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APPLICATIO . FOR CONSTRUCT'lNi PERMIT ��� <br /> TO BE COMPLETED IN BLACK INK-PLEASE PRINT <br /> BUILDING DEPARTMENT L HEATING SYSTEM: U�S ELEC7FIC [J ___� <br /> 259-8810 <br /> DEMOLITION �OMBINATION BUIIDING MECHANICAL PLUMBENG SIGN <br /> OtlNER MAIL RCOflESS GITV ZIP MHONF "—' --� <br /> ��►� i DPrd z io�+ - �},�a� E' Je�li q92n� .35s- 90 s � <br /> TENANT MFIL DDRESS CITY ZIP pHONE <br /> Sa.v►�.e. <br /> AfiCHITECTORDESI�NER MRILRODHESS CITV IIP PHONE <br /> ,/w,wl <br /> OENEfULCONTMCTpq MMLRDDHESS CI?Y ZIP PHONE STATELIC[NSE• ^— <br /> �� <br /> MECHMIIC�LCONTRACTOR MAILADORESS CITY ZIP PHONE STATELICENfE1 <br /> r� <br /> PLUAIBINGCpJTMCTUfl IMIL��DRE55 CITV ZIP PHONE STATELICEN6EI <br /> CUSSOFWORN � -� — <br /> ' ' NF.W ��Y�ADDITION 'i '�. ALTERATION � � REPAIR . DEMJlI110N �� �. WOODSTOVE/FRf�L INSERT � � BUILDING RELOCATION <br /> CONTAGT PEOSON AND PHONE Np. <br /> CONTMCT PRICE OF WORK �9p�� <br /> UESCRIBE�yORN U1D SOU�RE FOOTAGE INVOC ED <br /> � <br /> vnovose:�� oFauaox�c /'1� i HEREBY uERTIFV THAT I HAVE READ AND EXAMINED THiS ; <br /> �::�Sp -O�{�J o�C7 -opn"7 APPLICATION AND KNOW THE SAME TC BE TfiUE AND CORRECT ALL <br /> IEGALOESCRIPTIONOFPROPERTViSIqWNBELOWOPATfACHFOURCOPIES� PROVISiONSOFUWSA4DORDINANCESGOVERfdINGTHISTVPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREItJ OR <br /> �ot e�ocK oc NOT THE GRANTING OP A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER gTATE OR ICCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF G�JNSTAUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER OF TNIS PROPERTV TO PERfORM THE WORK FOR WHICH <br /> APPLICATION !S MADE AND I COMPLV WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> PRO,IECTADOPESS 9�G'uiUq��� �� wi[ � �� �� <br /> � rl7�f- �cQa.n'ls �l� F ���.m�,�����E�� <br /> PIUMBING MECNANICAL <br /> NO. TYPE OF FlXTURE d9 fTEM FEE NO. TYPE OF EOUIPMEi1T FEE <br /> WAT€R CLOSET(TOILET) A/CrA/HNDLG UNITS—H.P. i <br /> BATHTUE � FORCED AIA SVSTEMS—B.T.U. M E.A. <br /> LAVATORV(WASH BASIN) UNIT HEATERS—B.T.U. M ; <br /> SHOWEF CLOTHES GRVERS <br /> i— <br /> KITCHEN SINK 8 DISP ' VENTILAT!ON FAfJ <br /> DISHWASHER RANGE HOGD <br /> LAUNDRV TRAV ; WATEFl HEAZ'EH <br /> CLOTHES WASHER � WOOD STOVE <br /> URINAL MElAL hIR€PLAC€S CW.IMNEY <br /> DRINKING FOUNTAIN 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 /> i <br /> SUB TOTAL $ ; SUB TOTAL S { <br /> PERMR �$ PERMIT $ �� <br /> TOTAIFEE $ TOTALFEE S <br /> FOR OFflCE USE ONLY: <br /> iqONT SETBRCN RE�R SETBRC� SIOE SETB�('j(/ WAN CXECK NUMBER FEE ,��s pECE1PT� � <br /> � S 3 .� ' <br /> �� <br /> USE ZONE LOT AR A V�G1NT SITE FEES VALUATON FEE <br /> -Z O a���o�� 2p :— I <br /> IVVEOFGONTS.RILOW�BLE iYPE CONS?ACTURI aaA�Ntr xa0rovrtwrie:+nn i il <br /> � _ enav ,� PLUMBING __ — I <br /> $IZEOF&.OG. NO.OFSiORIES &�SEMENT MECHANICAL � <br /> OCCU��O FIqESPRNKLER� NEIGM LIMITATI9N ADDiTIONALPUNCHECK � <br /> �� ND � SPRMKLER —r� <br /> q FOR SFHINKLENS — �' <br /> STATE BUILDING SURCH�RGE <br /> INT�KE 8Y VLAHS APGFOVED BV CITY OF EVEREIT PUBLIC WORKS � <br /> � LOCALSALES <br /> J� TAII CODE K 3105 *�*w 2 2 ' � <br />