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APPLICATIC"I FOR CONSTRUCT"lN PERMIT ' <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT evrjrFn <br />BUILDING DEPARTMENT HEATING SYSTEM: ❑ GAS J ELECTRIC ij <br />259.8810 — — - <br />11 DEMOLITION I I COMBINATION ❑ BUILDING I I MECHANICAL 1 PLUMBING SIGN <br />OWNER MAIL ADDRESS CITY ZIP PHONE — -- --- <br />KAJK+ KaK.L.So#) )goo lo2Ns ST L'I/exed 9ho3 P. <br />y771 <br />TENANT MAIL ADDRESS CITY ZIP PHONE <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSEE <br />MECHANICAL CONTRACTOR MAIL ADDRESS <br />CITY <br />PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE) <br />C RACT PRICE OF WORK <br />/6 Ayer <br />— — <br />DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED <br />CONTACT PERSON AND PHONE NO <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 MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />iL_iCR� Q��� /sue <br />PROPOSED USE of BUILDING <br />LEGAL DESCRIPTION VPROPERTY (SHOWN BELOWOR ATTACH TWO COPIES) <br />LOTS— BLOCK 000 OF - a-00 <br />PARCEL TAX I D. NUMBER <br />S,P 7/ Ono <br />CONSTRUCTION LOAN LENDER. ADDRESS, TELEPHONE NUMBER <br />PROJECT ADDRESS <br />'�6 <br />BaAAroRL D <br />TT B~SBIXFNS,W ' <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 />I <br />AIC-A/HNDLG UNITS-H.P. <br />, <br />BATHTUB <br />FORCED AIR SYSTEMS-B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />II <br />UNIT HEATERS-B.T.U. M <br />SHOWER <br />CLOTHES DRYERS <br />, <br />KITCHEN SINK 8 DISP <br />I <br />VENTILATION FAN <br />DISHWASHER <br />I <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />URINAL <br />' <br />METAL FIREPLACE (WOOD BURNING) <br />I <br />DRINKING FOUNTAIN <br />I <br />FIREPLACE INSERT <br />FLOOR DRA114 <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />' <br />GAS PIPING <br />I <br />ROOF DRAINS-RAINLEADERS <br />I <br />EXHAUST FAN <br />, <br />SINK (SERVICE -BAR, ETC.) <br />, <br />I <br />( <br />I <br />I <br />I <br />I <br />T <br />SUB TOTAL $ <br />SUB TOTAL $ <br />PERMIT $ <br />PERMIT $ <br />TOTAL FEE S <br />_ <br />TOTAL FEE $ <br />I <br />FOR OFFICE USE ONLY: <br />FRONT SETBACK[:R:EAR;:BACf( <br />SIDEBETBACK//PLANCHECKNUMBEB <br />IEF <br />RECEjP NO -, <br />/ <br />USE ZONE <br />z <br />LOT AREA <br />VACANT SITE <br />[ ] YES f7 NO <br />FEEB <br />VALUATION <br />FEE <br />BUILDING <br />V <br />�O <br />TYPE OF CONS) <br />NO OF STORIES <br />ajC�urAuNrr <br />1-I,P•I <br />NB VNYTIUw; uNIT6 <br />PLUMBING <br />i <br />SIZE OF BLDG <br />I'HE SPRINKLERS REOD <br />BASEMENT <br />i YES POONO <br />MECHANICAL <br />' <br />ADDITIONAL PLAN CHECK <br />� <br />OCCUPANCY LOAD FIRE ALARM REDO HEIGHT LIMIT ION <br />PJA <br />REASON <br />OTHER <br />STATE BUILDING SURCHARGE <br />INTAKE BY <br />PLANS APPROVED BY <br />J <br />DATE <br />CITY OF EVEHETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />PUBLIC WORKS <br />TOTAL <br />