Laserfiche WebLink
1 <br />APPLICATIC'`I FOR CONSTRUCT"�N PERMIT �� <br />TO BE COMPLETED IN BLACK INK—PIEASE PRINT ' <br />BUILDING DEPARTMENT f HEA7ING SVSTEM: GAS J ELECTRiC J___ _ _� <br />259-8810 <br />DEMOLITION C7MBINATION ��BUILDINO p f I MECHANICAL i PLUMBING SIGN <br />OWNkR N�it �[A�Rf55 Pi� I ZiP PMONE <br />M���,S��-c1: Ai�-� 5sc�� :�`1�,,��E. s= ,.�i��c,���k�iA �j,�'�i�� :�el. "747�9`ic 1 <br />9�l—� Ciiv 2iP VHONE <br />rEr+�Nr unn �nonrs; <br />�RCNRECTOROESIONER M�R�ODNE45 ���� z�P P1KKlE <br />��ri4E.iiF,l�% �blN��h�G'���I.+� L-1r'L-T'r 6.� �I'�c:`� �S� ���3/ -- <br />fiENER�L CONTR�CiOR M�il ��URE55 CITY ZiP PHONE STATE LICENSE I <br />MEf,NANIC�L <br />PIUMBING CONTRACTON <br />CONTR�Ci PRICE OF WORIt <br />MMl �DORE95 <br />MAII �ODHESS <br />PROP09ED USE OF BUIl01N� <br />sWN�a o�-��r�En <br />LEG�I OESCRIPTION OF VROPERtt ISNOWN BEIOW OR �TT�CH <br />lOi BLOCN--�sQF�____ <br />CITV IIP <br />P�RCELiAMI� NUMBFN -� <br />gprygiqUCT�ONLO�NLENpE11 �ODRESS TELEPNONE NUM9ER <br />PROJECT ADDRE93 <br />PLUMBINO <br />N0. TYPE OF FIXTURE OR ITEM FEE <br />WATER CLOSET ITOILET) <br />BATHTUB r �I ___�. <br />LAVATORV (WASH BASIN) X <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRVTRAV � <br />CLOTHES WASHF�1 <br />URINAL <br />DFINHING FOI�NTAIN <br />r' FLOOR ORAIN <br />�" PACKFLOW FfiEVENTERS __� <br />�- ROOF DRAINS—RAINLEADERS <br />i SINK �SERVICE—BAR. ETC.) _ _ ; <br />SUBIOTAL <br />PERMIT <br />TOTAL FEE <br />FOR OFFICE USE ONLV: <br />iRON15E1B�f.N � PE�RSFLBACN <br />USE2 E l0 NEA <br />IVVFaico;�� NOO�sroAlFs <br />—1ka. '�'-- � _ <br />i1EOFB100 �iREFPR� lER9REb0 <br />lxd � � . <br />OCLUP�NCV LO�� f�RE �L RM HFOO <br />SEiB�CN <br />WUNi SrtE <br />VES NO <br />IKfI:��Nfr MnM�µYII�N.I <br />BASEMENI � <br />�ES x Na <br />MEIGNT LiMIL�TION <br />gy PI.ANS�PPROVE00Y CI7V OF EVENETT <br />�` � q'�h 'IAX CODE SL3105 <br />—�o�Te � .�'2 _ <br />21P <br />PNONE <br />P/qNE STATE <br />CON��f�-v1rc)rv�'S'�l-T'1F�-.� �v�"� . .._ <br />��tTS Lt'AO�N:/�F'r� �.3�—���� <br />gloaG LAS�q �f Jevc ygzms' <br />I HEREBV CERTIFV THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AN� CORFECT. ALL <br />PR7VISIONS OF LAWS AND ORDINANCES GOVEPNI�G THIS TVPE OF <br />WOHK WILI BE COMPLETED WITH WNETHER SPECIFIED HEHEIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PFESUME TO GIVF <br />AUTHORITV TO VIOLRTE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATF OR LOCAL LAW REGULATING CONSTRUCTION OR THF <br />PERFORMANCE OF CONSTfiUCT10N THA� I AM AUTHOFIZED BV THE <br />OWNER OF THIS PROPERTV TO PERFOr7M THE WORK FOR WHICH <br />APPLICATION IS MADE AN�' I COMPLV WITH THE �TATE <br />CONT,�iACTORS LAW 1827 FC�AND 296200 WAC <br />i/I � /' ' <br />� ���k;�U'i � �lr S -Yi-- <br />-- nuF <br />� r�„n�.. — '_ <br />N0. <br />A C—A�HNDLG UNIi <br />FQFCED AIR SVSTE <br />UNIT HEATERS--B.1 <br />CLOiHES ORYERS <br />VENTILATION FAN <br />RANGE HOOD _ <br />WATER HEATEF <br />WOODSTOVE <br />METAL FIREPLACE i <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />E%NAUST FAN /, <br />P <br />B T.U. <br />M <br />Fee <br />"T <br />S IB TOTAL S <br />PE�MIT S <br />�— TOTAL FEE $ <br />C <br />P1AN�NH:hHuufl[N fEE,�� � RF.CfiPiND <br />a �� <br />Bl1ILDING __ <br />PLUMBIN + <br />MECHANICAL <br />ADDITIONAL PLAN CHECN <br />OTHER <br />STPif BUIIDING SUHCHAPGE <br />PUBLIC WORKS <br />TOUL <br />0 <br />--T <br />0 <br />