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APPL�ICATIG J FOR CONSTRUCT.JN PERMIT <br /> TO BE COMPLETED IN BLACK INK-PLEASE PRINT � <br /> ���„ <br /> BUILDING DEPARTMENT HEATING SYSTEM: �GAS Q ELECTRIC ❑ � <br /> 259-8810 <br /> i � DEMOLITION I_; COMBINATION ; BUILDING r1(MECHANICAL ! ] PLUMBING I ! SIGN <br /> (7EY� N�'V�T�M��DPES�/� O��W�T C,L�� ZIP ���� P-JJ9 ��If.� <br /> TEN�NT MAILADDRESS CITV ZIP PHONE <br /> AFCNITECTORDESIGNER MAILADORE55 CI7V ZIP PHONE — <br /> GENERALCONTR�CTOR MAIL�DDRESS CITV ZIP PHONE SUTE�ICENSEI <br /> ���TJ1�lL 7'7fL <br /> MECHANICAL CONTMCTOR MAIL�DDRE55 CIN 21P PHONE STATE LICENSE� <br /> PLUMBMG CONTRACTOR MAI�AODRE55 CITV 21P PMONE STATE LICENSE/ <br /> CUSS OF WORK <br /> I I NEW I ' ADDITION �ALTERATION I I FEPAIR ! � DEMOLITION I ! WOODSTOVF�FRPL INSERT i 1 BUILDING RELOCATION <br /> � CONTACT PERSON AND PHONE NO. <br /> CONTRACT PqICE OF WORK <br /> DESCRIBE WORK ANO SOUARE FOOTAGE INVOLVED <br /> PflOP0.SE�USEOF8UIL01NG i HEREBY CERTIFY THAT I HAVE READ AND EIfAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGAL DESCRIPTION OF PROPERTY�SNOWN BELOW OR ATTACN FOUR COPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �oT �°°K oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTHUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> • � OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> � /Zo• •D /• AD X �i�ie�.r«4� �o%�q'3 <br /> PROIEC7ADDRE55 sav ua����. OAiE <br /> •'����`�� Lrtv BUS"455 L�CENSE NO <br /> PLUMBINCi MECHANICAL <br /> NO. TYPE OF flXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATERCLOSET(TOILET) � A/�fVHNDLGUNITS—H.P. <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> _ LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M ; <br /> SHOWER � CLOTHES ORYERS � <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN � <br /> DISHWASHER � RANGE HOOD , <br /> LAUNDRYTRAY ; WATER HEATER � <br /> CLOTHES WASHER � WOOD STOVE ; <br /> URINAL ' METAL FIREPLACE 8 CHIMNEY � <br /> DRINKING FOUNTAIN � FIFEPLACE INSERT ; <br /> FLOOR DRAIN HEAT PUMP , <br /> BACKFLOW PREVENTERS ; GAS PIPING � <br /> ROOF DRAINC�RAINLEADERS � EXHAUST FAN ' <br /> SINK(SERVICE—BAR,ETC.) � , <br /> � <br /> ' � <br /> � � <br /> i � <br /> SUB TOTAL $ ; SUB TOTAL 3 ' � <br /> PERMIT $ � PERMIT $ ; � � <br /> TOTAL FEE $ ' TOTAL FEE S � <br /> FQR OFFICE USE ONLY: <br /> FRONT SETBACN qEAR SETBACK SIDE SETBACK PLAN CHECK NUMBEP PEE RECEIPT NO. <br /> a�a� <br /> USEZONE LOTAREA VACANTSITE FEES VALUATION FEE <br /> BUILDING ' <br /> i <br /> TVPEOFCONTS.ALLOWf�BIE TYPEOfCONST.ACNAL OC[UPMCY HO.OiNttIIMGUNrtS <br /> GROUv � pLUM81NG i <br /> SREOFBLDG. Np.OFSTORIES BASEMENT MECHANICAL � <br /> OCCUPANCYLOAD FIRESPRNK�ERSREO'D HEIGMTLIMITATION ADDITIONALPLANCHECK � <br /> SPRINKLER i <br /> RE�SON FOR SPiiINKlERS � <br /> STATE BUILDINC�SURCHARGE � <br /> INTAKE BY PUNS APPROVED BV CITY OF EVEREIT PUBLIC WORKS i <br /> LOCALSALES ' <br /> TAX CODEIS 3105 TOTAL ; <br />