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APPLICATIO � � FOR CONSTRUCT; )N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEM: , GAS U ELECTRIC J <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING `�MECHANICAL PLUMBING SIGN <br /> O NER NAILA�DRE55 CITV ZiP PHONE <br /> LC meS — <br /> iENANT MAILAUDRE55 CIiY ZIP PH�NE <br /> ARCHRECTOB�ESIGNER MAILAOORE55 GIN ZIP PH01lE <br /> �GNERALGJNTRACTOR h1AILADDRE55 CITY ZIG PHONE STATELICENSEb <br /> qLC�./C RA�Or•'GSMMLADDBE55 CITV ZIP PHONE ST LICENSEN <br /> �p�t� <br /> �D��S �t�.2n�.� t�o I�x '�o/ol �(�'-. 9&�� �`/7-/�3� �h6S-�Cti2/.53�( <br /> PLUMBiNGCONTFACiOR IdAILADDRFSS � � / CITV ZIP PHONE S ATELICENSEp <br /> �� . <br /> CLA55OF WORN <br /> �NEW ADDITION ALTERATION REPAIR DEMOLITION WOODSTOVE/FRPL INSERT � BUILDING RELOCATION <br /> CONTACT PERSON AcND—PHONE NIO. ^ <br /> CONTPNGTPpICEOFWORK ��1 \,L��� ��� " � /�-+ C <br /> �ESGRIBE WORH AND SOUARE FOOTAGE INVOLVED <br /> ��;rac � C�MpI� FleaTm S s T� <br /> eAoeoseouSeoFem�owc I HEREBY CERT;FY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALl <br /> LEGAL DESCRIPTION OF PROPERTV(SHOWN BELOW OR ATTFCN FOUR COPIE51 PROVISIONS OF LAWS AND ORDINANCES GOVER�ING THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> ior S-3 BLOCK oF NOT. THE GIiANTING OF A PERA7IT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHEF STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORfr THE WORK FOR WHICH <br /> — APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> � CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> �gO� ��O I�121� ���,- — X - �v� 2 ��rL �/ ' <br /> PROJECi A�DRESS SiGrvniunE ��AiE <br /> GiY�lI5iNE55 UCENSE NO <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILET) AiC—NHNDLG UNITS—H.P. <br /> BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M i <br /> SHOWER CLOTHESDRYERS <br /> KITCHFN SINK&DISP i VENTILATION FAN ' <br /> DISHWASHER � RANGE HOOD <br /> ---r— <br /> LAUNDRYTRAY I W�TER HEATER <br /> CLOTHES WASHEF WOOD STOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN i FIREPLACE INSERI' i <br /> FLOOR DRAIN HEAi POMP � <br /> BACKF�OW PREVENTERS i GAS PIPING i <br /> ROOF DRAINS--RAINLEADERS � � EXHAUST FAN � <br /> SIMK(SERVICE—BAR,ETC.) [t�� r <br /> i <br /> — i <br /> i � <br /> i <br /> SUB TOTAL 5 _ SUB TOTAL $ ,)�(� ; ' <br /> PERMIT S PERMIT $ <br /> TOTALFEE $ TOTALFEE $ <br /> FOR OFFICE USE ONLY: <br /> FRONTSETOAGN FEAFSETBACY. Si0E5ET8ACK PUNCHECKNU1dBER PEE RECEIPTNO. <br /> �lL�o=',�c <br /> usezoNE �ornaen vncnrvrsire FEES VALUATION FEE <br /> OUILDING <br /> lYPEO�CONiS.ALLOWABLE iYPE0FWN5i.ACiIIAL oc[cnryp iapre'm!:uuau•�n5 i <br /> aenuv PWMBING � . <br /> SIZEOF,aLOG. No.oFSTOBiGS BnSEMENT MECHANICAL 1 <br /> a� 7(7 <br /> OCCUPANCV LOAD FlRE SPPNNLEFS REO'0 HEIGHi L�h11TATiON ADDITiONAL PLAN CHECK <br /> SPRINKLER <br /> REASON FOR SPRINNLERS i <br /> STATE BUILOING SURCHARGE <br /> INTpKEBv PIANSAPPROVEDBV CITYOFEVERE7T PUBLICWORK$ � <br /> LOCALSALES � <br /> TAX CODE IS 3105 TOTAL <br />