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� "� . <br /> APPLICATIOA FOR CONSTRUCTIt,N PERMIT eV��P« <br /> ��E,�,p,�„ TO BE COMPLETED IN INK—PLEASE PRINT � <br /> CITV OF <br /> eve rett HEATING SYSTEM: U GAS U ELECTRIC U <br /> BUILDING DEPARTMENT --- --- —_ <br /> 259-8810 <br /> DEMOLITION COMBINATION p( BUILDING MECHANICAL PLUMBING SIGN <br /> OWNIII MRiLA00�F55 U1V 71P PHONE <br /> �c��►�c ca .o. 6apc 3-�.0�, Ms oF� c_,� d�rc.��wa. 9t�zyrzL.7 sv�—sB�P <br /> iEN�Ni Ml�pOHE55 CItY ?IP PHONE <br /> s��,c ts owNca - <br /> ARCNIiEf,i OR 0[SiGNER 1.IMl�pOHE55 G1V ZiP PHONE <br /> S�I�,�,I,�G W4tiD /k4CavtteN �itiltslr� <br /> GENERyCONiRAGTOR MAII q00RE55 GtV 21P PHONE 11�EN5E/ � 'f,� r <br /> W�t�c�r su►ucka�r wa�.bea Re.B�uc Slly.� s�r�r�rc.c wA, 91izy A+�t,�4NT.fM li9Ga <br /> MECNANICIILCONTRACTOF IAMIADDRF.55 pLY IIP PNONE �ICENSEI <br /> PWMBIN6CONiR�CtOR M�IIAD�HE55 CItY ZIP PHONE LICENSEI <br /> CUSS OF WORN <br /> � NEW A�DITION ALTERATION REPAIR DEMOLITION WOODSTOVE/FRPL INSERT BUILDING FELOCATION <br /> CONTRCt PERSON RNO PNpNE NO r/ /� <br /> CONTP�CTPRICEOFW I� U OJv �� ��y^'I u�^3i� <br /> DESCRIBEWORR�NDSOU�REFOOi�OE Vq.VEO (f•'�5�• _ <br /> (;l.et�c (�L4C. <br /> PROPOSEDUS�pf�/y� wc I HEREBV CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> /�OYj�—6�Nf GJ �'O/t N46 APPLICATION AND KNOW THE SAME TO BE iRUE AND CORRECT. ALL <br /> IEOQ DESCRI qN OF PROPERTY�SIIOWNAEIOW OR�TT�CH FIXIRCOPIF51 PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WOPK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> ior a�acK ov NOT. THE GRANTING OF A PEFMIT �OES NOT PRESUME TO GIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION Ofi THE <br /> PERFORMANCE Of CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND 1 COMPLV WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> SIGNATUFEOiGONTR�CTORORAUTNOq12ED�GENT p�TE <br /> PRQIECTADDFE55 �0 ����• ��/ •l� I��� �/ �7/�I <br /> O `/�►J�ND W� ���INV I�. �PP���N LITVBUSMESSIICEN5EN0�NDBU5ME55N�ME <br /> PLUMBINO MECHANICAL <br /> NO. TYPE OF FU(TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET� A/C—NHNDLG UNITS—H.P. <br /> BATHTUB FORCED AIR S`.'STEMS—B.T.U. M E,A. <br /> LAVATORV(WASH BASIN) UNIT HEATERS—B.7.U. M <br /> SHOWER CLOTHES OfiVERS <br /> KITCHEN SINK 8 DISP VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> LAUNDRYTRAV ; WATERHEATER <br /> CLOTHES WASHER � WOODSTOVE <br /> URINAL METAL FIREPLACE 6 CHIMNEV <br /> DRINKING FOUNTAIN ; FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING � <br /> ROOF DRAINS—RAINLEADERS E%HAUST FAN <br /> SINH(SEHVICE—BAR.ETC.) <br /> � <br /> SUB TOTAL S SUB TOTAL S � <br /> PERMIT S PERMIT S ; <br /> TOTAI F[E S TOTAL FEE $ <br /> FOR OFFICE USE ONLY: <br /> FRONTSFiBACK qE�RSETBACN SIOESETA�CN PUGN�CHECNNUMBER FEE^ /.�/A / RECEIPTN/p/ <br /> /� a�� � l�" '�-C. .�CL! <br /> use zoNe ior eaee V�CANT SItE FEES VALUATION FEE <br /> BUILDING �yQJ�� 779 ; S'p <br /> tYPFOiCOHISAII(IWABIF lYPf01LON51�L10�1 nc�[pu>�N. �mnoWn��Mr.ux•�s <br /> rY� I Yl' I /7��� PLUMBING <br /> SrzE ov Bioc No oc StoaiEs BesFMeNt MECHANICAL <br /> ^ Ft. AOo�J , / N� --- — <br /> OCCUP�NCVIO�D FIRESPRNklEP5RE00 MEIGNiUMITA1iON ���`�P�yNCMECN �/ i / <br /> ) YFS a u <br /> OTHER <br /> REASON FOq 5�'RMKI ERS <br /> [� �(( — STATE BUILDIIIG SURCHAFOE __� ; 5 v <br /> INLANE PV � PI AN �PPROVFD AY CITY OF CVEREIT PUBLIC WOFKS <br /> LOCAL SALES <br /> �� � TAX CODE IS 3105 Tou� � J �o �� <br /> i <br />