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APPLICAT101�1 FO� �O�NSTRUCi'-�N PE�iMIT � <br />l'O BE CDMPLETE;i I!1 C�LACK IhK—PLEASE IPiiINT <br />HEATING SYSTEM: U GNS ❑ ELECTRIC ❑_ <br />BUILDING DEPARTMEtlT <br />25�8810 <br />��DEMOLITION LI CnM81NATION I] BUILDING ;7 MECHANICAL ❑ PLUMBING CJ SIGN <br />OWNEP M�ILA�OflE55 dTY ZIP PHONE <br />.av,� r'(-������ /�f�.5 .,y�� sj�_ S.I�_ Sr/�,� ���,�����7 ���o� ;_5-s,.77�0 <br />TENANT MAILAfi�RE55 GITY ZIP ' PHONE <br />i��Gpti ! <br />MAiL A�UiiE55 <br />P�IIMBING <br />GONTRFGT PFICE OF WORK <br />DESCRIBE WORK AND SOUAFE FOOTAGE <br />rJo..,�Lr-r,e� e•, <br />51,� �s <br />GITV ZIP <br />CITV ZIP <br />�y'" st. s;. <br />:ITY I�P <br />CITV ZIP <br />PPOPOSED lISE OF BWLOING <br />LEGAL DESCRIPTION OF PROPERTV (SHOWN BELOIY OR ARAGHTYJO COPIES) <br />LOT BLOCN OF <br />PqRCELTAXID NUMBEN <br />� 6 2 � U 5 � ^ 3 "{i��i' .. �-rJ.S� <br />CONSTRUCTiGN LOAN LGIDEq. AUORESS, TELEPHONE NUMBER <br />991/ r/7�- A//,L? 5��. <br />N0. <br />TYPE UF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF ORAINS—RAINLEADERS <br />SINK (SERVICE—BAR, ETC.) <br />FOR OFFICE USE ONLY: <br />FflONT SETBACN PEAR SET <br />115E20NE LOTAPEA <br />TVPE Of CONST <br />SIZE OF BLDG. <br />INTAKE BY <br />� <br />SUB TOTAL S <br />PERMIT S <br />TOTAL FEE $ <br />FIRE SPRINK�EPS iiEOD <br />FIRE ALARM REO'D <br />PLANS APPROVED 8V <br />onTe <br />.%Z <br />SIDE SETDACK <br />PNJNE ST�TELILENSEa <br />��.�Rh.r ��t� z, c�, <br />?HOh� STATE LICENSE u <br />MHONE STATE UCENSE a <br />CONTFLT PERSON AND PHONE N0. <br />i�.a����- �1'%'0<.�,_ 3s-�-77m <br />I HEREBY CERTIFY THAI' I HAVE REP.D 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 COMPLETE� WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISI�NS OF A'!Y <br />OTHEA STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APFL 6ATION IS MADE AND I COMPLY VJITH THE STATE <br />CONT AQTORS LAW �.27 RCW AND 29E.200 W.4C. <br />I '��c \ �j .� <br />( � ��,� -t'SJ <br />sicrurune � oa�E <br />CItY OOSiNE55liCO5E f:0 � <br />MECHANICAL <br />NO. TYPE OF EOUIPMENT FEE <br />A/C—A� NDLG UNITS—H.P. <br />FORCED i.IR 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 />WOOD STOVE � <br />METAL FIREPLACE (WUOD F7URNING) � _ <br />FIREPLACE INSERT � <br />HEATPUMP ' <br />GAS f'IPING � <br />EXHAUSTFAN � <br />PLAN CHECN NUMBER <br />❑ YES ^' NO BUIL�ING <br />acu:nucr reoarow[wr:cumns � <br />�flCO' PLUIdBING <br />BaSEMEV? MECHANICAL <br />❑ Yf_S �.:� NO <br />HEIGI+T �_IMITATION NDDITIONAL PLAN CHECK <br />OTHER <br />S7ATE BUILOING SURCHARGE <br />CITY OF EUERETT PUBLIC WORKS <br />LOCAL SALES — <br />TAX CODE IS 3105 rora� <br />SUB TOTAL 5 <br />PERMIT S <br />TOTAL FEE 5 <br />i <br />i <br />�tl <br />N <br />. <br />