Laserfiche WebLink
�� � <br /> �^�f �'� APPLICATION FOa CONSTRiJC'�ION <br /> PERMIT <br /> Ihe EverO�een everetl <br /> CI7Y OF <br /> ever�tt �' <br /> BUlLDING DEPARTMENT <br /> 25P•8810 TO BE COMPLETED IN INK— PLEASE PRINT <br /> OWNER MhILh0�RE55 CI1T ZIP PIIONE <br /> _'.DnnJ �,QC_'t.i_TI' a/y3s-E�G�v r..H_ 1�h�e�, ��a3F 7Jy 6�,��-- <br /> TEN�N� MAILrl00dE55 LIIY ZIP PIIONE <br /> ���--c�� <br /> ARGNIiECTOH�E5IGNER MnILn��RE55 GIiY Zla PNONE <br /> "- zA��9Lt5 Drsi� ,� /79�rs���Le �t�u se��rrts 98/.33 �j �p -0�5� <br /> OENERALGONTFPGLOR MPILAODOFSS CIiY ZIP PIIONE LICENSE• <br /> -��DQ,��[�{1/L!S_L__�,l�3s ��M Dh, �l-�'t'r ��03 � 7��[?3� ocwouc /borr <br /> M[CMRHIGALG01iPAGTOR MAI� OO�ESS LIIY 2iP PHONE LlGENSE• <br /> VLUM8146CONiPACIOR MRII�DORE53 CIIY 21P P�IONE UGENSE• <br /> CL�590F WORK <br /> �NEW ❑ ADDITION ❑ ALTERATION ❑ REf'AIR ❑ DrE�t'JLITION ❑ WOODSTOVE/FRPL INSERT ❑ BUILDING fiELOCATION <br /> 1E11PNTIMPHOVE1dENiORIMERIOFHEMOOELONLY O �{��l�y�,_ GONtAGiPERS�NANDP110N[NOMJ/./I <br /> o `�� ��,�'I ZRD � <br /> CANTRACTPFICEOFWOaK ��/ /�� / 7"���/u_�lSZ1/^�1�urf V�"-� �� �2 3S5'9698 _ <br /> DESCRIBEWORNANDSGUnREFOOT EINVOLVED ��� -._ <br /> – /S9�' �' a�Ec� /-1ousE C�oNsn•ur✓�o,� '�-----��""�-�`� — <br /> PNOPOSEO USE OF BUILUINO I FI F.REBV CERTIFV THAt I HAVE RF.AD AND EaAMI NED THIS APPLICA710N AND <br /> Y/�Wl�- S' �wLL �F �L KNOWTHESAMETOBETRUEANDCORRECTALLPROVISIONSOFLAW3AND <br /> �.l" - OFDINANCES GOVERNING THIS TYP[OF WORK WIIL BE COMPLETED WITH <br /> LEGALDESGPIPTI NOFPHOPEPTV�SHOWNtl OWOBATf�GMFOURGOPIES� y,�HE7HERSPEGFIE�HEFiEINORNOT.THEGFANTINGOFAPERMITDOESNOT <br /> n I / PRESUME-TO GIVE C,UTh10RIN TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> �orJ� e�ocK or X�1IC�C!1T_�J1:L�tifi °d ��t ion; ANYOTFIERSTATEORLOCALLAWREGULAiINGCONSTRUCiIONOR7HEPER� <br /> FORMANCE OF CUNSTRUCTION.THAT I AM AU7HOPIZED BV 7HE OWNER OF <br /> �F.� I�I�THC��IE� THISPROPERNTOPERFORMTHEWORKFORWHICHAPPLICATIONISMADE <br /> AND I COM1IPLY WITH THE STATE COtJTRACTO(75 LAW iB27 RCW AND <br /> 296200 WAC. <br /> SIGNAIU fCONiFACiORORAl11110PRE0AGENi I]AlE <br /> �RDJEGTPO�PE55 'I /,�/ � ��i}$ �`� _�— <br /> �/ i- n�'*�" w�� aPPLGNi"CIIvO 55 6F.�SENr,O^;DOUSIN[SS���T <br /> � /�� T,n/T�r�:7�c. A £. � �Tr — <br /> PLUMBING MECHANICAL <br /> N0. 7YPE OF FI%TUfiE OR ITEM FEE NO. TYPE OF EOUIPMENT I'EE <br /> WATERCLOSET(TOILET) '� WC-N�iNULGUNITS-4.P. __ <br /> BATHTUB FORCED AIR SYSTEMS-B.T.U. M EA _ <br /> LAVATORY(WASHBASIN) J UNITHEATEF75-B.T.U. MWq2CNfitrt.•s <br /> SHOWER '��(j-rj'{kjcVF✓� _ CLO7HESORYEf75 F�jCC� u%�1�� <br /> KITCHEN SINH 8 DISP. _ `�`�_ -� VENTILATION FAN ��� <br /> � DISHWASHEF � -'" / RANGEHOOODUC�L�55 _ ; `�� <br /> LAUNORYTFAY WATER HEATER _ 7� <br /> CLOTHES WASHER __L_ �M1'OOD S70VE _ <br /> URINAL ETAI 8 CIIIMNE� _ _ <br /> D(iINKING FOUNTAIN FIREPLACE INSERT <br /> FLGOR DRAIN HEAT PUMP _ <br /> BACKFLOW PREVENTERS GAS PIPING _ <br /> ROOF DRAINS-RAI NLEADERS EXIIAUST FAN <br /> SIN K(SERVICE-BAR,E7C.) — <br /> V <br /> SUBTOTAL $ SUBTOTAL 5 ' <br /> � PEPMIT 5 PERMIT S <br /> TO7AL FEE 5 ' l TOTAL FEE S � <br /> FPONi5ET0aGH �ERPSElOACN SIOESEIBACN PLANCIIECNNUMBEO FF.E �ECF.IPTNO. <br /> _�� ; 6 � � ' sg aa�rb 33( �O �s <br /> usezoNr. .' -ornnen � �AChNT511E FEES VALUATION FEE <br /> 7 �YES ❑ NO /�2 ��(7'�} � <br /> '� I � • � O ' BUILDING/-�SL` -,oC�J L ___�oLi1- <br /> P.'^EOFGONSI. OCGUPANCYGPOVP NO-0FDWELLINGUNIiS � � ���L� <br /> . AL�OWAOIE/PCTURL �_ �Z I (��UMBING <br /> , �f�� � — <br /> SIZEOFB4 D�3� NOOFSiORIES BSMI. OGGLOAD ^,� <br /> �. �G�7J / 6Cv MECHANICAL _ '� _ <br /> . .3�G Ojr;- � N <br /> { -4L,G G�e�.��� N[icHruMi.�ioN OTHER _ <br /> � /� --_ <br /> ; FwE5PaI1�N RSPEduI'tiE`o ❑YES N� STATEBUILDINGSURCHARGE � <br /> STATE ENERGV Sl1RCH�RGE <br /> �PPLICATIONACC6Y PUNSAPPR.9Y �� 1 <br /> • PUBLIC WORKS ( <br /> � (VD/•l ) � � TOTAL �L.� = I - <br /> CY"�C. 1�- 52=� {) �!t L ICK� ��`� 1 ) L���, rE�. <br /> ( �;t' C:�CY'l. ?2y171E'J �T��t� �f=�'=lIL� C',1�� /`� <br />