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APPLICATIC l FAR CONSTRUCT' 1N PERMIT � <br /> TO BE COMPLETED IN BLAGK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEA7WG SYSTEM: J GAS ECTRIC J ___� <br /> 259-8810 <br /> DEMOLITION �COMBINATION BUILDING MECHANICAL PLUMBING ' : SIGN <br /> OWNER MAIL�DORESS GTY ZiP PHONE <br /> �TTif' �'m-,-,.�o���A�r.�• LC'Qo�� , /hc /.sct��3_,,�a''-`.qvE�, .lY.,%/�oe.7 9�a 37 <br /> TEN�Ni M�ILADORE55 � C 21P PNONE �- G�� <br /> _ ��� <br /> ARLNRECTOR�ESIONER MI1IL�DDRE55 C11V IIP PNONE <br /> GENER�L CONTRALTOR M�II A�DRE55 piY ZiP PHONE SJI.IF LICEHSE I <br /> �'n�nvon��E',o.c .—�a �.-r-.t:.����B� s�d[' � ,ls%,%,�woo� %cfd37(o�/C _ <br /> MECM�NIG�L CONTR�CTON MML�ODPE55 fltY IIP P110NE gUTE IICENSE I <br /> PWMBINOCONTR�CTOR MAR�DORE55 C11Y 21P PHONB ST�TELIGFNSE� <br /> CONTN�CT PRICE OF WORN <br /> DESCPIBE WORIc�NO50UARE FOOTAGE 1NVOlVEO CONTAGT PERSON AND PHOHE ^� w� <br /> nNo✓Ani /�A.tT • �y� �' <br /> S'iNG.t1'OSo.+sit� �1 Si.Jr�r � — <br /> i HEREBV CERTIFV tHAT 1 HAVE REA� AND E%AMINED THIS <br /> PROPOSEDUSEOF BUILDING APPLICA710N AND KNOW THE SAME TO BE TRUE AND CORRECT. AlL <br /> �FS'/ {7 F(Y C � PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEOALOBSGfiiPT10N0°fA�'tNLY�SHOWNBELOWORATT�CHiWOCOPIES� WORK WILL BE COMPLETED WI7H WHETHER SPLCIFIED HEFlEIN OR <br /> NOT. THE GRANtING OF A PEHMIT DOES NOT PRESUME TO GIVE <br /> �or� eiwK � — AUTHORITV TO VIOLATE OR CANCEL THE PFOVISIONS CF ANV <br /> �� _ CJ� _ OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION GR THE <br /> {'�,--' PEPFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED EIV THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR INHICH <br /> APPLICATION IS MADE AND I COMP N'ITN THE STATE <br /> PARCELTA%IDNUMBER CONTRACT W1 RCW 2JG.Y WAC <br /> CONSiRUCT10N LO�N IENDER.ADDRE55�./T�EL,,E�PNONE NUMBER /�� <br /> �/'T�/i34A�/C . �/��07' ?4!Y J�. .l41f� ��'� / �- ����L�JC�C� <br /> PEo.IdC wDv E89 � srtw� o.rz <br /> C��C/ �p � (,i�YBUYNE4911CFN5E WJ <br /> �O Z 2 z._ MECHANICAL <br /> PLUMBINO <br /> qp, TYPE OF FIKTURE OR ITEM FEE N0. TVPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � � A/C—A/HNDLG UNITS—H.P. <br /> BATHTUB � ; FORCEDAIRSVSTEMS—B.T,U. M E.A. ; <br /> LAVATORV(WASH BASIN� �r —� UNIT HEATERS—B.T.U. M � <br /> SHOWER CLOTHESORYERS � ' <br /> KITCHEN SINK 6 DISP � � VENTIIATION FAN <br /> DISHWASHER i � RANGE HOOD ' <br /> LAUNDRYTRAY ; WATER HEATER / <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL ' METAL FIREPLACE(WOOD BURIJING) 3 ' <br /> ORINKINO FOUNTAIN � FIREPLA EINSERT � <br /> FLOOR ORAIN HEAT PUMP <br /> BACKFLOW PREVENTERS ; GAS PIPING __ <br /> ROOF DfiAINS—RAINLEADERS � EXHAUST FAN �- � __ <br /> SINK(SERVICE—BAA,ETC.) _ � <br /> � ' <br /> SUB TOTAL S ; &UB TOTAL S <br /> PERA�71T S I�ERMIT S <br /> TOTALFEE S TOTAL FEE S <br /> FOR OFfICE USE ONLY: <br /> FRONTSETB�Ge RFAPSCIB�CK SIDESETB�C�t� PUNC CICNUMB fEE pECE1PTN0 <br /> Zp � T.O ' S Jlvlv� 3 ,�7 `3 7 <br /> . use t LOT�RE� V�C�NT SRE FEES VALUIITION FEE <br /> � �Z �i VES fl NO BUILDING S g7o �� 'J` V <br /> '� irPEacONSi rqoFstoa�Es «cunxcr rmamni�iwuxns � <br /> � � I " PLUMBING ,� � <br /> ���A�p4f� FIRESPRINNlER5NE0'D B�SEMENT � � MECHANICAL �(D i <br /> }D S i i VES YNO <br /> 440 SF CiATAG qpDliIONAL PLAN CNECK �- <br /> OCGUP�NCV LOAD FlRE I1L�IIM RE00 MEIOH7 LIMIL�TION <br /> � / OTHER � �Q T__ <br /> RE�SON <br /> E7ATE BUILDINC SURCNAROE � � r(�� <br /> INiANE BV PLANS�PPN VEDBY CITY OF EVEHEIT PUBLIC WOHKS ZO � � \ <br /> J LOCAL SIILES <br /> o,,,E TAI(CODE IS 3105 rotn� 2 I� <br />