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APPLICATIO. : FOR CONSTRUCTI N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ � <br /> 259-8810 <br /> �7 DEMOLITION ❑ COMBINATION ❑ BUILDING ❑MECHANICAL ❑ PLUMBING ❑ SIGN <br /> �q� / M�ILAOD ESS CITY 21P PHONE <br /> .or� C�c[�t�� � �- .., i ��^� 7- /5��� <br /> TENA MAILADDflFS '/ v—'�j�(T��—� 2��/� PHO <br /> loY 3 cv Y I �'l,c.•Ko�.c U /d'i �D�-�'�'+�c �0 9�a 9a� <br /> ARCHITECTOROESIGNER MRILAD�PESS GTV ZIP PHONE <br /> GENER/�Lf.ONTRACTOR MRILADDRESS dTV ZIP PMONE STATEULENSEII <br /> MECH�NICA�CONTRRCTOR MAILADDRESS CITY ZIP PHONE STATELICENSEI <br /> PLUMBMG CONTRACTOR MAI�ADDpE55 CITV 21P PHONE STATE LICENSE� <br /> CONTRACT PRIGE OF�K <br /> O� <br /> DESCRIBE WORK M!D SOUARE FOOTAGE INVOLVED CONTACT PERSON AND PHONE NO. <br /> SI d� �t-t F� [tJi/�Gt�O� �{��X � <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOS�USE OF BUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> J PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEG�LOESCRIPTIONOFPROPERTV�SHOYMBELOWORATTACMTWOCOPIES) WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> � NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ior BLOCK oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORI2ED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARLEL TA%ID.NUMBEq CONTRACTORS LAW 1827 RC ND 296200 WAC. <br /> CONSTRUCTION LOAN LENDER.AODPE55.TELEPHONE NUMBER <br /> � ,3- -� <br /> � PROJECT ADORESS I, / LO R(y,� p� sar� E D�IE <br /> �7� n enveusmecsi¢eHsara <br /> , PLUMBIN(i MECHANICAL <br /> �. qp, TYPE OF fl)(TURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � NC--A/HNDLG UNITS—H.P. � <br /> BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> � UWATORY(WASH BASIN) � UNIT HEAtERS—B.T.U. M 1 <br /> SHOWER CLOTHES DRYERS <br /> KI?CHEN SINK 8 DISP � VENTILATION FAN � <br /> DISHWASHER RANGE HOOD � <br /> � LAUNDRY TRAY ; WATER HEATER ' <br /> , <br /> CLOTHES WASHER � WOOD STOVE � <br /> URINAL ' METAL FIREPLACE(WOOD BURNING) ' <br /> DRINKING FOUNTAIN � FIREPLACE INSERT � <br /> FLOOR DRAIN ' HEAT PUMP ' <br /> BACKFLOW PREVENTERS � GAS PIPING <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN � <br /> , SINK(SERVICE—BAR,ETCJ I � <br /> , <br /> � � <br /> i , � <br /> � � <br /> , <br /> j SUB TOTAL S ; SUB TOTAL S ' <br /> � PERMIT S � PERM�T $ <br /> � TOTAL FEE S ' TOTAL FEE $ ' <br /> � FOR OFflCE USE ONLY: <br /> FRONTSETBACK PE�FSETBRCK SIOESETBRCN PLANCHE NUAIBE� FEE RECEIPTNO. <br /> � 7 <br /> � usezor+e LOTARER V�LRNTSITE FEES VALUATION FEE <br /> � ❑ YES ❑ NO BUILDING �'v� <br /> � NO.OFSTORIES aNvsNtr NaaOwFluxGuxiiS � <br /> TYPE 0�CONST <br /> 4P0°� pLUMBING � <br /> � <br /> S�h pF�p�. FIRE SPRINKLEFS REO'0 B�SEMENT MCCHANICAL � <br /> ❑ YES L NO � <br /> ' OCCUPANCY LOAD FIRE ALARM REO'0 HEIGMT LIMITATION ADDITIONAL PLAN CHECK i <br /> UTHER � <br /> REASON � ('7� <br /> STATE BUILDING SURCHARGE ���� <br /> INT�KE BV PLANS APPROVED BV CITY OF EVEREIT PUBLIC WORKS i <br /> LOCALSALES <br /> onre TAX CODE IS 3105 �oTA� �� <br />