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�- APPLICATIa_i FOR CONS7RUCT;��N PERIVSIT �� <br /> • TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEM: U GAS h;l ELECTRIC ❑ I <br /> BUILDING DEPARTMENT <br /> 259-8810 <br />' DEMOUTION COMBINATION }c BUILDING h MECHANICAL X PLUMBING SIGN <br /> pY:tif{i l.L11L ApDRF.55 CIiV ZIP PMONE <br /> i�Av�o � i1�c . � 5c� \4�Z�N E�leti'�ii �i$Lc i Zti� -o7cc'— <br /> TENANT MAIIApDRE55 CITY ZIP PNONE <br /> b1 �V y ARGNITECTOPDESIGN[Ry�'� A1ALL�ODRE55 GITY ZIP PMONE <br /> i0 A w \ � � ' IuuTM D � C � ti �' Lri�til � k���c `�c��'-73Gt> <br /> � � N ��� GENERAICONTRRCTOR MRILA�DPESS Cltt 21P PHONE STATELICENSE� <br /> �' � ��L�vA�s A [� ��� 123� ' C' �'3c N � M1�LWC (LN i51>3 5'?i�5^14�' �('Eli,,�/P-/JfM7 <br /> � y � MEGHANIGLCCNTRRGTOR MAI�ADDRE55 diV Z�P PNONE STATELILENSE• <br /> O Pf O <br /> � N I�-i <br /> F11161pINGCONiRACiOR AUILADDRESS CITY 21P PHONE ST4TELICENS[1 <br /> � y � <br /> CtA55OP WOi1K <br /> � � {oy NEW ��ADDITION �� ALTERATION PEPAIR DEMOLITION � WOODSTOVE.'FRPL INSERT BUILDING RELOCATION <br /> M . � '�t yr,��ti /� ��J CONTACTPERSON/ANDPHONENO. <br /> C ~ CONTP�CT PR CE OF WORK �� Z lJ L� . O U �� � /` " �- '}��" <br /> G N <br /> ` �ESCHIBE\YORN AND SOUARE FOO AGE INVOLVED <br /> M n <br /> pp H �y �7� ir�f/ �lcY/Y.'J.t F �T/Y /�/���`��✓ <br /> A O N pqOPOSEDUSEOFBUILDING i HEREBY CERTIFY THAT 1 HAVE REAO ANO E:CAMINED THIS <br /> � � � � ' APPLICATION AND KNOW THE SAME TO 8E TRUE AND COHPECT.ALL <br /> I� c4rC. M � L�/�T�J PROVISIONS OP LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> � y lEG4LDESCRIPTIONOFPROPERttISMOWNBELO\VOFATfACHFOURCOPIES� yyOPK WILL BE COMPLETEC WITH WHETHER SPEGFIED HEREIN OR <br /> ior /F L- o�ocK )// oF S� ll/dr��✓�R� W��i NOT. TH[ GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> -�x�� �,'�^ �// _nC�/��L, 7 PERFORMANCEOOFOCONSLRUCT ON.TH TG AM AUTHORIZOEJ BY THE <br /> OWNER OF THIS PROPE(iTY TO PERFORM THE WORK FOR WHICH <br /> APPUCATION IS MACE AND I C061PLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 298200 WAC. <br /> - x `� �,D�-�!' �j� - ic f�� _ <br /> PFOJECTAOORE55 �^ - s:c.•.�m�n • � � .�..�r� <br /> �sai r"4�r ' �!� � ,� uwnvs•niss�.ccnsrno . <br /> PLUM8ING MECHANICAL <br /> / '� NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPc OF EOUIPMENT FEE <br /> j �� � r'� _ A-C—AHNDLGUNITS—HP. <br /> WATER CLOSET(TOILET) � . <br /> � � / BATHTUB J � FOFCED AIR SYSTEMS—B.T,U. M E.A. <br /> 1 � / LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M _ <br /> SH(JWER CLOTHES DRYERS <br /> � KITCHEN SINK 8 DISP VENTILATIJN FAN <br /> '��' DISHWASHER RANGE HJO� <br /> ' LAUNDRYTRAV WATERI-,EATER _ <br /> ' CLOTHES WASHER i WOOD STOVE � <br /> I !�r URINAL METAL FIREPLACE&CHIMNEY <br /> '' DRINKWG FOUNTAW FIREP'l�CE INSERT _ <br /> FLOOH DRAIN HEAT PUh1P <br /> B�CKFLOW PREVENTERS GAS PIPING �_ <br /> �'� ROOF DRAINS—RAINLEADERS � EXFAUST FAN <br /> � SINK(SERVICE—BAR.ETC.) <br /> i <br /> r I <br /> t ', • SUB TOTAL 5 SUB TOTAL 5 IS� <br /> I I PEFAl1T 5 PERMIT 5 i <br /> �� '_1�i TOT.IL FEE S TGTAL FEE 5 <br /> ■ <br /> � FOR OFFICE USE ONLY: <br /> FRONTSETOACK R[ARSETOALK SIOESETBnCK/ PL/NLN[CKNUAIBER �EE � �ECEIVTNO <br /> i / �j .��• 91�/ 9.3 �a �p,Q 7.G <br /> usezor/+�e LOTAREA VAGVlTSITE FEES VALUATION FEE <br /> /�� BUILDIIlG 2 � ��� ; <br /> iVGEJ�LONiSAll01VABlE i`PFOfCON9;GtUAI OC[ceu.b x0cihntc��.�.�,'.'�s - J <br /> LPN' PLUMBING �� <br /> SiZE OF BLbG NO OP STORIES BASEMENI �,�ECf1ANICAL �� � <br /> Z�v sf nnoN ,U,p <br /> OCCUPANGVIOAp FlRESPB'.hLEiiSREOD HE�iJG�MTlrt.11�lON <br /> — ADDITIONAL PLAN CHECK "'y� <br /> ' Q �,J.J /`� SPRINKLLR T <br /> P[ASON FOR SPRiNKl6RS <br /> STATE Bl11LDING SURCHARGE ��D <br /> I`liAHE�Y PU�iSRPPR0VE�0Y CITYOFEVEREIT PII�LICWORKS <br /> LOCAL SALf.S <br /> J��' TAX CODE IS 7105 TOTAi 7� � �' <br /> -- -- —� <br />