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APPLICATION FOR CONSTRUC7 .ON PERMIT <br /> PVC'f('ll <br /> ���verett � <br /> BUILDING DEPARTMENT 70 BE COMPLETED IN INK—PLEASE PRINT <br /> 259-8810 <br /> DEMOLITION COMBINATION k BUILDING MECHANICAL PLUMBING SIGN <br /> OVlNFli MAILADDNESS LIiV ZiP VII@f[ <br /> 1�av��uhn,x�n 1a=izz SisrA� {'l1nr�� ����rll� IV�� 4ba���s3-1O3U-- <br /> IENANT MAILADOflE55 CIiY iP �—PNONE <br /> �_V �� <br /> y�~ ARQ�RECTOR�ESIGNER MAILADORE$$ ��TY ZiP PNa�E <br /> x r=7 <br /> �a,� I�,���C ����ln o �t na C'� <br /> ,�J�x ��.':iAI.LCONTP�GiOF MALAD�RE55 GITV Z�P PHONE LICENSE• <br /> 'C H � 1 �i <br /> 9 H V� <br /> C .x !!c',�nrv�CSICONTFACTOF MAILRDDFE55 GITY ZIP PMONE UGENSE• <br /> H �� i� <br /> f-1 H �� <br /> �' y� v—i,,.��!1v.GLONTRAGTOH MAILRD�RE55 GITY LP PNONE LICENSE• <br /> � �0 i• �� <br /> �i] H�+J <br /> CAH �. �.YO�WORK <br /> � Z� tJ[W �ADDITION �� . ALTERATION � � REPAIR . DEMOLITION WOODSTOVE/FRPL INSERT . BUILDING RELOCATION <br /> C7 O� rpy,ql iMPROVEMENIOR INTERIOR flEMODEI ONLV CCNTAGT PERSON AND PNONE NO ��3 _1�3 <br /> OH CCIIiHnCTPRIGEOFWORN: IS OO� - � <br /> � �� ,=,L��iC[WORNANDSOURREFOOiqGEMVOIY[n-i fei.ylV <br /> 6 T�i <br /> 4�� c� '1 �-�n �l('q!� I� — ' � <br /> N <br /> z H i::::roscouseoFow� ac � � I HEREBY CERTIFV THAT I HAVE READ AND ExAMWED THIS <br /> C y 2 SI�l Q -�, • , I�P U APPLICATION AN�KNOW THE SAME TO 9E TRUE AN�CJRRECT.ALL <br /> H H �<<;:,i nesca rior+oFraorearv is wr+se�owoa nnncHFouacoviesi PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVf'E OP <br /> d � WORK WILL BE COMPLETED WITH WHFTHEH SPECIFIED HER[IN OR <br /> O �n ���,�� Z� " L o�ocK 370 aF ��V � NOT THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHOFIITY TO VIOLATE OR CANCF.L i HE PROVISIONS OF hNV <br /> C OTHER S7ATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> � mr <br /> [s7 PERFORIdANCE OF CONSTRUCTION.THAT 1 AM AUTHORIZED BY THE <br /> H O N OIVNER GF THIS PROPERTY TO PEHFORM THE WORK FOR WHICH , �� <br /> APPLICATION 15 A1ADE AND I COMPLY WITH THE ST?TE k <br /> �-- CONTRACTORS LAW 1827 RCW ANG 296200 WAC. � <br /> SiGNAT�qEOiCONiROCtOROBAUiNORIZEDAGENT �ATE <br /> V ( <br /> - l�l� � 1 � � �� � � [ <br /> ano�esrnoo��._:; ,{� 1�2��� F <br /> pPP IlTS Cli ISME55 LIC E NO 0.4�BUSiNi'S5 NaNE � <br /> PLUMBING MECHANICAL . <br /> .� � FEE <br /> � ' NO. TYAE OF FIXTURE OR ITEM FEE NO. TVPE OF EOUIPMENT � _ <br /> � WATER CLOSET IiOILeT) __ A C—A,�HNDLG UNITS—F1.P. _ <br /> BATHTUB FORCED AIR SVSTEMS�—B.T.U. M E.A _ <br /> ��-� .�, LAVA70RY(WASH BASW) _ � UNIT NEATERS—B.T.U. M _ <br /> -:. .� SHOWER � CLOTHES DRYERS <br /> KIT.�HEN SINK 8 DISP VENTILATION FAN <br /> �jISHWASHER RANGE HOOD <br /> LAUNDRYTRAY WATER HEATER _ <br /> ��� CLOTHES WASHER WOOD STOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEV _ <br /> DRINKING FOUNTAIN FIREPLACEINSERT _ . <br /> �-� ,,,� PLOOR DRAIN HEAT PUMP _ _ <br /> BAGKFLOW PREVENT'eRS GAS PIPING __ _ _. <br /> qOOF DRAINS—RAINLEADERS EXHAUST FAN ._ I _ __. <br /> f b�� SINK(SERVICE—BAR,ETC.) � - <br /> ,. � <br /> ` (.�� --T <br /> SUBTOTAL $ SUBTOTAL 5 _ <br /> � PERMIT 5 --r PERMIT 5 _ ._ <br /> � -�� TOTALFEE S TOTALFEE S _ <br /> accemtNo <br /> �'�=;'l15E1�ACH'^� REnfl5E1BRCN �� SID[5[TBaGK �� PI�No[.�'IA�[i fFE ��� >� � <br /> .�� W ' <br /> .! :orvc LOT�qEA V9CAM'SITE FEES VALUATION ��FE�E _ <br /> �Z S�o l� ves }C No BUILDING t - � •`'' A � �I�J �� <br /> ..iOiLONSCPIIOWABIE IYPFOfCON5iAC1U�L ���o��v x00irnvflv44uNn5 �� •� ^ �� —Il�~O ' <br /> LPIX'�° ` PLUMBUdG <br /> .:: oFBIW No OFGTOR�ES BASEMENT MELHANICAL <br /> �y�� � z I �. YES X NO <br /> :iIPANGYLOAD FIRESVFNMLERSFE00 MEIGMTIIMIiRiION OTN.ER <br /> 4 �. ! VES SC NO 2�� 57ATEBUILDINGSURCHARGE 1 �i.>t% <br /> ---�— <br /> � ��.�,';ONFORS�9�NKLERS <br /> STATEENERGVSURGHARGC <br /> ;.'��iliCAiIONACGOY FIANShCPROVEDBY CITYOFEVERI:TT PUBLICWORK$ I lI i� % <br /> LOCALSALES <br /> --L�� TAX COOE�5 3105 rora� _ , <br /> . . . . . . i .1 - J ;��ii ; ��, . � i . . �� }.� �� <br /> - . � , , - I ' • � <br /> i , <br />