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APPLICATIC��i FOR CONSTRUCZ�JN PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEM: GAS ❑ELECTRIC ❑ � <br /> BUILDING DEPARTMENT , <br /> 259-8610 <br /> i I �EMOUTION � i COMBINATION I � BUILDING �MECHANICAL � 1 PLUMBING � I SIGN <br /> OWNER \;n�� ��MAII�.PDDRES� CITY ZIP� PHONE <br /> C T �`�'o <br /> TENArI �� YJ IviC[ MAILAUY l�1 1 1 �C ] C� �V l 1 � 1 1 I ���NE ���V l a59- G <br /> /� I I <br /> 4RCHITE�GNER 61AILAODRESS CI1Y ZIP PMONE <br /> � I� <br /> GENERALCON��iO� MAILADDRE55 CITV ZIP PHONE STATELICENSEI <br /> MECNANICAL CONTRACTOR MRII AOOR[55 GTV 21P PHONE STATE LICENSE� <br /> �l,�,a�. a. ��1\9 �1�� �� t�v� ���-. 9�'�0 � �-�3��i na v-�ti�h�o3�a <br /> PLUAIBING CONTflACTOfl MAI.,nUDRESS GITV ZIP PHONE STATE�ICENSE� <br /> � 1 � <br /> SS OF WORK <br /> � ' NEW ' ' ADDITION ! ! ALTERATION I I REPAIR I I DEMOUTION f� i WOODSTOVE/FRPLINSERT Cl BUILDINGRELOCATION <br /> �}(�� ']'� CONTACT PERSON ANO PHONE NO. <br /> CONTRAC7 PRICE OF WORK(�J� ���,�J D <br /> DE�B�K ND SIXURE FOOTAGE INVOLVED <br /> ��— �1 � S � e � <br /> rn DUSEOFBUILDING i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> D rr1 rh�rC . c� \ APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> LEGALDESCRIPT:ONOF PPOPERTV�SMOWN BELOW ORAITPCHFWRCOPIES� PqOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE Of� <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or e�ocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATINQ CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> x � c� ldL�q 9�- <br /> PROJEGT ADOpE55 SiGrutUaE �iE <br /> � Cirv susx�ss iKcrsE r+o <br /> PLUMB MECHANICAL <br /> NO. TYPE OF Fll(TURE OR REM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILEn � NC—A/HNDLG UNI?S—H.P. � <br /> BATHTUB ; FORCED AIR SVSTEMS—B.T.U. M E.A. � <br /> UVATORY(WASH BASIN) � UNIT HEATEFS—B.LU. M � <br /> SHOWER ' CLOTHES DRYERS � <br /> KITCHEN SINK 8 DISP � VENTILATION FAN ; <br /> DISHWASHER � RANGE HOOD � <br /> LAUNDRY TRAY ; WATER HEATER ' <br /> CLOTHES WASHEH � WOOD STOVE � <br /> -— --� <br /> URINAL ' METAL FIREPLACE d CHIMNEY ' <br /> DRINKING FOUNTAIN � FIREPLACE INSERT � <br /> FLOOR DRAIN � HEAT PUMP � <br /> BACKFLOW PFiEVENTERS ; GAS PIPING ; <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) ; ' <br /> � � <br /> � � <br /> SUB TOTAL $ ; SUB TOTAL S � <br /> PERMIT $ PEflMiT $ <br /> TOTAL FEE 5 TOTAI FEE $ ' <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBACK REAPSET9Af.N SIDESE70ACK PLANCNECKNUMBER FEE RECEIPTNO. <br /> 3 9i�`—.3 <br /> USE20NE IOTAREA VACANTSIT[ FEES VALUATION FEE <br /> BUILOING � <br /> TYPt Of CONIS.ALlOWA6LE 7Yi'E Of CCNSf.ACiUAL KCUMx[r NO R VMwMGUNnS i <br /> 4aav p�UMBING i <br /> 52E OF 9LDG. NO.OF STORIES BASEMENT MECHANICAL ' � <br /> i <br /> OCCUPANCYLOAD fIRESPRNKLEP5RE0'D HEIGNTLIMIT�TION ADDITIONALPLANCHECK i <br /> SPRINKLER ' <br /> REASON FOR SPRINNLENS 1 <br /> STATE BUILDING SURCHARGE � . <br /> IN7ANE BV PUNSAPPROVED AY CITY OF EVEREIT PUBLIC WORKS � <br /> LOCALSALES , <br /> TAX CODE IS 3105 Tor�� ; <br />