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� � <br /> APPLICATIO.J FOR CONSTRUCT. JN PERMIT � <br /> TO BE COMPLETED IN ELACK INK—PLEASE PRINT <br /> HEATING SYSTEM: U GAS ❑ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259-BS?0 <br /> I I DEBIOLITION I ; COMBINATION ! BUILDING I :MECHANICAL I_I PLUMBING i J SIGN <br /> OWNER MAILADDRE55 CITV ZIP PHONE <br /> i <br /> /Nu+�IF+S u�t.�c- 3o.t Nt"�THc�c c?� rvEx.=7r ��1�a z �y - �� 2- " <br /> TENANT MAILAD�RESS CITY ZIP PNONE <br /> ARCHITECTORDESIGNER MAILAC�0E55 CITY ZIP PHOYE <br /> GEN ALCONTPACTUB MAILADORE55 CITY ZIP PHONE STATEUCENSEI <br /> ���� _ <br /> MEGnANIG�CONTRACTOR MAILADORE55 CITY Z:P PHONE STATE LICENSE M <br /> PLUMBINGCONTRACIOR MA'.ADDRE55 CITV ZIP PHONE STATEUCENSEII <br /> CLASS OF WORK , <br /> A( NEW I I AOOITION i 1 ALTERATION i i REPAIR i . DEMOLITION � WOODSTQVE/FRPL INSERT i i BUILDING RELOCATION <br /> —• // �/ (J/� LONTAC�NSON AND PMONE RC. q� �J /, <br /> CONTRACT PBICE OF WORK�G{ U/�- /�(Q V `_ d`-� � � /�av <br /> :c5CR18EWOflKAND50UAREF00TAGEINVOLVED � <br /> ��2�vE' aoX ay �d"v �� <br /> PROPO:F.DUSF.OFBUILUING i HEREBY CERTIFY THAT I HAVF READ AtiD EXAMINED THIS <br /> ����__ APPLICATION AND KNOW THE SAMF f0 t7E TRUE AND CORRECT.ALL <br /> LEGALDF.SCRIHIONOFPqOPERTY�.:HOWNBELOWOFATfACHFOURCOPIES� PROVISIOWSOFLAWSANDORDINArIGrSC�1VERNINGTHISTYPEOF <br /> WOqK WILL BE COMPLETED WITH'�;H�c'' SFECIFIED HEREIN OR <br /> LOC BLOCK _ OF NOT. THE GRANTING OF A PEHhair N;,� - - OT PflESUME TO GIVE <br /> ,_,�� / / AUTHORITY TO VIOLATE OR CANCF'. �, PROVISIONS OF AHY <br /> �LCGL C/�G'�—� OTHER STATE OR LOCAL LAW RcGUL�SfIN(i CONSTRUCTION OR THE <br /> �— PERfORMANCE OF CONSTRUCi'ION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PEAFORM THE WORK FOR WHICH <br /> APPLICATION IS MADF AIVD I COIAPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> � - X ��^-� ��.�.c �I/��/�L <br /> f�:::c`��S ,/ T SiGNATUPE OATE <br /> /�fra.C�� atr eusw[ss ucENSE r�o <br /> - PIUMBING MECHANICAL <br /> NO. TYPE OP FIXTURE OR REM FEE NO. TYPE OF EOUIPMENT FEE <br /> -� � WATER CLOSET(TOILET) � A/C—A/HNDLG UNITS—H.P. <br /> BATHTUB FORCED AIR SYSTEMS—.B.T.U. M E.A. ' . <br /> � LAVATOflY(WASH BASIN) � UNIT HEATERS—B.T.U. 1.7 _�_ <br /> �. SHOWER � CLOTHES DRYERS ' <br /> �K�iCHEN SINK 8 DIS? I VENTILATION FAN ; <br /> DISHWASHER RANGE HOOD <br /> � . LAUNaRYTRAY WATERHEATER ' <br /> CLOTHES WASNER WOOD STOVE � <br /> � J �UFfNAL ' METAL PIREPLACE 8 CHIMNEY ; <br /> DRINKING'CUNTAIN � FIREPLACE INSERT � <br /> rL00Ft URAI� � � HEAT PUMP � <br /> � 1. � <br /> BA'i.KFI,MV PPEVENTENS . I GAS PIPING ._ <br /> ` ROOF DRAI,IS—RAINLEACERS EXHAUST FAN � <br /> � SINK(SEF3V!CE->BAh,FTC.) ; � <br /> � - � <br /> � <br /> �� _, , � <br /> � <br /> —.,-- � ; � <br /> i <br /> ' -- --'— --" � <br /> �—� �UBTOTAL $ ' � SUBTOTAL $ <br /> -� FF_RMIT � � PERMIT $ <br /> TGTAL FEE g ' TUTAL FEE $ i_ <br /> FOR OF610E US,£ONLX: <br /> FRO('S°TBP.CK PE\R SET{�PGK S.UE SETBACK PLAN CHEGK NUMBER FEE ./ FECEIPT N0. <br /> ��� ' �039/0 l05� 3S Cv7� � 7 <br /> /� �-.�-.. <br /> usezori�� �oraaia l VACANTuITE FEES VALUATION FEET_ <br /> BUILDING �"�(� '!/c� <br /> 7YPEOfCONiEAlLOY/ABLE TVPEOFLO457.A^.1UAt I oCCUvsNtv NO.OfoN'✓usGUNnS i <br /> �_N � 1 oeour � pLUMBING i <br /> 1 <br /> SIZEOFBLDG NO.O�STORIES ASEMENT � <br /> I, MECHANICFi ' <br /> Lf� $ � 1�10 �. <br /> OCCUP�NCYI.OF� FiAESr`NNKIEF^Ru0'0 NE�IGJHTL:MIfF'ION ADDITIONALPLANCHECK i _ <br /> A A1� `' SPRINKI�R ' <br /> PEHSON F R SPRINNLERS <br /> STATE BUILDING Sl1RCHARGE �SU <br /> INTAKE�9V PLANSAPPROVED9Y CITYOFEVEREIT PUBLICWOflK$ p7CJ i� <br /> LOCAL SALES � <br /> .�� s��q TAX GOOE IS 31D5 TOT�� ; <br />