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APPLICATIC�1 FOR CONSTRUCT�N PERMIT � <br /> TO BE CpMPLETED IN BLACK INK—PLEASE PRINT <br /> BU�LDING DEPARTMENT HFATING SYSTEM: �GAS 0 ELECTRIC ❑ <br /> 259-B810 <br /> DEMOLITION COMBINATION l�C BUILDING �iAECHANICAL i ' PLUMBING ' SIGN <br /> M'NE M�IL AD�RE55 CITY Zip pryppE <br /> � �,��r a�� ' <br /> 3 Gr�w�Q ��b L-�-art1- q�aor as� -�ay8 <br /> lEN � �wni�wvncaa QTY ZIF PHONE <br /> Sl� <br /> ARCHITECT OR DESIGNER M�IL ADDRE55 GITY Ilp PNONE <br /> �� <br /> GENERQCONTRACTOR MAILADDRE55 CITV ZIP PMONE STATELICENSE� <br /> �) <br /> MECMMIIG4CONTR�GTOR MAILMDRESS CITY 21P PNONE ST�iE�IC,EN$E• <br /> �� <br /> PLUMBMGCONTq1LTOR M�RADDRESS CITV ZIP PNONE STATELICENSE� <br /> LLA55 OF WORK <br /> I �; NEW i I ADDITION I ] ALTERATION i-' REPAIR �� i DEMOLITION '�. I WOODSTOVBFqPL INSERT D BUILDING RELOCATION <br /> � /� CONTACT PERSON AND PHONE NO. <br /> CONTR�CT PPIGE OF�MORK O <br /> RIBE N'OB((�ND SOUARE F00T� INVOL D <br /> th�� �G�v <br /> FNOPOSEDUSEOFBUILOING I I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> SJ�IU IE FM'h1 l APPLICATION AND KNOW THE SAME TO BE TRUE AND CORqECT.ALL <br /> LEWL DESCRIPTpNOF PROPERTY� ee�avon�tr�c WR COVIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> /_ i l y3 a p�pt � /"���. WORK WILL BE COMPLETEU WITH WHETHER SPECIFlED HEREIN OR <br /> . �oT-j�p--�— e�°�K °F �� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW qEGULATIN6 CONSTRUCTION OR THE <br /> � PEFFORMANCE OF CANSTRUCTION.THAT I AM AUTHORIZED DY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> CONTRACTORS LAW 182�RCW AND 296200 WAC. <br /> ���``�6`� l� II-17 -9a <br /> PROJECT/�DDRE55 w�i E D�tE <br /> L CT'BUSMESS I�CEHSE NO <br /> ��� MECHAMCAL <br /> NO. TYPE OF RIRURE OR ITEM FEE NO. TYPE pF EOUIPMENT fEE <br /> WATER CLOSET(TUILE� � A/C—AMNDLO 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 � ( CLOTHES DRVERS � <br /> , KITCHEN SINK 8 DISP ; VENTILATION FAN ' <br /> DISHWASHER � RAN6E HOOD —T <br /> LAUNDHY?RAY ; � WATERHEATER � <br /> , � CLOTHES WASHER � WOOD STOVE ; <br /> � URINAL ' METAL FIREPLACE 8 CMIMNEV � <br /> , DRINKING FOUNTAIN I FIREPLACE INSERT ; <br /> � . FLOOR DHAIN � HEAT PUMP � <br /> BACKFLOW PREVENTERS ; QAS PIPING ' <br /> ROOF DRAINS--RAINLEADERS � EXHAUST FAN ' � <br /> . SINK(SERVICE—BAR,ETC.) ; � <br /> � ; <br /> � � <br /> � SUB TOTAL S ; SUB TOTAL S ' <br /> PERMIT S � PERMIT S y� <br /> TOTAL FEE E TOTAL FEE S ' <br /> FOR OFFlCE USE ONLY: (p . 3S� <br /> FRONTSETBACK RE�fl5ET8ACR SIDESETB�CK PLANCNECKNUMBER FEE REGEIPTNO. <br /> � ZO � � _ 3d'7 /of3a 7ys'a/ <br /> USEZONE LOTAREA VqCANT5ITE FEES VALUATION FEE <br /> BUILDING ( 7 i �/ <br /> TVPEOFCONTS.pILOWA6LE TYPEOfCONST.RCTUAL otCU>�Mn HoorOwFwHGUNrts � <br /> PLUMBING � � <br /> i <br /> SIZE OF 6lDG� NO.OF STORIES BRSEMENT MECHANICAL 5� <br /> OCCUPAN Y LOl�D FIRE SPRNKL 5 REO'D HEIGHT LIMITATION / ADDITIONAL PLAN CHECK � <br /> � SPRINKLER � <br /> pEASON FOR SPRINKLERS <br /> STATE BUILDING SURCHAFGE ; J � <br /> INTAKE BY CLANS APPROVED BY CITY OF EVEREIT PUBLIC WORKS � � <br /> LOCAL SALES ' <br /> ( ( TAX CODE IS 3105 ror�� � ;�� <br />