Laserfiche WebLink
�N <br />� APPLICATII.�V FOR CONSTRUCI .ON PERMIT <br /> ITO BE COMPLETED IN BLACK IYK-PLEASE PRINT �r <br /> BUILDING DEPARTMENT HEATING SYSTEM: U GAS U ELECTRIC ❑ _� <br /> 259-8810 <br /> , <br /> I I DEMOLITION �COMBINATION jll�BWLDING I I MECHANICAL I I PLUMBING i � SIGN <br /> OWNER I M�IL�DDRESS CITY ZIP PHONE �• <br /> J�n� i.J /1bba� Bsa_S L�' �v'f�.�� G�..k1H �3��c1� �� 9�'�// f-PS- 0�--5 <br /> II T NANT MMlA0DflE55 CIN --�?IP PIIONE <br /> IARCHITECTqiDESIGNEfl MRIlA0DRE55 CITV ZIP PIIONE <br /> �'�ha ���1�T�� �9cZ� � / z-�� .rw�c F_l�)�OhfilS�L�i.��v����z� �s <br /> G EP�V.OT^�/ IV�G� nREYS�OS �C ��'�f.l� I� Y(lOI/ Y' •S /U�� �^'3�r��Z <br /> A .� v /�- <br /> MECHANICALCONTRA TOR MAILADDRESS CIfV ZIP PIIOIIE SI�IfIN;U15f;� <br /> i <br /> � GLOMBINOCONTflACTOfl M�ILADDRE55 CITY ZIP PINNIL SUIELICENSE� <br /> I � CLASSOF WOfiK <br /> �( NEW I.1 ADDITION CI ALTERATION f I RFPAIR I I DEMOLITION I I WOODSTOVE/FRPL INSERT � I BUILDING RELOCATIOt: <br />' � eoriTncT rensoN�wo rtae�e uo. c �) p <br /> CONTRACT PRICE OF WO L-C � /Y,3-/r� _ ��� �g .)�7 O Z% <br /> � DESCRIBE'NOHNAND ARE FOOT�GE INV VEO <br /> , � �oG,��TRoP�1 r �7�s�s� <br /> vnoroseouseoFeuao a �.fi6 S� I HEREBY CERTIFY THAT I I1AVE READ AND EXAMINED THIS <br /> �D� APPLICATION�ND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> �eMLDESCflIPTpNOFPROPERiV�5110WNBELOWORATfACHFWRCOPIES� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br />� . WORK WILL BE COMPLETED WITH WHETHEfi SPECIFIED HEREIN OR <br />. . �or ei.ocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PHESUME TO GIVE <br /> AUTHORITY TO VIO'ATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LIX:AL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORI2ED BV THE <br /> OWNER OF THIS PROPERTY TO PERFOFlM 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 /> ' ��3a� X k�� � y/z.�9v <br /> . '� PROJECTADORESS o � q � � ��`/]y[/(f � siGHnl�. - onlE �� <br /> . �. , ��� I / Lu�-C �E �` LItYPlI5NF.55lICEN5EN0 <br /> � . PLUMBING • MECHANICAL <br /> ', NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> I�� � '�� WATER CIOSET(TOILET) � N�AIHNDLG UNITS—H.P. � <br /> � ' BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> . � � , LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M ; <br /> —T <br /> SHOWER ' CLOTHES DRYERS � <br /> � KITCHEN SINK 8 DISP � VENTILATION FAN ' <br /> � <br /> � � DISHWASHER � RANGE HOOD �— <br /> . � LAUNDRYTRAY ; WATER HEATER �_ <br />, � . CLOTHES WASHER � WOOD STOVE � <br />. � � �. URINAL ' METAL FIREPLACE R CNIMNEY � <br /> � � ORINKING FOUNTAIN I FIREPLACE INSERT ; <br /> ' FLOOR DRAIN � HEAT PUMP � <br /> . � , BACKFLOW PREVENTERS ; GAS PIPING ; <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN � <br />� SINK(SERVICE—BAR,ETC.) ; ' <br /> � <br /> � �— <br /> � � <br /> ' SUB TOTAL S � SUB TOTAL E ' <br /> PERMIT S � PERMIT $ � <br /> � TOTAL FEE S ' TOT�L FEE $ ' <br /> FOR OFFICE USE ONLY: <br /> FHONTSEiBACK REARSETBACN SIDESEl0l1CK �I�NCHECNNI1M0Efl PEE �ECEIPTNO. <br /> �G Z �� O�u9 .Q A G ��7 <br /> USE2d7E �OTANE� vnc�uistte FEES VALU TION FEE <br /> OUILDING � 1�� ;�D <br /> tYPEOiCONtS.ALIOW�BIE TYPEOFCONST.�CiW1L ocCUMur.r tqalrMwxGuxns —��— � <br /> "17�' ,� I 11b � �° � 7/L PLUMBING _i�_ <br /> .LL fiI'� �I / <br /> SIZEOFBLD6. NO.OFSTORIE^u BASEMENi l MECHANICAL � <br /> 13 �i7 3 u � <br /> V � <br /> OCCUPANCY OAO FIPE SPRNNLERS f1EdD HEIGHT LIMIIAIION ADOITIONAL PLAN CHECK i <br /> REASONFORSPIIIM(LEPS �� — �� 1� <br /> ��� STATE BUILDING SURCHARGE �� 15O <br /> i <br /> INTAKEBV PL�NSAPPPOVEDBY CITYOFEYERETT PUBUCWORKS � <br /> LOCALSALES <br /> 7� ,�Z M TAX CODE IS 3105 TOTAL 2[���� <br />