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� <br />_ APPLICATIQN FOR CONSTRI�CT�ON PERIVIIT `�'�Y <br />TO BE t,..MPLETED IN BLACK INK—PLEASE PRhv I" <br />dUILDING DEPARTMENT HE.4TING SYSTEM: " GAS ❑ ELECTRIC ❑ <br />259-6810 <br />❑ DEMOLITION ❑ COMBINQTION ❑ BUILDING �ME�HANICAL �pLUMBING U SIGN <br />OWNEfl nnnwocc <br />• I . �� � <br />ii�.Ra��,n� <br />/HCHITEGTORDESIGNER MRILAOORESS <br />GENERA'LfCON^TflACTOR MpILA00RE5S <br />� I I'C (� <br />'WMBING CONTflACTOR <br />CONTflACT PRILE OF WO.iN <br />PHOPpSE� USE OF BUILDING <br />LEGALHE LR�PfIONOFPpOPi <br />LOT BIOCK <br />MAIL pODRESS <br />PARCEITA%I.D.NUMDER <br />GO45TFJLTION LOAN LENDEP. ADOflE55. <br />NO. <br />CITY Z�p <br />� • �,tt� `�$ <br />CITY I�p <br />QTV 21P <br />CITY Z�o <br />CITY ZIP <br />CITV $IP <br />CONTA�T pER50N AN� PHONE N0. <br />PHONE <br />PHONE <br />PHONE <br />PHONE <br />LICENSE I <br />a <br />I HEREBY CERTIFY THF,T I HAVE READ AND EXAMINED THIS <br />.-?�- �/� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />��-4-�- PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />IBELOWONATTACHTWOCOAIES) WORK WILL BE COPAPLETED WITH WHETHER SPECIFIED HEREIN OR <br />_ oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHOhiTY TO VIOLATE UR CANCEL TH[ PROVISIONS 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 296200 WAC. <br />BATHTUB <br />LAVATORY(WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWhSHER <br />LAUNDF,Y TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFI.OW PREVENTERS <br />ROOF DRAINS—RAINLEAC <br />SINK (SERVIJE—BAR. ETC <br />OR ITEM <br />SUB TOTAL <br />PERMIT <br />FOR OFFICE USE ONLY: <br />FflONT5ET8ACK REARSETBACK <br />USEZONE LOTAREA <br />lYPEOiCON57 NOOFSTOPIES <br />SRE OF BLDG. FIRE SPRINKLERS REO'D <br />OCCUPANCY LOAD FIFE AIARM REO'D <br />REASON <br />INTAKEpY PLANSAPPROVE�BV <br />onre <br />FEE NO. TVPE OF EUUIPMENT <br />AIC—A/HNDLG UNITS—H.P. <br />; FORCED AIR SYSTEM�—B.T.U. M E.A. <br />� UNIT HEATERS—B.T.U. M <br />' CLOTHESDRYERS <br />� � VENTILATION FAN <br />T� <br />PANGEHOOD <br />' WATER HEATER <br />� V✓OOD STOVE <br />; METAI FIREPLACE (WOOD BURNING) <br />� FIRF.PLACE INSERT <br />~— HEA7 PUMP <br />GAS PIPINu <br />� <br />. EXHAUSTFAN <br />SI�E SETBACK p�AN CNECN NOMBER FEE <br />vacnNrsrce FEES <br />❑ YES ❑ NO BUILDING <br />IXCIIVANCv N� W pW[lIiMGUH115 <br />teWv pLUMBING <br />BaSEMeNT ;AECHANICAL <br />❑ YES ❑ NO <br />NEIGHT LIMITATI04 ADDITIONAL PLAN CHECK <br />OTHER <br />STATE BUILDING SURCHARGE <br />CITY OF EVERF.TT pUBLIC WORKS <br />LOCAL SALES <br />TAX COOE IS 3105 TOTAL <br />�$ <br />RECEIPT <br />■ <br />0 <br />8 <br />� <br />