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APPLICATIC� � FOR CONSTRUCT'- )N PERM17' �� <br /> TO BE COP7PLETED IN BLACK INK—PLEASE PRINT E <br /> BUILDING DEPARTMENT HEATING S`(STEM: f�GAS ❑ELECTRIC O l <br /> 259-8810 <br /> ❑ DEMOLITION ❑ COMBINATION ��BUILDING C i MECHANICAL i7 PLUMBING L', SIGN <br /> OWNER MAILAODRE55 � CITY ZIP PHONE <br /> �/�'1bP �1ss« •a-�I-�r f�6zs i;,.�.��.W.,.����,�y rio4 �'�n��rl� c,�i� `31'20E- 39d=-(GGu <br /> TELNANT I --�� MAILADDRESS � CITY ZIP FHONE <br /> /�.f� �I\ �� �M�04�-�-N ��Ov'(JIC�RS <br /> Ai�CHITECTORDE5IGNER MAILAODRESu GTY ZIP PHONE �O — �TU <br /> �,or.k.t�t,� �'�;i��1 l���ou� fc�f� 2zo'"s w ���F 204 M��� ��'uz� ��3 <br /> GENERdLCONTRRCTCi MAILA�OPE55 GITY 21P PHONE STATE�ICENSEu <br /> MECHANICAL CONTRACTOR MAIL AODFESS GTY ZIP PHONE STpTE LICENSE k <br /> PLUMBINGCONTRFCTOR MMLADORESS CITV ZIP PIIONE STATELICENSE� <br /> CONTRAC�F�E OF WGRN <br /> UUl/ <br /> OESCFI WOII NOSOUA EFOOTAGEIN'JOLVED CONI'ACTPERSONAND?HONENO. <br /> .�tS�iN� I MF�ar�✓wF-.NCS��_p�ZT��rs a� �N�� K�.r3 Cr� �2'/0 - (�7 o Co <br /> ���, �, . <br /> i HEREBY CERTIFY THAT I HAVE READ AND EXAMIMED THIS <br /> raoaosenus�oFeuaoiN� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> /,��� �,�,� PROVISIONS OF LAWS AND ORDINANCES GO`/ERNING THIS TYPE OF <br /> ��LOESCRIPTIONOFPROPeRtt�SHOWN�EIOWORATTACHRYOCOPIES� WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �or BLOCK oF AUTHORITY TO VIOLATE OR CANCEI. THE PROVISIONS OF ANY <br /> � � .��I� OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY TfiE <br /> OWNER OF THIS PROPERTY TO PFRFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCEL TAX I.� UMBER CONTRACTO S LAW 18 27 RCW AND 296.200 WAC. <br /> ��Z�' - �.�3 -oC�(� -Ooo� <br /> CONSTRUCTION LOAN LENOER,AOORESS,T[LEPNONE NUMBER <br /> / <br /> PROJECT ADDRESS s�cHnruee — o"�E <br /> lo�o s� C��.u�` M�.�l c.��� �,.,a�,��Esz�����sE�o <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILET) NC—A/HNDLG UNITS—H.P. � <br /> � BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> LAVATORY(WASH BASIN) UNIT HFJ�TERS—B.T.U, M I <br /> SHOWcR CLOTHESDRYERS ' <br /> KITCHEN SINK&DISP � VENTILATION FAN � <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY ; WATER HEATER ` <br /> CLOTHES WA.SHER � WOODSTOVE � <br /> URINAL ' METAL FIREPLACE(WOOD BURNING) ' <br /> DRINKING FCUN'"AIN � FIREPLACE INSERT � <br /> FLOOR DRAIU HEAT PUMP <br /> BACKFLOW PFlEVENTERS GAS PIPING � <br /> RCOF LRAINS—RAINLEADERS � EXHAUST FAN � <br /> SWK(SERVICE—BAR,ETC.) � <br /> � <br /> � <br /> � ' <br /> � <br /> � ' <br /> � <br /> SUB TOTNL $ ' SUB TOTAL 5 ; <br /> PERMIT 5 PERMIT $ � <br /> TOTAL FEE 5 TOTAL FEE $ ' <br /> FOR OFFICE USE ONLY: -- <br /> FRONTSETBFCK REARSETBPCK SI�EgETBACk PLANCHECKNl1M6ER FEE RECEIPTNO. <br /> �%�fiOG� / � 5 <br /> usezoNe �o�NREA VACANT9TE FEES � VALUATION FEE <br /> C' YES ❑ NO gUILDING ZG � � LO�' G�) <br /> iYYEOFCON51. NOAFSTORIES OttuPA2LY Na.OimVFLUHGUNIiS � <br /> 6flOJP � <br /> ,1LA1 Nd Gbf�t9l.'C��. �z PLUMBING <br /> SIZE OF BLOG. FiRE SPRI.tlKIEflS FEO'0 BASEMEN7 MECHANICAL <br /> ZECD�J_� .f • /LG ❑ YES ❑ NO � C <br /> ADDITIONAL PLAN CHECK �J ��..i <br /> OCCUPANCY LOAD FIRE A�GM REO'D HEIGHT LIMITATION --ti <br /> i <br /> � �J' OTHER i <br /> REASUN � �— <br /> S7ATE BUILDING SURCHAFGE � �� <br /> INT�NEOV PLANSAPPFOVGOBV CITYOFEVERE7T PUBLICWORKS � � <br /> vIA LOCAL SALES � <br /> DATE �� �t� TAX COOE IS 3105 TOTAL 3 � �li ; C1J . <br />