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APPLICATII .� FOR CONST�iUC7 _JN PERMIT � <br /> TO BE CQMPLETED IN BLACK INK—PLEASE PRINT ��r��� <br /> BUILDING DEPARTMENT HEATING SYSTEM: ❑GAS ❑ELECTRIC lJ <br /> 259-8810 <br /> DEAMOLITION COMBINATION BUILDING MECHANICAL PLUMBING X SIGN <br /> 01YNER MAILADDRESS CI1Y 21P FHONE <br /> TEN NT • MAIL`FDDRE55 ����CIIV / ��p ' � —�"O� <br /> . � � ield �c� s� lY r�}�►I t.Ju. aa�- r�.c!- 50� <br /> ARGHIT`cCTORpE51GNER IAAILADDRESS CIiY ZiP PHf1NG <br /> �SiQI]S_I.I$IK.AI� 11G��ST.,�.i��-aL1�9$�'3�} (0�-310D_4.i_�q-»-1rJ�lE�.z�'S' <br /> GENERALCONTRACi��) IAMLAODRE55 CiiV 21P PMON[ STn7ELIGENSEa <br /> MECHnNICALCONTRACTOR 6SAILAOORE55 CITY 21P PH0Y6 ST.�TEU�ENS[n <br /> PLUMBINGGONTRACTOR MAILAD�RE55 �ITV 21P PHONE STATEIICENSEa <br /> CLASS C°WORH — <br /> NEW � ADDITION �(ALTERATION REPAIR DEMOLITION � � WOODSTOVE/FRPL INSERT . BUILDING RELOCATION <br /> p GONTACT PERSON AHC PHONc N0. ' <br /> CONTR�CT PRICE OF WORw 1 <br /> DESCRIBE WOFN FND SOU�RE FOOTAGE INVOLVE[1 ' <br /> �e ex;cl;��e a� � I� <br /> PROPOSEDUSEOF�UILOMG J i HEREBY CERTIFY THAT I HAVE READ AND EXAMWED THIS <br /> ��� APPLICATION AND KN�W THE SAME?O BE TRUE AND CORqf_CT..4LL <br /> LEGAL DESCRIPTION OP PROPERTV�SHOWN BEIOW ORATTACN FO�RCOPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEHEIN UR <br /> �or atocK oF NOT. THE GRANTING OF A PERMIT �OES NOT PRESUMC- 1"0 GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL 1"HE PROVISIONS OF ANY <br /> _ OTHER STATE OR LOCAL LAW REGULATING COPISTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCiION.THAT I�M AUTHORIZCD BY THE <br /> OWNER OF THIS PFOPERTY TO PERFORM THE 'NORK.FOh WHICH <br /> APPLICATION IS MADE AND I COMPLV IVITH THE STA7E <br /> CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> I � 5 E �-r1-�- ` � ////��� <br /> PR0.IECTA�DRLSS XH ma Q p�rC�— <br /> '— —1� _— <br /> Ci1v005,._ Jf.f4ifN0 <br /> PLUMBING � MECHANICAL <br /> NO. TVPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOS[T(TOILET) A�C—AiHNDLG UNITS—H.P. <br /> BATHTUB ; FORCEDAIRSYgTEMS—�.T.U. M E.A. --� <br /> LAVATORY(WASH BASIN) I UNIT HEATEF_—B.T.U. M ; <br /> SHOWEF � CLOTHES ORYERS ---�— <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN <br /> DISHWASHER RANGE HOOD —�— <br /> LAUNDRYTRAY ' WATER H[ATeR <br /> CLOTNES WASHER � WOOD STOVE ' <br /> URINAL � METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN � FIREPLA�E INSERT � <br /> FLOOR DRAW � HEAT PUMP �— <br /> BACKFLOW PREVENTERS ; GAS PIPING � <br /> ROOF DRAINS—RAMLEADERS BXHAUST FAN <br /> SINK(SERVICE—BAR, ETC.) � � <br /> ' � <br /> �_ <br /> —— <br /> � <br /> — , —�-- <br /> SUB TOTAL 3 SUB TOTAL 5 <br /> PERIAIT 5 PERMIT $ ; <br /> TOTAL FEE S TOTAL FEE 5 � <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBACK REARSEi�ALK S�DES[TUACK P�ANCHEC N l.qEL FEE ` ID P[CEIPTNO. <br /> C� � � l �/ <br /> USEZONE LOTAREA VAGAIJTSITE FEES VALUA?ION FEE <br /> Y � <br /> BUILDING � <br /> 7VPEOfCONiS.AILOWABIC IYPFOFCONSTACIVAL r.tarahtv NOOrC.YuucGwutS � <br /> caouo pLUMbING � <br /> SIZEOFBLDQ NOAFSTORIES BASEMENT MECHANICAL ' <br /> � <br /> OCCUPqNCYLOAD FIRESPRNKLEBSREO'D NE`IGN.i�_LIh-11TATI0N ADDITIONALPLANCHECK � <br /> 1��"��� SPRINKLER i <br /> HEASONFOHSPRINKLER$ __ T <br /> STA7B BWLDING SLIRCHARGE / C <br /> INTAKEBV PLANSRPCROVED�V CITYOFEUERETT � <br /> PUBLIC WOFKS i <br /> LOCAL SALES —r <br /> Q�c��?�• �f�l� TAX CODE IS 3105 tora� % c , '>� <br /> . <br />