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APPLICATIC^I FOR CONSTRUCT' 1N PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT � <br /> BUILD�NG DEPARTMENT G'� �n �� HEATING SYSTEM: �J GAS U ELECTRIC J <br /> 259-8810 � <br /> i ; DEMOLITION ' ' COMBINATION I I BUILDING 'MECHANICAI I I PLUMBING i � SIGN <br /> ONMER M�II AO�RE55 ��r� .. <br /> z�P PHON[ <br /> /?ogert (Ui.Lfmon 2SOS C.lev.land Ave �vertetff 9820/ 252-6852 <br /> iENANT MML�ODR SS CiiV ZIP p�E ' <br /> ARCNITECTpqDE51GNER M�ILAO�RESS qiV ziP <br /> PMONE <br /> GENERAI CONiR�CTOR MAIL IIDDRE55 pTV ZIP PNONE SUTE LICENSE� <br /> d400de cout Inc //2/y-60th Sf N� Lk Sfeven.i 9825'8 334-9262 NOY2%N6 /2/�LO <br /> Qc B r a9bu�eooRess arr <br /> ziP P�E ST,1TE LILENSE• <br /> Pl11M81NGCONiRACTOR IA�IIAD�RE55 CITV ZIP PNONE <br /> ST�iE LICENSE� <br /> CONTq��i PRICE OF NORK <br /> 8 9r�o - <br /> UESCRIBE N'ORK ANO SIXURE FOOTAOE INVOIVED CONT�GT PERSON AND PHONE NO <br /> �AortiseouseorewioiNa t HEREBV CERTIFV THAT I HAVE READ AND E%AMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> lE4ALDESCRIPiqNOFPqOPERTY�SHOWN0EL01VOR�iTACNTY/OCOPIE51 WORK WILL DE COMPLETED WITH WHETHER SPECIFIED HEFEIN OR <br /> �or---�.��BIOCK—�u� ov n/a oI�lr r���( NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME 70 GNE <br /> ImpCO�d AUTHORITV TO VIOLqTE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGUTATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> �,���T_��9 OWNER OF 7HIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> P�RCELTAxIDNUMER APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> s���_S�2 �/� CONTRACTOFS LAW 18.27 RCW AND 296.200 WAC. <br /> CONSTRUCTqNLO�NIENDEN.A0DNE55.TELEPHONENUMBER / � <br /> f — � / <br /> PROJECTADDRESS ��4R ����i(/�/ _ <br /> SM.N �t D�if �—�-- <br /> blYpU5�Nf5911f[NSf NU � <br /> PLUMBIN6 MECHANICAL <br /> NO. TYPE OF FlI(T OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) _ /VC—NHNDLG UNITS—H.P. <br /> 0A7HTU8 _ ; FORCED AIR SVSTEMS--B.T.U. M E.A. <br /> LAVATORV(WASH BASIN) UNIT HEATERS—B.T.U. M <br /> SHOWER CLOTHES DRVERS �— <br /> KITCHEN SINK 8 OISP VENTILATION FAN � <br /> DISHWASHER � RANGE HOOD —�T— <br /> _ LAUNDRYTRAV ; WATERHEATER <br /> CLOTHES WASHER � WOODSTOVE <br /> URINAL � METAL FIREPLACE(WOOD BURNING) —� <br /> DFINKING FOUNTAIN ' FIREPLACE INSERT � <br /> FLOOR DRAIN � HEAT PUMP T— <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—RAINLEADERS � E%HAUST FAN � <br />' SINK(SERVICE—BAR,ETC.� � <br /> � <br /> � <br /> � <br /> _ � <br /> SUB TOTAL S ' SUB TOTAL S <br /> PERMIT $ PERMIT $ ' <br /> TOTALFEE S ' TOTALFEE a � <br /> FOR OFFICE USE ONLY': <br /> FRpNi SETB�CK pE�R SETBACN SIOE SETA N P�AN CNEC NUMBER FE <br /> � y� RECHPI NO <br /> �— d S ��'�� ��. d-� 3�� <br /> USE20NE^� LOTARE� � V�C�Nt51TE FEES VALUATION PEE <br /> � �7 VES i? NO <br /> BUILDING O _ <br /> TYP�f}IX'�yg—NSt NOOFSTORIES aNwNtr NoaVMiimGUNrts <br /> �l— � � GpWo � pLUM81N0 <br /> SIZE OF BLDO FIHE SPRINKlENS R6ry0 BASEMENT MECHANICAL � <br /> 56U S F � ❑ vEs ,wvu <br /> OCCUPANGv�O�U FIREAURMPEO'D MEIONTLIMITATION ADDITIONALPUNCHECK � <br /> ,4 l� Z � � <br /> _ OTMER ' <br /> REASON _ i <br /> STATE BUILOING SURCHARGE v�� <br /> INT�NE BY PL�n�PppVED IIY CITY OF EVEREIT PUa11C r/ORKS �� � <br /> F LOCAL SALES � <br /> _ o.re Z�Z��e�� TAX CODE IS 3105 TOTAL ; <br />