Laserfiche WebLink
APPLICATIC ' FOR CONSTRUCT' IN PERMIT <br /> TO BE COMPLETED IN BLACK INK-PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM J GAS ,ELECTRIC J __- <br /> 259-8810 <br /> 1 1 DEMOLITION I COMBINATION f i BUILDING LI MECHANICAL E-1 PLUMBING I I SIGN <br /> OWNER MAIL ADDRESS CITY ZIP PHONE SS3 <br /> IE.� '°_xi ,x���p - 3o �Pa} N 5� EgPr"- r �c6b1D � a 966, <br /> TE'IANT MAIL ADDRESS CITY ZIP PHONE <br /> ARCHITECT OR DESIGNER MAR ADDRESS CITY ZIP PHONE <br /> GENERAL CONTRACTOR MAR ADDRESS CITY ZIP PHONE STATE LICENSE <br /> owm e.c' -- <br /> MECNANICALCONTRACTOR MAL ADDRESS CITY ZIP PHONE STATE LICENSE <br /> PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE IT <br /> CONTRACT PRICE OF WORK <br /> DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED CONTACT PERSON AND PHONE NO <br /> 0 <br /> - CKj <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSED USE 0-BUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> rj F PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGAL DESCRIPTION OF PROPERTY'SHOWN BELOW OR ATTACH TWO COPIES) WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> LOT BLOCK OF 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 MADE AND 1 COMPLY WITH THE STATE <br /> PARCEL TAXI D.NUMBER CONTRACTORS LAW 18.27 RCW AND 296.200 C. <br /> L - - o <br /> CONSTRUCTION LOAN LENDER,ADDRE S.TFI EPHONE NUMBER L f ,E� <br /> PROJECT ADDRESS SK.NATIIF <br /> CITY BUSNEIS L¢LNSE w <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) I AIC-AMNDLG UNITS-H.P._ <br /> BATHTUB FORCED AIR SYSTEMS-B.T.U. M E.A. ' <br /> UNIT HEATERS <br /> LAVATORY(WASH BASIN) _ I <br /> SHOWER CLOTHES DRYER S _ <br /> KITCHEN SINK 8 DISP ' VENTILATION FAN 1 <br /> DISHWASHER I RANGE HOOD ' <br /> _ LAUNDRY TRAY WATER HEATER <br /> CLOTHES WASHER I WOOD STOVE ' <br /> URINAL ' METAL FIREPLACE(WOOD BURNING) <br /> DRINKING FOUNTAIN I FIREPLACE INSERT <br /> HEAT PUMP ' <br /> FLOOR DRAIN , <br /> _ BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS-RAINLEADERS I EXHAUST FAN "$ ! <br /> SINK(SERVICE-BAR.ET <br /> C.)SUB TOTAL S I SUB TOPERMIT S I PERMITTOTAL FEE S TOTAL <br /> FOR OFFICE USE ONLY: _ <br /> ONT SETBACK REAN SETBACK SIDE SETBACK <br /> PLAN CHECK NOMRE R n Ia CFIPT NO <br /> FR . <br /> r'�l•7 <br /> USEZONE LOT AREA VACANT SITE FEES VALUATION FEE <br /> ❑ YES ❑ NO BUILDING <br /> TYPE OF CONST NO OF STORIES OCLBMKY <br /> PLUMBING ' <br /> SIZEOFBLDG FIRESPRINKLERSREOD BASEMENT MECHANICAL _ <br /> f 1 YES ❑ NO <br /> ADDITIONAL PLAN CHECK I <br /> OCCUPANCY LOAD FlRE ALARM REOD NENIIT LIMITATION � <br /> OTHER <br /> REASON <br /> STATE BUILDING SURCHARGE ' <br /> T <br /> INTAKE 11 PLANSAPPROVEDPlCITY OF EYERETT PUBLIC WORKS T <br /> LOCAL SALES <br /> DATE TAX CODE IS 3105 TOTAL <br />