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APPLICATIf�Y FOR CONSTRUCT''JN PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> t <br /> BUILDING DEPARTMENT HEATING SVSTEM: U GAS ELECTRIC U <br /> 259-8810 <br /> I 1 DEMOLITION i COMBINATION I I BUIIDING �MECHANICAL ! I PLUMBING I i SIGN <br /> ownEa uuinnoaess eiTv zm rHorve <br /> �.8• GRh1L 1�00 5.6•M4ia Sl.�"� Tr�iHe CA. 926i4 7�9 � 85� -(o3b <br /> TEN�NT MML�D�RE55 CITY zIP PHONE <br /> rt�7Pr+4 /31c�a '� '4/I r�/ee'tt- q8�1 3V2- i342 <br /> ANCHITECi DESIGNEP MAIL Q10RE S �IiV 1iP PNONE <br /> GENERQCONTRACTOP M�IL�ODRESS CITY ZIP PIIONE SiAtELICENSE• <br /> �u . Cao�h�� ZkU SS wb,i� �l• -lr✓�Ne G� �i7�,/Y 714� 85�Y�So PERfoH�1SOkl <br /> MEG��r����C70� M�ILA�DHE55 CITv ZIP PHONE STQELICENSE� <br /> / <br /> PIUMBINGC TR�COR M�ILA�ORESS CRY 21P PHONE ST�TEUCENSE• <br /> [ONTR�CT PRIGE OF <br /> /S�O.Oo <br /> OESCRIBE WJHN�ND SW�RE f00UGE INVOIV[D <br /> CONTRCT PERSON�ND PNONE NO <br /> i?a �T• / �,n <br /> 2�4 N . TA, ► -yzs -zsi -oss� <br /> S�'}' V� ee����F1W41/� i HEREBY CEHTIFV THAT 1 HAVE READ AND EXAMINED TIiIS <br /> PROPOSEDU ow� inc APPUCATION ANO KNOW THE SAME TO BE 7RUE AND CORRECT.ALL <br /> � �L� PROVISIONS OF LAWS ANO ORDINANCES GOVERNING THIS TYPE OF <br /> LEO�LOESCNIPTIONOFPROPENTV�SNOWNBELOWOR�TTACNTWOCOPIE51 WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES irvT PRESUME TO GIVE <br /> ior etceK ov AUTHGRITY TU VIOLATE OH CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTFiUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUiHORIZED BV THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> PAPCEL TA%ID.NUMBER CONTRACTORS LAW 18.27 RCW AND 29G200 WAC. <br /> CGNSTf1UCTION LO�N:ENDER,ADDRESS.TEIEPNONE NUMBEq � �p �-7 <br /> X F/ • � [TI �2� ( <br /> PqWECTADDRE33 �I u0 ' y/I s�c�umnr -o.;E <br /> y fIIYPO5Mf55lifFNSf 1A7 <br /> PLUMBINO MECHANICAL <br /> N0. TVPE OF FIXTURE OR ITEM FEE N0. TVPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) NC—A�HNULG UNITS—H.P. �— <br /> BATHTUB FORCED AIR SVSTEMS—B.T.U. M E.A. �— <br /> LAVATORY(WASH BASIN) UNIT HEATEPS—B.T.U. M <br /> SHOWER CLOTHES DNYERS <br /> KITCHEN SINK 8 DISP VENTILATION FAN <br /> DISHWASHER RANGE HOOD —r <br /> LAUNDRY TRAY ; WATER HEATER <br /> CLOTHES WASHEF WOO�STOVE <br /> URINAL METAL FIREPLACE(WOOD BURNING) <br /> DRINKING 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 /> SUA TOTAL 5 SUB TOTAL S O ' � <br /> PERMIT $ PERMIT S <br /> TOTAL FEE S TOTAL FEE S <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBALK RERRSFiB�CK SIDFSEiBRCN PUNf,HECNNUMBER �(E RECBPiNO <br /> .��L3% <br /> USE ZONE LOT�RE� WCPNT SIIE FEES VALUATION FEE <br /> ��: YES (l NO BWLOING <br /> fYPE Of CON51 NO OF STORIES acunxr qo w owrtuNcuxns -- <br /> cnar PLUMBING <br /> --i— <br /> SIZEOFBL00 FIRESPRINNlCN5BE0'D BASEMENT MECNANICAL <br /> I�1 VES ''� NO <br /> OCCUPANCY LO�O FIRE ALAPM REOD HEIGNT LIMIT�iION ADDITIONAL PLAN CHECK <br /> OTMER <br /> PE�SON � <br /> STATE BUILOING SURCHARGE <br /> INT�NE PY PUNS�PPROVED BY CITY OF EVEREIT PIIBLIC WORNS � <br /> LOCAL SALES <br /> o�rE TAR CODE IS 3105 TOiAL <br />