Laserfiche WebLink
APPLICATIO� FOR CONSTRUCT�N PERMIT� <br />TO BE COMPLETED IN DLACK INK-PLEASE PRINT �;,�'�,� <br />�J_"" <br />HEATING SYSTEM• �GAS <br />BUILDING DEPARTMENT • ❑ ELECTRIC ❑ —� <br />259-8810 <br />DEMOLITION COMBINATION <br />(�'1�1Efjr / / MAILAODRE$$ � <br />PLUMBING CONTRACTOR <br />C1A55 OF WORK <br />I �� NEW ! ' ADDITION <br />MALL A�OFE55 <br />MAIL AOOFE55 <br />ALTERATION <br />� OF <br />� f� � <br />sE�'A �_� /.� - I/ _, <br />PRDJECTAQOflESt <br />NO. <br />WATER CLO: ET (TOIL <br />BATHTUB <br />LAVATORY (N�ASH BA: <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISH6VASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTI <br />ROOF DRAINS1RAINL <br />SINK ISERVICE—BAR. <br />FOR OFFICE USE ONLY: <br />fRONTSEiBAGK qEAPt <br />l�. � 1 <br />VJCCVIVL �� <br />�. <br />7VPFOFCONIS.AILOWABIE <br />Jt.- � Ii1`L <br />SIZE OF BLOG. <br />��IQ7� ✓�1 • <br />OCGUPANCYLO�D <br />REASON FOF SPIiINNLERS/ <br />WiRKEBY ` <br />SUB TOTAL S <br />PERtd1T 5 <br />TOTAL FEE $ <br />/ <br />LqfAREA <br />f1.� <br />iYP( 01 CONSi. AA <br />� <br />NOAF STORIES <br />FIRE SP�KLERS <br />Y� <br />WAAY� � <br />PLANSAPPRO EI <br />X BUILDING <br />'` CIiV <br />S7 �!� <br />GTY <br />GTV <br />� <br />cirv <br />�--c� <br />CITY <br />CRY <br />REPAIR DEMOLITION <br />MECHANICAL <br />ZIP PNONE <br />� 7 <br />'IP PNONE <br />21���� i pqppE <br />�J \�v� • <br />Z�P PHONE <br />21P <br />PHONE <br />PHOYE <br />PLUMBING <br />WOODSTOVEiFRPL INSERT <br />Aj.'D PM(jyE NO / <br />SIGN <br />ST��� <br />�-y, Z ) <br />STATELI ENSE+1 <br />SiATt LICENSE k <br />BUILDING RELOCATION <br />i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO 8E 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 PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PqOVIS17NS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COh1PLY WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br />X <br />S�GNAtl1RC q� <br />FEE NO. TYPE OF EQUIPMENT FEE <br />A/C—AiHNDLG UNITS—H.P. <br />f,'" FORCED AIR SYSTEMS—B.T.U. M E.A. <br />� UNIT HEATERS—B.T.U. M <br />CLOTHES ORVERS <br />I VENTILATION FAN i' <br />HANGEHOOD <br />; WATERHEATER �' <br />� WOOD STOVE <br />; METAL FIREPLACE 8 CHIMNEY <br />� FIREPLACE INSERT % <br />HEAT PUMP �� <br />; GAS PIPING . <br />S.lC�. S� / <br />SI�ESETBACK = PLANCHECK <br />,., i � <br />' BUILOING <br />wavnx� �;oorowtwncuxrts <br />�( saou= .y PLUM�ING <br />, � <br />BASG1ENi MECHANICAL <br />i HEIGHTL�nnoN�7[ ADDITIONALPLANCHECK�. <br />�� V / <br />SPRINKLER <br />� � �� � STATE BUILDING SURCHARGE <br />CITY OF EUERETT PUBLIC WORKS <br />LOCAL SALES <br />Jf/� TAX COOE IS 3105 TOTAL <br />SUB TOTAL $ <br />PERMIT $ i <br />TOTAL FEE S <br />�`/ � � >•.r t– <br />FEE �/� RECE/IPT��NO. _ <br />� 7 Cv. <br />VALUATION FEE <br />�%J G � ' <br />. � ,�� i S y� <br />�' <br />�� <br />—L <br />� I� <br />� <br />� �S� <br />� <br />_? S".?2 �O L <br />