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APPLICATIC-! FAR CONSTRUCT' 1N PERMIT � <br />TO BE COMPL'cTED IN 9LACK INK—PLEASE PRINT <br />HEATING SYS7EM i.] GAS ❑ EI ECTRIC �l <br />BUILDING DEPARTMENT � " <br />259-8810 <br />rl DEMOLITION i_l COMBINATION i"� BUILDING i 1 MECHANICAL i PLUMBING i-J SIGN <br />ON(M`EP (� MA�L� yD�{j[I,S$ GITV 21P G} /PrD4E /) (�I <br />\�I�G�VK�J�]�l.��i)�F\LVM`S 3foC�9�1�•,e1�E �V\ I��OJ J J� _�� V� <br />1ENANt M61lA0DRE55 dTV 21P PHONE <br />Sla+ti� r�t I��iovA <br />ARCHITELTORDESIGNEF MAILADDRES$ CITY 2iP VNONE <br />GEHEPALCONTRPCTOR MAILAODRE55 CITV 21P pMONE SThTELICENSE� <br />5�•� as �bo� c <br />MEGMAMCALGONttiApTON MAILADDRE55 CT' ZIP P/qNE ST�TEUCENSE+ <br />PLUMBING CONTRFCTOfl MAIL AD�PESS dTY ZIP PMON2 5....2 LIL[NSE I <br />CONiRACi PR10E OF WORN <br />DESCRIBE WORK AND SWARE FOOIACsE INVOLVED <br />PROPOSEO USE OF BUILOING <br />IEGAI DESGRIPTION OF PROPERTY <br />l0T BLO:K — <br />PRFCFLTA%ID.NUMBEN <br />GONSTRUG110M LOAN LENDEP. AD�RESS. <br />PROdECTA9D�S.� � C <br />�:a <br />PLUMBING <br />BATHTUB <br />LAVATORY�WASH BP <br />5l10WER <br />KITCHEN SINK 8 DI51 <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />CONTACT PERSON NND PHONE NO. <br />t HEREBY CEFTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />LOWOflRTTACHTWOCOPIES) WORK WILL BE COMPLETED WITH WHETHER SPECIFIEO HEREIN OR <br />NOT. THE GRANTING OF A PERA4IT DOES NOT PRESUME TO GIVE <br />oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CJNSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLV WITH THE STATE <br />CONTRACT S LAW iB.D RCW AND 296,200 WAC. <br />�HONE NUMBEP , � <br />/ 1 s'av�:�m� ��ei�. �� <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEADERS <br />SINK ISERVICE—BAF. ETC.1 <br />FOR OFFICE USE ONLN: <br />FRONiS@TpACN RERRSETBACN <br />USE ZONE <br />TVCE OF LONST. <br />SIZE OF BLOG. <br />OCCUPANCYLO�.O <br />(iEASON <br />INTANE 0" <br />SUB TOTAL $ <br />PERMIT S <br />LOTPREA <br />NO.OF STOflIES <br />FIFE SPRINKlEFS FEO'0 <br />FIRE ALARM qW'D <br />PLANS APPROVED BV <br />DATE <br />FtE NO. TYPE OF EOUIPMENT <br />P✓C—A'HNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B.T.U. <br />� UNITHEATERS—B.T.U. M <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />FIREPLACE INSERT <br />H[AT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SIDE SETBACN PLAN CHECK N% MB�R !EE <br />�� 7Cf �% <br />VACANT SITE FEES <br />C YES ❑ NO pUILDING <br />DLttIF.14CY NO OfUW[ILiNG�4i�5 <br />ceour PLUMBING <br />BASEMENT MECMANICAL <br />�� vEs ❑ No <br />HEiGni uMiTAnoN ADDITIONAL PLAN CHECK <br />OTHER <br />S7ATE BWLDING SUFCHAFGE <br />CIIY OF EV[RETT PUBLIC WO(iKS <br />LOCAL SALES <br />TAX COUE IS 3105 TOTAL <br />FEE <br />E.A. <br />0 <br />� <br />SUB TOTAL $ ; <br />PERMIT $ ; <br />TOTAIFEE 5 � <br />RECHPT NO. <br />VALUATION FEE <br />� <br />1 <br />i <br />i <br />i <br />� <br />i <br />