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APPLICATIC -4 FOR CONSTRUCT JN PERMIT 4,,� <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />BUILDING DEPARTMENT <br />259-8810 <br />! DEMOLITION <br />OWNER ue1 <br />COMBINATION <br />MAIL ADDRESS <br />HEATING SYSTEM: U GAS ❑ ELECTRIC ❑ <br />BUILDING I MECHANICAL <br />CCIITY ZIP <br />PHONE <br />aCITY ZIP PHONE <br />PLUMBING ✓SIGN <br />f/ y7co <br />­­.,.w. <br />CITY ZIP <br />PHONE <br />GENERAL CONTRACTOR <br />� �Ns�P✓ir�r <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />5r»i 4 '0-s =07 6,,, <br />MAIL ADDRESS <br />CITYwZIP <br />.► air �0'10/ <br />CITY ZIP <br />PHONE <br />a 58 Df/S9 <br />PHONE <br />STATE LICENSED <br />STATE LICENSE p <br />PLUMBING CONTRACTOR <br />MAILADDRESS <br />CITY ZIP <br />PHONE <br />STATE LICENSE q <br />CLASS CF WORK <br />'✓NEW 11 ADDITION <br />I I ALTERATION ! RIFae Ui <br />I I no...,..1.1.1 1, <br />-----••—• <br />•- ••.+A+wo,vvvrnrurv3tHF BUILDING RELOCATION <br />OO <br />CONTACT PERSON AND PHONE NO. — <br />CONTRACT PRICE OF WORK <br />DESCRIBE WORK AND SQUARE FOOTAGE INVOLVED <br />3'X a7 <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />%Ax/Z— <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />LEGAL DESCRIPTION OF PROPERTY (SHOWN BELOW OR ATTACH FOUR COPIES) <br />LOT_ BLOCK OF <br />OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO <br />G,' <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS <br />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 PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />s� � <br />.SOS <br />X 9-3-� � <br />SIGNATURE <br />PROJECTADDRESS <br />• OkYlrlV l <br />% h 4 �v & <br />ORiE <br />Wy PUSiNESSLICENSE NO <br />PLUMBING <br />MECHANICAL <br />NO. TYPE OF FIXTURE OR ITEM FEE <br />NO. TYPE OF EQUIPMENT FEE <br />WATER CLOSET (TOILET) <br />A/C—A/HNDLU UNITS—H.P. ' <br />BATHTUB <br />; <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />, <br />UNIT HEATERS—B.T.U. M <br />' <br />SHOWER <br />' <br />CLOTHES DRYERS <br />KITCHEN SINK & DISP' <br />, <br />VENTILATION FAN <br />' <br />, <br />DISHWASHER <br />' <br />RANGE HOOD <br />LAUNDRY TRAY <br />; <br />WATER HEATER <br />, <br />_ <br />CLOTHES WASHER <br />, <br />WOOD STOVE <br />' <br />URINAL <br />METAL FIREPLACE & CHIMNEY <br />, <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />, <br />FLOOR DRAIN <br />' <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEADERS <br />; <br />GAS PIPING <br />EXHAUST FAN <br />, <br />SINK (SERVICE —BAR, ETC.) <br />, <br />, <br />, <br />, <br />, <br />I <br />, <br />SUB TOTAL $ <br />PERMIT $ <br />PERMIT $ <br />' <br />TOTAL FEE $ <br />TOTAL FEE $ <br />, <br />run urrlUt U5t ONLY: <br />FRONT SETBACK <br />use ZONE <br />C-r 2 <br />REARSETBACK <br />REA <br />a� <br />SIDE SETBACK <br />VACANT SITE <br />PLAN CHECK NUMBER FFL <br />9/ <br />FEES VALUATION <br />RECEIPT NO. <br />FEE <br />BUILDING - <br />---T <br />' <br />TYPEOFCONTS.ALLOWABLE <br />TYPE OF CONST. ACTUAL <br />OCB"CT <br />cBauP <br />NO. BiMLLINCUMRS <br />01 <br />PLUMBING <br />, ' <br />SIZE Of BLDG. <br />NO. OF STORIES <br />BASEMENT <br />MECHANICAL <br />--T-- <br />� <br />OCCUPANCY LOAD FIRE SPRNKLERS REO'D V4GHT LIMITATION <br />ADDITIONAL PLAN CHECK <br />REASON FOR SPRINKLERS <br />, <br />SPRINKLER <br />STATE BUILDING SURCHARGE <br />INTAKE BY <br />PLANS APPROVED BY <br />CITY O�EVERM <br />PUBLIC WORKSLOCTAX <br />TOTAL <br />—r_ <br />CO <br />