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IIPPLICATIGn1 FOR CONSTRUCT�ON PF.RMIT <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT :rr <br />HEATING SYSTEM� U GAS ❑ ELECTRIC ❑ � <br />BUILDING DEPARTMENT <br />259•8810 <br />� <br />DQ DEMOLITION I:I COMBINATION I I BUIL�ING I I MECHANICAL I I PLUMBING I I SIGN <br />�O E 'MAIL�U✓O iESS� CITY ZIP PHpNE <br />� �r.����x�,C �5'�/ F�-r� 98.ze�G 7�z iyi7 <br />TE ANT MAILAODRE55 � CITV ZIP PMONE <br />�RCHITE TORDESIGNEq MRILAO�RESS <br />� � <br />GENERRL ONTAACTOR :dFILAU0RE5S <br />,r���- <br />MECN� I ALCONTflRCTOR MqILADORE55 <br />A)�.� <br />PLUM.%1 �CON7R�CTOR M�ILAUOf1E55 <br />���� <br />Gl OF WOPK <br />I I NEW I I ADDITION I I ALTERATION I I REPAIR <br />CONTR�CT PRICE OF WOflK <br />� DESCRIBE WORK AND SOURFE FOOTAGE INVOLVED <br />�or��BIOCN >G� or <br />/�__ I / /='` ,�I. <br />�� <br />Gr_-Oa � � i •� _ � <br />PR0.IECTRODRE55 <br />OR ITEM <br />WATER CLOSET(TOIL <br />BATHTUB <br />LAVATORY(WASHBA: <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEADERS <br />SINK ISERVICE—BAR. ETC.1 <br />FOR OFFICE USE ONLY: <br />FRONiSETB�CK REARSETOACK <br />7YPE OF GONIS. AIlOWAOtE <br />52EOFBLDG. <br />OCCUPANCVLOAD <br />NEASON PON SPRINKLERS <br />IN1�NE BY <br />SUB TOTAL 3 <br />PERMIT $ <br />TOTAL FEE $ <br />iYf'E Of CON51. ACIUA: <br />FlIIE SPRNNLER$ PEOD <br />PL/NS r1PPIlOVEO �Y <br />SIDL SE7BACH <br />GIIY <br />CITY <br />ur rrn�nt <br />21P PIIONE <br />21P PHONE <br />nr r�ror+e <br />STATE LICENSE / <br />SiATE UCENSE / <br />SLATE LICENSf / <br />)LITION I I WOODSTOVE/FRPL INSERT I I BUILDING RELOCATION <br />CONIACT PERSON AND PNONE NO. <br />1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND OFi01NANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETIIER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERM�T DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEI. THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW fiEGULATING CONSTRUCTION OR THE <br />PER�ORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPEFTY i0 PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br />X N/� t��„�,� .`L �lJ /�� <br />SMHnNn[ / �p <br />MECHANICAL <br />NOT— <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 />WOODSTOVE <br />METAL FIREPtACE 8 CHIMNEY <br />GAS P�PING <br />EXHAUSTFAN <br />PLAN �CH�BCK NUMB�E7R I FEE <br />.._1`D �G� / <br />BUIIDING <br />nccururtr xoao�vni�Ncuhits <br />enwr - pLUM�ING <br />O�SEMENT MECHANIC�L <br />HEIGNiLIMIIAIION �ODITIONALPL�NCHECK <br />SPqINKLER <br />STATf DUILDING SUflCHAfiGE <br />CITY OF EYERETf rueuc wonKs <br />LOCALSALES <br />TAX CODE IS 3105 TOTAL <br />SUBTOTAL $ <br />PERMIT $ <br />TOTAL FEE $ <br />� <br />N0. <br />C/ <br />