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APPLICATIC ] FOR CONSTRUCT�)N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEM: U GAS ❑ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259-8610 � <br /> i 1 DEMOLITION I I COMBINATION I✓ BUILDING i MECHANICAL !l!pLUMBING ' ! SIGN <br /> OWNEfl MAILADDRESS CITV ZIP PHONE <br /> ��e��„� �.e,=.,...�- f h l I ��{�.�it- ��- �„�.,�� , �.9 <<�z zo � <br /> TENANT MAILADDRESS CITV ZIP PHONE <br /> �h^-t C� l� V-�� <br /> ARCHITECTORUESIGNER MAILADDRESS CITY ZIP PHONE ysr�-bs'�b� <br /> � : �1 �t� Kway 3 a- � b w�-�",..,�r.e ,q v.e_ �v..��f/ r.ri9- 9�ao1 <br /> � GENERALCONTRACT R RILADDRESS CITY ZIP PHONE STATEUCENSE� <br /> !1-e...� E��l1e,� i-�11 ¢.v-e�-e-� f�w- EVs-v.�..� � a.A q a'2-�I a54- 1'I sd <br /> MECHANICAL LONTPACTOR MAIL A�URE55 CITY ZIP PHONE STATE LICENSE i <br /> PLUMBING CONTRACTOR MAIL ADDPE55 CITV 21P PNONE STATE UCENSE� <br /> (�J�.t 1' �-�"�� <br /> CLASS OF WORK <br /> I_l NEW I J ADDITION I � ALTERATION . �. REPAIR . �� OEMOLITION �. ��. WOODSTOVE/FRPL INSERT � '�. BUILDING RELOCATION <br /> ^ f,ONTACT PERSON AND PHONE NO. �y <br /> CIXJTRRCT PRICE OF WORK ..�[rL.� l � � v J� „-C�+ �..M /-S'7 -I7 SG <br /> OESCPIBE WORK AND SOUARE FOOTAGE INVOLVED .� <br /> f _ . <br /> n �nn �irv.c G� <br /> PROPOSEOUSEOFBUILDIN � I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEfALDESCRIPTIONOFPROPEPTV�SHOWNJEIOWORATTACHFOUFiCOPIES) PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> WORK WILL BE COMPLETED WITH WHET:iER SPECIFIED HEREIN OR <br /> �oT BLOCK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORII�V TO VIOLATF OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFQRM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I CO'.IPLY W�TH THE STATE <br /> CONTRAGTORS LAW 18.27 RCW AND 296.200 WAC. � <br /> n JIP.c// �r �-L <br /> X ... _ 0� . T�-2a- ��2 <br /> PRQIECT ADDRESS G SiGrveiUne oetE <br /> � l-��/�Q� �^ (!/� 98a� I CiivBUSiNESSIiC[NSENO � �� •�C� - / � <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> .� WATER CLOSET(TOILET) � A/C—NHNDLG UNITS—H.P. <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> . 3 LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M ; <br /> OWER ' CLOTHES DRYERS � <br /> KIT N SINK&DISP � VENTILATION FAN ; <br /> DISHWA R � RANGE HOOD <br /> LAUNDRYT ; WATER HEATER ; <br /> CLOTHES WASH � WOOD STOVE � <br /> URINAL ' METAL FIREPLACE 8 CHIMNEY � <br /> DRINKING FOUNTAIN � FIREPLACE IIJSERT ; <br /> FLOOR DRAIN � HEAT PUMP <br /> BACKFIOW PREVENTERS ; GAS PIPING ; <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN <br /> SINf((SERVICE—BAR,ETC.) � <br /> � � <br /> � <br /> SUB TOTAL 5 ; SUB TOTAI 5 ' <br /> PERMIT 5 PERMIT S � <br /> TOTAL FEE S ' TOTAL FEE S <br /> FOR OFFICE USE ONLY: <br /> fRONTSETBACK REARSETBACK SI�ESETBACK PLANCHECKNU �E FEE AELEIPTNO <br /> — • �a 3�� '� .�i'. a:� �U 9 � 7 <br /> USE20NE LOTAflEA VACANTSITE FEES VALUATION FEE <br /> � � BUILDING Q� ��i � <br /> TYPfOFCONiS.PIIOWABIE iYPEOFCONSi.ACTIIAt atuv�Htt M1oOrW.'[whGUNrtS � i <br /> ��I " I �/r • - p PLUMBING � <br /> \ <br /> "IZEOFBLOG. NO.OFSTORIES BASEMENT MECHANICAL ' <br /> �' 753J7 .J'T� n � " �r1IJn � <br /> <K UPANCV LOAO FIqE SPPNKLERS NEO'D MEIGMT LIMITATION ADDITIONAL PLAN CHECK i <br /> q -, <br /> � �-- ��� i SPRINKLER ' <br /> FEASON fOR SPRINKLER$ r �. j�f `� � <br /> � ������ STATE BUILDING SURCHAFIGE i <br /> �= .r�� a� V N� <br /> INTFNEBY' PLANSAPPROiEDBV CITYOFEVERE7T PUBLICWORKS � <br /> LOCAL SALES � <br /> � �y TAX CODE IS 3105 TOTAL � <br />