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APPLICAT'IC'1 FOR CONSTRUCT"l� PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMEN( HEATING SYSTEM: U GAS .J ELECTRIC J _ <br /> 259-8810 <br /> I i DEMOLITION � ' COMBINATION Dt BUILDING I i MECHANICAI � !PLUMBING � ! SIGN <br /> OWNER M.1L�ODRESS Ci1Y TIP PMONE <br /> 7"�}E �����/� C.d. � P0� BOX 3�e7. P1S O/�-12, .$ERiTl.Lr, �•A . qBRN 216-3si3 <br /> 7ENANT M��l�DJFE55 CITY 21P pHpN[ <br /> S A-rh IC A� ow r✓6 r� <br /> ARLHRECTOq0E5�ONER M�IIFDDRE53 CITY 21P PHONE <br /> a���.— <br /> GENEML CONTR�CTOR MML�OORESS CITv 2iP PHONE SiQE UCENSE� <br /> �It.�W62 Gu• <br /> MEf,NANICALCq+iR�GTOP M�iIA�DRfSS CITV Zlo PNONE SUTEIICEN5E1 <br /> PLUMOINOCONiR�CiOq M�IL�DORESS CITY IiP PNONE STATELN.F.NSE� <br /> CONTRALT PqICE OF WORK <br /> �� ZOG <br /> DESGRIBE WORY�ND SOUARE FOOU6E INVOLVED CONT�CT PFASON AN�PIIONE NO <br /> L�oMrr� �TP�.I�l,3�2S,Ci 2G6-yS63 <br /> l '� ' i HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> P110POSED USE OF BUIl01N� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> U'FF�C�__. _. PqOVISIONS OF LAWS AND ORUINANCES OOVERNINO THIS TYPE OF <br /> LEGAI.DESCOIPTqN' �NOPENTV�SHOWNBELOWOP�TT�LNTYKICOPIE51 WORK WILL BE COMPLETFD WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE 6RANTINO OF A PERMIT DOES NOT PqF';i1ME TO GIVE <br /> �or — FiocK a AUTHORITV TO VIOLATE OP. CANCEL 1HE PROc :,:ONS �F ANY <br /> OTHER STATE OR LOCAL LAW REGULATINO CONSTPI'�;7ION OR THE <br /> — PERFORMANCE OF CONSTHl1CTI0N.THAT I AM AU" iJRIZED BV THG <br /> OWNER OF THIS PROPERTV TO PERFORM TI1E W:iRH FOR WHI,^.H <br /> P�RCELT�NIDNUM9ER APPLICATION IS MADE AND I COMPIV N'•TH THE STATE <br /> CUNTRAC70RS LAW 1827 RCW AND 296.200 WAC. <br /> CONSTRUGTIONLOANLENDER,ADDNESS.TELEPHONE NUMBER <br /> Y i �'� J • ��� L � <br /> PNOJECT ADDRE88 snr���une wrt <br /> ' AD l,r. CA5t.�0 I�D. �JD— 16 ��,.a,��„�:s,���s,�— <br /> PLUMSINO MECHANIC�L <br /> N0. TYPE OF FlIfTURE OR ITEM PEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILE7") � NC—A/HNDLG UNITS—H.P. <br /> BATHTUB ' FOHCED AIR SYSTEMS—B.7.U. M E.A. �_ <br /> LAVATORV(WASH BASIN) � UNIT HEATERS—B.T.U. M �,, <br /> SHOWER � CLOTHESOHVERS � i <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN ; I <br /> DISHWASHER RANOE HOOD � �'i <br /> LAUNDRYTRAV � WATER HEATER I <br /> CLOTHES WASHEH � WOOD STOVE �I <br /> URINAL ' METAL FIREPLACE(WOOD BURNMG) � ''� <br /> DRINKING FOUNTAIN i FIREPLACF INSERT ; <br /> T <br /> FLOOR DRAIN HEAT PUMP � <br />' BACKFLOW PREVEN?ERS ; c,AS PIPWC� <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN <br />' SINH(SERVICE—BAR,ETC.) ; _ _�_ <br /> , <br /> � � <br /> -- —T <br /> � � <br /> T <br /> . SUB TOTAL S I _ SUB TOTAL E _ I, <br /> PERMIT S PERMIT f � <br /> 'OTAL FEE E TOTAL FEE S ; <br />� fOR OFFIC�USE ONLY: <br /> FRONTSE7B�CN REARliETAACM SIOESETB�CN PL�NCNEC NUMB�P FEE '��FIPTNO <br /> � 7 <br />� use ior+e ioT enee V�L�NT SITE FEES VALUATION F�E <br /> �� YES I ': NO BUIIDING 1�O V � <br /> lYPfpCONSi NOOFSTORIES acuwrcr hopoWRiiNGUMi�s <br /> v_ � RO1°� PLUMAING ; <br /> SREOfBLDO FIRESPRINI(lER5NE00 O�SEMENi MECH�NICAL � <br /> � <br /> `� yo �o � ves No � <br /> fIRE�Uf1MRE0U neiurrLIMITAIION ADDITIONALPLANCHECK ; . <br /> O/:GUPANCY IOAD . <br /> N° OTHER ' I <br /> -- � <br /> REA50N - <br /> STATE BUILOING SURCHARaE <br /> INTANEflV PL�NS�PP YE�BY CITYOFEVEREIT PUBLICWORKS � I, <br /> ��1 LOCAI SALEB <br /> n�re � _ q TAK CODE IS 3105 10TAL b <br /> �� <br />