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APPL'ICATiC l �'OR CONSTRU�CT )N PERM�T ���� <br /> TO BE COMf�LETED IN BLACK INK—PLEASe PRINT ev� <br /> BUILDING DEPARTMENT [ HEATING SYSTEM: y(GAS ,�ELECTRIC 'J _� <br /> "[59-88i0 <br /> DEMOLITION COMBINATION BUILDING __�,ECHANICAL PLUMBING SIGN <br /> 4NER fdAILApOFESS CITV ZiP PHOt1E <br /> A�cy f-lDim es <br /> iENANi �.fAILq�DRE55 CITY 21P PHOIJE <br /> A9CNITELTOR�ESIGtcF h1AILA0�RES5 CITV Zf� PHONE <br /> GEIIERALCONTRACTOF h1AILAD08E55 CITV ;'IP PHONE STATELIGENSEu <br /> A�iCI� �m�S <br /> ECNANICALC NiR4CTOR �I�IL OORESS CITY IIF PHONE ST UCENSEu <br /> l� �1� -�-�.,2��w��_ �� �x �oio� de,c.�, 9�1 7_y�-/bJo /�o/s � is3c�f <br /> FLU1d81NG GONiRACTOR MAIL 4pORE55 CITY ZIP PHONE STATE LICENSE n <br /> CLASS OF YJOFH — <br /> �NEW ADDITION ALTERATION REPAIR DEMOLITIGN WOODSTOVE/FRPL WSERT . �. BUILDING RELOCATION <br /> ^/ CONTACT PF.q50N AND PNONE N0. <br /> CONTRqCT PRICE OF WOFK 4� � �� CD� r-���� <br /> OESCFIBE WORK AND SOUARE FOOTAGE INVOLVED ' — <br /> �S(A[.L Gom��.e3t"d� ��- Sy� <br /> aacaoseouseoFew�onuc I HEREBY CERT�Fr T�,AT I HAVE READ AND EXAMINED THIS <br /> 11PPLICATION AND KNOW THE SAME TO 8E TRUE AND CORRECT.ALL <br /> �ecn�oesceipTioruoFaaoaearv�sr+owNeeiowoanrTacHcouacoaies� PROV{SIONSOFLAWSANDORDINANCESGOVERNINGTHiSTYPEOF <br /> r� � �5�� WORK WILL BE COM°LETED WITH WHETHER SPECIFIED HEREIN OR <br /> �ot�� BLOCK OF C- NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTFUCTIOt'JR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHCRIZED BY TH[ <br /> OWNER OF THIS PRO?ERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITii THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> � l�r�in�/z Av� �� S/�/9s <br /> PRGJECTAOD E55 5ic�imune oniE <br /> cnr eusiHess uco:se rio <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIY.TURE OR Il'EM FEE N0. TYPE OF E�UIPA7ENT FEE <br /> WATER CLOSET(TOILET) A/C—AiHNDLG UNITS—H.P. <br /> BATHTUB ( FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M � <br /> SHOWER � CLOTHESDRYFRS <br /> KITCHEN SiNK&DISP � VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY THAY WATER HEATER <br /> CLOTHES WASHER WOODSTOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACE INSEFiT ' <br /> FLOOR DRAIN HEAT PUMP �—� <br /> BACKFLOW PREVENTERS ; GAS PIPING <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN ' <br /> SINK(SERVICE—B�R,ETG) i <br /> i <br /> i <br /> i <br /> i <br /> SUBTOTAL � ; SUBTOTAL $ <br /> PERMIT S PERMIT S � <br /> TOTALFEE S TOTALFEE � � � <br /> FOR OFFICE USE ONLY: <br /> FfiO��TSETpAGK REARSETB�CK SIpESETBACK PLANCHECKNUM///BER FEE RELEiPTNO. <br /> � <br /> usezoNe LOTAREA vacnNTsirE FEES VALUATION FEE <br /> BUILDING <br /> ivPCOFCON75.ALLOWABtE 7VPEOFGONSi.ACiUAL oau�ancr Noovo�vnuucU':��s — <br /> cAou� pWA1BING � <br /> i <br /> SIZE OF BLUG. NO.OF STORIL� BASE��ENT MECHANICAL <br /> CCCIIPANCYLOAD FIRESPFNKLERSflEO'D HEIGHTLIMITATION <br /> ADDITiONqL PLAN CHECK � <br /> SPRINKLER � <br /> liF.A50N FOR SPRINNlERS <br /> STATE BUILDING SURCHAFGE � <br /> rtii,ixEBY PLANSAPPROVEOBV CITYOFEVEREIT PUBLICVlORKS <br /> LOCALSALES <br /> TAX COD� IS 3105 TOTAL <br />