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.— - <br /> APPLICATI� FOR CONSTRUCTGWN PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: ;j GAS J ELECTRtC J <br /> 259-88'0 <br /> DEMOLITION ` COMBINATION �: BUILDING MECHANICAL PLUMBING I SIGN <br /> UV.R�ER MAILAD�qE55 CiTv ZIP PHONE <br /> S�au l��{�ocGr�, 23ai ��(,yA�e-�Z �'ve,�¢f-£ t.�/3-981b1 2 �-/ZoG <br /> TE� �M MRILRDORESS � <br /> QTY ZIP PHONE <br /> t�R�HIiEGTORDESIGNER �dqIIFDORESS CIiY ZIP PHONE <br /> �P�6e,� � roa� a.� 10434 F12Pu�cu{/�P SP4 .PQ <br /> GENLR4lCOHTRqCTOP MAILADDRE55 LITY ilP PHONE STATELICENSE� <br /> �W11'Q� <br /> �A[CHANICqLGONTFACiOR IAAILAODRE55 CttY ilP PHONE STATELICENSEt <br /> PLUMBIN�CONTRp�TOR IM0.AODRE55 CITY ZIi PMONE STATE LICENSE• <br /> � CONiRACT PF�CL OF WORK <br /> /5�0 <br /> DESCRIFIE WOA AN� UARE FppTA VOlVEO C AGT PE SON aND PHONE NO <br /> � �h vn;��a�l�k� � '��-I�nG, <br /> ..� ,Pr�.Qi S� �o� • Raa � <br /> I?�QQ� S u/!�N Gf.Q USP i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> � PilOPOSLD SE OF BUILDING <br /> � V� �l�� APPLICATIOIJ AND KNOW THE SAME TO BE?RUE AND CORRECT.ALL <br /> T PROVISIONS OF LAWS AIJD ORDINANCES GOVERNING THIS TYPE OF <br /> ieca�oescAianonoFraoveaTvis�o��Neaow RATTACNTWOCOP�ES� WORK WILL BE COIdPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> ��oT eioc•. oF NOT. THE GRANTING OF A PERMIT DOES NOT PpESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGULAIING CONSTRUC710N OA THE <br /> PEflFORA4ANCE OF CONSTFUCTION.THAT I qM AUTHORI2ED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> rnncE�TnKio NUMeen APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> �.�.. �c11 - y c���- O d' ,� V CONTFACTORS LAW 18.27 RCW AND 296200 WAC. <br /> f.OtlSiRUCTION IOAN LEN�ER.ADDRCS$TELE4HONE NUMBER <br /> �G PROJECTADORESS �— — IV � r � <br /> f1� � � � ' w*� <br /> .rn.� ���n. <br /> PLUMBING MECHANICAL�� <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSGT(TOILET) A'C—ANIJDLG UWIT>—H.P. <br /> L '��'"" BATHTUD FORCEDAIRSVSTEMS—B.T.U. M E.A. � <br /> ' iN LAVAiORY(WASH BASIN) UNIT HEATEFS—B.T.U. M <br /> �u : SH�WER CLOTHESDRYERS <br /> ��� i,�. ;. KITCHEN SINK 8 DISP VENTILATION FAN � <br /> , � � � DISHWASHER _ RANGE HOOD , <br /> " LAUNDRV TFAY ; WATER HEATER I <br />�� =�'�irr; CLOTHES WASHER WOOD S70VE ; <br /> ���.��P URINAL � METAL FIREPLACE(WOOD BURNING) <br /> .:�::K DRINKING FOUNTAIN i FIREPLACE INSERT � <br /> t FLOOR DRAIN � HGAT PUMP � <br /> ��� BACKFLOW PREVE�JTERS � GAS PIPING <br /> II ROOFDFAINS—RAWLEADERS � EXHAUSTFAN <br />� �����'!"�' SINK ISEFiVICE—BAF. ETC.� <br /> �.I --T__ <br /> ;�.; • <br /> — � <br />�,�I � "i SUB TOTAL $ SUB TOTAL $ <br /> _ PERMIT $ PERMIT $ <br />' � ���•�', TOTALFEE $ TOTALFEE $ <br /> ;a i FOR OFFICE USE ONLY: <br /> FRONTSE1BhCK q@ARS[T�4CK SIpE5ET8ACK PLnNGN[CY,NUiABER FEE R[CEIPTNO. ' <br /> � �f�(Cn'3`( .7 5L 053£f ` <br /> I usezoNE �otaHen lACANTSITE FEES VAIUATION FEE <br /> , � - � �. YES :-� NO BUILDING /'S�DO _Z!7� <br /> iYPE Of CONSi NO OF STORIES -- re�or p�i_iuG u�,es <br /> � ` N � �; B�J/' � PLUMBING i <br />�� SIZEOFBLDG FIRESPFINKLERSHEO'D ��E'.�/tEr1i ,� MECHANICAL � <br /> �p 0 �D � . YES '�NO ' <br /> OCCUPANC LOAD FIREAI REOD 4EIGHiIRlnnT10Y ADDI710NALPLANCHECK � <br /> n Q <br /> � OTHER ' <br /> RERSON <br /> FX��7, STAfE BUILDING SURCHAfiGE L <br /> INTAKE BV PLANS 4�' i�pVED B� CITY OF EVEFIE7T � I <br /> �1�� � UBUC WORKS I <br /> LOCALSALES <br /> on,e S �_ TAX C�DE IS:i105 �oTn� � <br />�. <br /> � ��7� <br />