Laserfiche WebLink
APPLICATIC`"� FOR CONSTRUCT'lN PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />_ --_-1 <br />HFATING SYSTEM: U GAS �] ELECTRIC :J <br />BUILDING DEPARTMENT '— <br />259-8810 <br />i 7 DEMOLITIQN I 1 COMBINATION <br />OW ER M�ILADD 55 <br />� ��I ��-��, L ^1 G�, _�- <br />TENPNT • MAILAODRESS <br />AiiCHITEGT OR OESIGNER MA1l FDDRESS <br />r.cucaA! C,']NiRACTON MAIL ADDRE55 <br />� <br />i l BUILDING l i MECHANICAL <br />C�TY � ZI J\ C\I(' PI <br />�-�--c-� n�' � <br />��T� <br />GITY t�� <br />ZIP <br />0 <br />GONTPAGT PRIGE OF WORK <br />� D�1CQRIBQE VIaFK A${[l� <br />��� � <br />WVOWED <br />x� ��;o�,�`�r home <br />,. . <br />LEG�LDESGRIP OHJFPR�PERTYISHOWNBELOWORAtTRGNTWOCOFI � <br />LOT — BLOCN OF <br />PARCELTA%ID.NUMBER <br />�ONSTRUCTKK� �O�N LEI <br />�1• PRG^�1 �('�_ / <br />SINK & <br />DRAIN <br />SUBTO7AL � <br />PERMIT 8 <br />CONiACT PERSON AND PHONE N0. <br />1 HEREBY CERTIFY TM1AT I HAVE READ AND EXAMINED TH�S <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN CR <br />NOT. THE GRANTINC OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />PERFORMANCE OF�CONSTRUCTION. THAT I AM AUTHORI ED BY THE <br />APPLICAT�ONISISRMADE ANDPE COMP YH WIT�HKT ER 5 ATE <br />enuTwer.7naS WW td27 RCW AND 296.200 WAC. <br />FOR OFFICE USE ONLY: P�nN cNecK r,uMeea <br />FRONTSETBACK <br />REAR SETBRCK SIDE SETBACK � <br />.....��� l0T AREA <br />VACANT SITE FEES <br />7vPE Of <71:L7 <br />JGCUPANG`/LOAD <br />PEASON <br />INTAKE 9Y <br />Ci YES ,��� N� BUILDING <br />NO.OFSTORIES O1011AHCY HOIXCNEIlING041i5 <br />cnou> PWMBING <br />FIRESPRINNLERSFiEO'0 BPSEMENT MECHANICAL <br />�, -�. YES ❑ NO --- <br />MEiGNT IIMITAPON ADDITIONAL PLAN CHECK <br />FIRE ALRRM �E00 <br />OTHER <br />STATE BUILDING SURGHARGE <br />P�ANSAPPROVEDBV CITY OF EYERETT PUBLIC WORKS _ <br />LOCIIL SALES <br />TAX CODEIS 3105 TOTAI <br />DATE <br />.U. M <br />FEE <br />r+o <br />i <br />