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APPLICATI� FOR CONSTRUCT.JN PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT �� <br /> BUILDING DEPARTMENT HEATING SYSTEM: [)GAS ELECTRIC ❑ <br /> 259•8810 <br /> DEMOLITION COMBINATION ocBUILDING MECHANICAL PLUMBING SIGN <br /> OVMEF / MAIL qDDflESS CITV ZIP PMONE / <br /> ���C��� i{'��n »< ,�C�Z �-S �Sf ������ I�k.�11� �� Q �/ �1 <br /> YENANT MAILADU 55 CITV 21P PHONE <br /> ARCNITELT 08 UESIGNER M�IL RD�RE55 CI7Y ZIP PMOYE <br /> GENERALCONTAACTOR MAILADDPE55 GITY ZIP PHpIJE <br /> ST�TE LICENSE• <br /> r�.��, <br /> MECHANIGALCONTRACTOR MAILADDRESS dTY ZIP PMOflE <br /> STRTE LICENSE� <br /> PLUMBMGCONiRACTOR MRILADDR855 LITY ZIP PNpb'E <br /> STATE UCENSE• <br /> CLASS OF WORK <br /> ' i NEW : � ADDI710N � ALTERATfON 4(REPAIR � DEMOLITION '�� � WGODSTOVEiFRPL INSERT . BUILDING RELOCATION <br /> CANT/q�CJ T,PERSON AhD P E NO 7 <br /> CONTRACTPPICEOFWORK , , ��\ yC��(,) �14�// L / nt �5 �){C���/ <br /> l <br /> DE$GpIBE WORK�ND$OU�RE FOpTpGE�NVOLVED <br /> �7' 1 x�ZM � � L • . <br /> � ED/USEOFBUILDMG i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> 0. l� Y! � / � /d/.v � u,✓i i � p✓r � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> LEGIILDESCNIGTIONOFpqOPEBTY(SNOWNBELOWORATTACNFIXIqCOGIES� �y7e,dr PROVISIONSOFLAWSANDORD�NANCESGOVERNINGTHISTVPEOF <br /> �oT�� eL�K L��S �F y/� ,�/'�✓��� WCRK WILL BE COMPLETED WITH WHETHER SPECiFlED HEREIN OR <br /> -,- NOT. THE GRANT�NG OF A PERMIT DOES NOT PRES�IME TO GIVE <br /> / h'` �' AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> N �' � ' �r �� � ' G OTHEFi STATE OR LOCAL LAW REGULATING CONSTRUCTION pR THE <br /> PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> 1 (a. C.�� l�a/ �rr✓r,/� � '� `, �� �� OWNER OF THIS PROPEfiTV TO PERFORM THE WORK POR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> '� � CONTRAGTORS LAW 78.27 RCW AND 296.200 WAC. <br /> ;i a <br /> � <br /> S) '" � <br /> "' 5---��—�5 ' x G' f /b u��4/ <br /> PR� ECT�DDRES si ai a[ oat — <br /> �� � � crreusn�ssi.wrNsrHO <br /> PLUMBINCi MECHANICAL <br /> NO• TYPE OF flI(TURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOIIET) NC—A/HNDLG UNITS—H P. <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) � UNIT HEA7ERS—B.T.U. Iv1 <br /> SHOWEF � CLOTHES DRYERS , <br /> _ KITCHEN SINK 8 DISP ' VENTILATION FAN �— <br /> _ DISHWASHER � RANGE HOOD <br /> LAUNDRVTqAV ; WATERHEATER <br /> CLOTHES WASHER � WOOD S70VE <br /> _ UR�NAL ; METAL FIREPLACE 8 CHIMNEY <br /> _ DRINKING FOUNTAIN FIREPLACE INSERT <br />, FLOOR ORAIN HEAT PUMP , <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) � <br /> � <br /> � <br /> � � <br /> SUB TOTAL $ ; SUB TOTAL $ � <br /> PERMIT y � PERMIT $ ; <br /> TOTAL FEE $ TOTAI FEE $ � <br /> FOR OFflCE USE ONLY: <br /> FPONT SETBRCK o,EAR SETBACK SIDE SETBACK PLAN GHECN NUMBEP FEE RECE�PT NO. <br /> USE 20NE �or�aE� VALANT SITE FEES VALUATION FEE <br /> BUILDING '¢.9.0� �� � v0 <br /> TYPEOfLONiS.ALLOWABLE iYPEOFCONST.ACiUAL Ctcu>�m:v xOmoWFIUNGUNnS <br /> _�_�_ __�', � G3� PLUMBING � <br /> $RCOGBLDa. NO.OFSTORiES BASEMENT MECHANICAL --�� <br /> � <br /> K' � � V <br /> OCCUPANCY LOAO FlqE SPRNKLERS REOD HEIGHT LIMI7ATION ADDITICNAL PLAN CHECK �� <br /> ( SPtiRJKLER ' <br /> REASpfG FOR SPRINKLERS <br /> � <br /> STA7E BUIIDING SURCHARGE y 's'� <br /> INT�KEBY PLANSAPPROVEUOY CITYOFEVEREIT PUBLICWOflKS i <br /> LOCAL SALES <br /> y"� TA➢(CODE IS 3105 TOTAL �� � � <br />