br />SiG t DAiE� � <br />� C11Y 01151NE55 UC(NSE NO <br />MECHANICAL <br />1 FEE NO. T'PE OF EOUIPMENT FEE <br />PERMIT $ <br />TOTAL FEE $ <br />FOR OFFlCE USE ONLY: <br />FRONTSETB�GK REARSETBACN <br />USE ZONE LOT AREA <br />TYPE Of LONST. NO. OF STORIES <br />SIZEOFBLDG. FIRESPRINKLERSREO'D <br />OCCUPANCYlOAO <br />PEASON <br />FIRE ALAFM <br />PLAN�RPPROVED BY <br />DATE � 7I9f <br />A/C—A/HNDLG UNITS—H.P. <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 (WOOD BUflNING) <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SIDE SETBACK ?L�N CHECH NUMBEN <br />39�0 <br />VACANT SITE FEES <br />❑ YE� ❑ NO gUILDING <br />awr~xcr xoaoweuixcirons <br />�R°0v PLUMBING <br />BASEMENT MECHANICAL <br />❑ YES ❑ NO <br />HEIGHTLIMITAiION A�DITIONALPLANCHECK <br />OTHER <br />STATE BUILOING SURCHARGE <br />CITY OF EUERETT PUBLI� WORKS <br />LOCIIL SALES <br />TAI( CODE IS 3105 TOTIIL <br />SUB TOTAL $ — <br />PERMIT $ � � <br />TOTAL FEE $ . 'S �i ! —' <br />FEE � RECEIPT NO. <br />i <br />i <br />i <br />i <br />