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ARPLICATIQ''1 FOR COI�ISTRUCT''1N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: GAS ❑ELECTRIC ❑ 1 <br /> 259-8810 <br /> ❑ DEMOLITION ❑ COMBINATION O BUILDING ❑MECHANICAL L;PL.UMBING ❑ SIGN <br /> OWNE ` MAILADDRESS CITY ZIP PHONE <br /> 7 .�.53� �7% . <br /> i ANT MAIL ADDRESS CITV IIP PHOp:E � <br /> i <br /> ARCMITECTOHDESIGNER MAILADDRESS qTV ZIP PHONE <br /> GENEFALCONTAACTOR MA�LADDRESS CITV 21P PHONE STATELICENSE� <br /> M�ANICRLCONTFRCTOfl MAILAODRE55 CITV ZIP PHONE STATEUCENSEt <br /> 11»0 ,.S��t2`ir�D t��l�'.�3G llti'� S��u�n c 9�.�ss� �3.�•i�ii�i Al�G-�7�1�!���Pd <br /> PL GCONTRACTOR AILADDPE55 pTY ZIP PHONE STATEUCENSER <br /> CONTRRCT PHICE OF WOP� ^^ <br /> E� <br /> DESCFIIBEWORKMlDSIX1ANEFOOTAGEINVOWED CONTACTPE ANOP ONEN <br /> _�1�m Pr �.3 U- yl�l �,t� <br /> D/� yy�ohi Ce � a,3�i - �a.,c��� <br /> i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> Pfl D USE OF BUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> IEGALDESCRIPTIONOFPROPERTV�SHOWNBELOWORATTACHTNOCOPIESj WORK WILL BE COMPLETED WITH WHETIIER SPECIFIED HEREIN OR <br /> LOT — BLOCK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO CaIVE <br /> ) AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> Cr�3 � /l�S% D� L!� OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OH THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> � APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCELTA%I.�.NUMBER �l,/� CONTRACTORS LP,W 1827 RCW AND 296200 WAC. <br /> � Y 7/���Q — <br /> CONSTRUCTION LOAN LI:NDEF,ADDRESS.TELEPHONE NUMBER ,,/ �- n <br /> ?NOJECTADDRE85 �� ���GR�6L.� �'X.1/� 0���'7'� <br /> �� s e o�re <br /> CITY BUSMESS IICENSE NO. <br /> PLUMBING MECHANICAL <br /> N0. IYPE OF FIXTURE OR REM FEE NO. TYPE OF EGUIPMENT FEE <br /> WATER CI.OSET(TOILE� � AI�A/HNDLG UNITS-H.P. � <br /> BATHTUB ; FORCEDAIRSYSTEMS--B.T.U. M E.A. � <br /> LAVATORY(1YASH BASIN) i UNIT HEATERS-B.T.U. M ; <br /> SHOWER ' CLOTHES DRYERS � <br /> KITCHEN SINK G DISP ; VENTILATION FAN ; <br /> DISHWASHER � RANGE HOOD � <br /> LAUNDRY TRAY ; WATER HEATER ' . <br /> C�OTHES WASHER � WOOD STOVE � <br /> URINAL METAL FIREPLACE(WOOD BURNING) � <br /> DRINKING FOUNTAIN � FIREPLACE INSERT ; <br /> PLOOR DRAIN � HEAT PUMP � <br /> BACKFLOW PREVENTERS � I GAS PIPING ; <br /> ROOF DRAINS-RAINLEADEPS � EXHAUST FAN � <br /> SINK(SERVICE-BAR,ETC.) ; ' <br /> � <br /> � <br /> � � <br /> SUB TOTAL $ ; SUB TOTAL $ ' <br /> PEflM1T $ � PERMIT $ � <br /> TOTAL FEE $ ' TOTAL FEE $ ' <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBACK REARSETBACK SIDESETBACK PUNCMECKNUMBER FEE RECEIPTNO. <br /> USEZONE LOTAflEA VACANTSITE FEES VALUATION FEE <br /> ❑ YES ❑ NO gUILDING � <br /> 7VVE0FCON5T. NO.OFSTORIES accuw,xn xo.ovow[uixGuxiis � <br /> GROUP PLUMBING � <br /> SIZEOFBLDG. FIRESPRINKLERSREO'D BASEMENT MECHANICAL � <br /> ❑ YES ❑ NO � <br /> OCCUPANCV LOAD FIRE ALARM REO'D XEIGHT LIMITATION ADDITIONAL PLAN CHECK i <br /> i <br /> OTHER � <br /> PEASON <br /> STATE BUILDING SURCHARGE i <br /> INTAKE BY PLANS APPROVEO BY CITY OF EYEREIT PUBLIC WORKS � <br /> LOCALSALES � <br /> oATE TAX CODE IS 3105 TOTAL � <br />