Laserfiche WebLink
APPLICATIOd FOR CONSTRUCT.JN PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />BUILDING DEPARTMENT I HEATING SYSTEM: U GAS �ALECTRIC U <br />259-8810 <br />DEMOLITION --COMBINATION- BUILDING MECHANICAL PLUMBING _SIGN <br />JWMCR MAR ADDRESS 64«Dw CITY ZIP PHONE <br />TENANT MAC ADDRESS <br />CITY <br />ZIP <br />vN:AL <br />N 5�: gs_—pi-ei Tr <br />ARCHITECT OR DESIGNER MAC ADDRESS <br />G1Y <br />ZIP <br />PNORt <br />GENERAL CONTRACTOR MAC ADDRESS <br />CITY <br />ZIP <br />PNCNE <br />SIAM LICOREA <br />,Lu. a. 6;:�Dctc v <br />MECHANICAL CONTRACTOR MAX ADDRESS <br />CITY <br />ZIP <br />R.CNE <br />SIAM LICENSE <br />P,UMBMOCONTRACTDR MAX ADDRESS <br />CIT, <br />ZIP <br />P E <br />61ATELCENYA <br />CIA:S OF wa+x <br />NEW ADDITION ALTERATION <br />REPAIR , ✓DEMOLITION <br />WOODSTOVEIFRPL INSERT <br />BUILDING RELOCATION <br />J' <br />CONTRACT PRICE GG <br />CONTACT ERSCNANDIT"ENO <br />FOOTAGE <br />DESCRIBE V,ONN AND SIXIAREfWlAGE INVOVF <br />N SQUAWORKRE <br />e1-C <br />N/ <br />vnpros[o USE aBUILDING <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 WHETHER 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 MADc AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 8.2'RCW AND 2962DO WAC. <br />LEGAL D[SCRPTIONCF PROPERTY ISNOYIN BELONOR ATTACH FOUR CwIESI <br />LOT BLOCK OF <br />g5c -19a fI" S 0- V—_ 13 <br />DAYS'Isr Tan Tu LQ i?o F7 �l S <br />Ti/ ^ i3j <br />PRDhCT ADDRESS <br />?74=_ rit�K <br />a`C <br />nIIE,N.F <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AC —A HNDLG UNITS—H. P. <br />BATHTUB <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />UNIT HEATER$—B.TU. M <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK d DISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WAS14ER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE A CHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />i <br />ROOF DRAINS—RAINLEADERS <br />EXHAUST FAN <br />SINK (SERVICE —BAR, ETC.) <br />SUBTOTAL S <br />SUBTOTAL S <br />PERMIT S <br />IPERMIT <br />S <br />TOTALFEE S <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />FROM SE TRACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAH CNEC[NDMRER <br />TEE <br />RECLIPI I:O <br />URIC ZONE <br />LOT AREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />PLUMBING <br />1YR DI [DNiS AIIPMABIE <br />TAd[p4\KfWI <br />PSUNP AOopRllKlnils <br />pOpA <br />SIZE OE BIDG <br />NO OF STORIES <br />BASEMENT <br />MECHANICAL <br />ADDITK)NAL PUN CHECK <br />OC=PANCYLOAD FIRE SPRNKLERS RE00 KOFF LIMITATKIN <br />REASON FOR NRrtME[PS <br />SLRINKMA <br />STATE BUILDING SURCHARGE <br />WAKEBY <br />PUNSAPPRwEOBY <br />CITY OF EYERETT <br />LOCAL STILES <br />TAX CODE IS 8105 <br />PUBLIC WORKS <br />TOTAL <br />p' <br />