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APPLICATIC 1 FOR CO�VSTRUCT' lN <br />TO BE COMPLETED IN BLACK. iNK—PLEASE PRINT <br />PERMIT � <br />BUILDWG DEPARTMENT HEATING SYSTEM: J GAS J ELECTRIC ,.I _ <br />259-8E10 <br />DEMO! ITION ! COMBINATION i BUILDING ECHANICAL I PLUh161NG ! SIGN <br />cririea �.�nanooaess cirv zia v��oa� <br />�_LU ISGF_2 i�rxs. �Dfo_�k �UL�2�'� w��r„rt�,`f — <br />TEIJANT MAIL4pDqE55 G;�V ZIP oNrv;t <br />�TI�Tf' n f- W fF. l�d�lZp�/p" _tC��S <br />h^n�HRECTOROESIGNER 1d�ILADDRESS "� CRY ZIP PHGVE <br />GENeR��LCOY7PoICTOR IdqILFDOF[55 CIiY ZIP PMONE STATELIGENSEd <br />�'�' G� C. l�02 A�4 �4%: 9ofy f�fO,�w.✓4 uJf1- y'�'o� �jFs,-1f1oo <br />l.1[CHANICALCD RACTOP IdAILA�OfiESS QiV ZIP PHONE SiATELICENSEu <br />Ia�rru�R.<,a� �,�e.1te.� � srav�cr co._/�.3_S��U,�'��'� ����e/tri.�.�,siaaT� <br />PWLI�INGCONTqACTOR fAqll�UpRE55 CiTV ZIP PNONE STAiEL�CEN5E4 <br />CONTRAGT PRiGE OF YJORK � <br />��O • <br />O[SCRI�E NJORH qND SOUARE FOOTnGE INVOLVE� <br />PRorOSED USE oF BUIloIrv6 <br />i.or <br />h <br />DESCflIPTIGN OF PROPERTV �SHOYlN BELOW OR FTTACM T WO GOPI[51 <br />BLOCK — — OF <br />PpRCELTAXID.NUM�ER <br />CONSTRUCTIONl04NLENDEP.�O�FESS.TELEPNONENU1dBER <br />NO. I TYPE OF <br />BATHTUB <br />LAVATORY(WASH BA; <br />S�10WEF <br />KITCHEN SINK & DISP <br />DISF"NASHER <br />LAUNORYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />BACKFLON'PREVENTERS <br />ROOF DRAINS—RAINLEADE <br />SINK (SERVICE—BAR, ETC.� <br />FOR OFFICE USE ONLY: <br />FNOiJT5ET84.:K REARSEiCACK <br />USEZONE <br />IYPL aF GOHSi. <br />9Z[OFAL�G. <br />Gc;UP�NCVLOAD <br />r�[nspi� <br />rt:rr,� �-nv <br />ITEM <br />PHO�JE <br />I HEREBY CEFTIFY THAT I HAVE READ AND ENAMINED THIS <br />APPLICATION P.ND KNOW THE SAME TO BE TRUE AND CORREGi ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHFfi SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRcSUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THF PRO�JISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORPdANCE OF CONSTRUCTION. THAT I AM AUTHOHIZED BY iHE <br />OWNER OF THIS PROPEATY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS IdADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 78.27 RCW AND'e99.200 WAC. <br />/ cnv <br />ME <br />FEE NO. <br />T — <br />T <br />� <br />SUB TOTAL S <br />PEflM1T $ <br />TOTAL FEE $ <br />SIDE SET�aCK � PL�1! <br />LGi AREF <br />NO OF STOFI�S <br />FIRE SPRINKLERS REO'D <br />FIRE ALANfd PEOD <br />rinNs naaRov�o ov <br />ome <br />VFCAIlT SITE <br />r� ves � i nio <br />OCGUCc•:LY 60a�pWRLI.Lu'A6 <br />GnCui <br />BASEMENT <br />� ves _ nio <br />HEIGNT LIMIT�TION <br />CITY OF EVEFEi7 <br />LOCAL SAI.ES <br />TAX CODE IS 3105 <br />TYPE OF E�UIPMENT <br />NC—A�HNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HE�TERS—B.T.U. M <br />CLOTHESDHYERS <br />VENTILATION FAN <br />RANG�HOOD <br />WATER HEAT[R <br />WOODSTOVE <br />METAL FIHEPLACE (WOOD BURNING) <br />FIREPLACE INSERT <br />FIEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />BUILDING <br />PLUMfiING <br />MECHANICAL <br />ADDITIONAL PLAN CH[CK <br />OTHER <br />STATE BUILDING SURCHARGE <br />PUBLIC WOFNS <br />TOTAl. <br />FEE <br />SUB IUTAL S <br />PERMIT S <br />TOTAL FEE 3 <br />FEE RECFIPTt.p. <br />VALUATIOIr V FEE <br />i <br />— , <br />—T— <br />� <br />