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APPLICATIt�.�l FOR CON�TRUC? �ON PERMIT eV1f�« <br /> IheEve�green TO BE COMPLETED IN INK— CEASE PRINT � <br /> CITV OF <br /> eve rett HEATING SYSTEM: :J GAS ❑ELECTiiIC ❑ � <br /> BUILDING DEPARTMENT <br /> 259•8810 <br /> DEMOLITION COMBINATION BUILDING ECHANICAL PLUMBING SIGN <br /> OW ER /' MRILFD� /1 ITY y/ 2/1P/ Q f P�NONEJ a �' �n,,.� yI� / <br /> �C/ / ' *�— )L�L �� C 'Y. 'Z1.L� / .+.'I�-F v/.NE/' '/-:� �/ D_h.�'-7/��1 �� <br /> iENANT AI/. R��RESS ��T�T <br /> ARCMITECTO��� MRILAD�RESS CITY Z�P PMONE <br /> GENER0.CONTRACTOR MRILADORESS CITY 21P PHONc LICENSE• <br /> Hr� . <br /> MECHRNICpLWNiPAGTOR MAILr1DDNE5 LV �� �P PHO LIGENSE• <br /> �r�H -�/�}a:-��" L�a��'l ���.%�- y�!.l�rrf;(iL. ,G� ���� '��% ���-r����rf*�z2,��f���{ <br /> [�H PLU 61NGGONTRACTOR MAILR flE55 CITY ZIP � PIIONE LICENSE <br /> r xi�' � <br /> � �� CUSSOF WORK �c . , I <br /> y ~ �. ' NEW . � ADDITION •�ALTERATION ��I REPAIR I. l DEMOLITION !.: WOODSTOVE/FRPL�NSERT � �. BUILDINGRELOCATION <br /> 1-3�•C �!'J/�� �F� CONTRCT PER WN AN�PMONE NO. I <br /> � H� CONTRALT PRICE Oi WOFK � ��`-�✓ � _— /^ ! �I <br /> � y�~-1 �ESCNIBE\VORN AND SS]UARE TAG�INVOLVED ' �' <br /> � o� �;1�"r'r,�2^.i(c'tr 1 •� <<; n,, : �r.>�n,�� %'f'��,- (�Y�'�; I <br /> yty PROPOSE�USEOFOUILDiNG I HEREBV CEFiTIFY THAT I HAVE READ AND EXAMINED THIS � <br /> � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.AlL <br /> IEGRL0E5CRIPT10NOFPROPEFTYISMOWNBELOWORATTRCNFOURCOPIES� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> 4�')�O WORK WILL BE COMPLETED WITH WHETHER SPEqFIED HEREIN OR '� <br /> � �oi e�ocK oF NOT. THE GRANTING OF A PERMIT DOES N0T PRESUME TO GIVE <br /> > �yj-, AUTHORITY TO VIOLATE OR CANCEL TkiE PROVISIONS OF ANY <br /> �+ H y %f'r�� — ! OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> � V H PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFOFM THE WORK FOR WHICH <br /> C] tyf/� APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> � �"� CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> SiGNRil1RE0FGONTRAGiOFORAUTHORIZEDAGENT DATE <br /> HON /7 (� '/^`/�1.�+ <br /> PR0.1ECTn�DNE55 � � �(/ / �h�'v „ •'� ?1�J� <br /> ` � � 'L�O) �'1�l�C'� /) RPPLICRNTS CITY 9USME55 LICE SE N NO BIl51NE55 �UE <br /> / i..(/� �7 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> � WATER CLOSET(TOILET) i A/C—A�HNDLG UNITS—H.P. �? '� <br /> "'� BATHTUB ' 1 FORCED AIR SYSTEMS B.T. M E.A. '� <br /> !�' LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M � <br /> SHOWER CLOTHESORVERS ' i <br /> �� r <br /> KITCHEN SINK 8 DISP VENTILATION FAN I 'i <br /> � � DISHWASHER RANGE HOOD � <br /> LAUNDRV TRAV WATER HEATER I, <br /> CLOTHES WASHER WOOD STOVE I <br /> '"' "'� URINAL METAL FIREPLACE 8 CHIMNEV <br /> !! DPINKING FOUNiAIN FIREPLACEINSERT i <br /> FLOOR DRAIN HEAT PUMP � <br /> s BACKFLOW PREVENTERS GAS PIPING �� <br /> I' � ROOF DRAINS—RAINLEADERS EXHAUST FAN I <br /> SINK(SERVICE—BAF.ET0.) I <br /> �i� <br /> SUB TOTAL 5 SUB TOTAL i U' <br /> ��' ' PERMIT $ PERMIT S /S� <br /> TOTAL FEE § TOTAL FEE 5 <br /> FOR OFFICE USE ONLY: <br /> � �I FRONTSETBACK AEARSETBACN SIpE5ET8�CK PUNCn[CNNURIOER FEE PECEtPTNO , <br /> ��� J <br /> usezorve LOTRREA WCRNiSRE FEES VALUATION FEE I <br /> BUIL�ING <br /> ImFOfLOH75AlOWABIE 7YPEOiCOHSIALiOFt �Ctu>�xr xoavn5�nh±uv�15 � <br /> c"pp° pWM81NG � '� <br /> SREOFBLD6. NOAFSTOPIES [`SEMENT h1ECHANICAL <br /> OCCUPR1CYl0�0 FIRESPflNNL[RSPEO�� NEIGNTLIMITATION ADDITIONALPLANCHECK i <br /> i <br /> OTHER � <br /> P[450N FOO SPRINNLERS �— <br /> STATE DUIlOING SURCHAfiGE ', <br /> rt�tnx�uv nnr+,arr�aoveoor CITYOFEVEREIT Puot.�CWo��Ks I <br /> LOCAL SALES i <br /> TAX COOE IS 3105 TOT^� <br />