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APPLICATIC 1 FOR CONSTRUCT�N PE�tMIT ��� <br /> TO BE COMPLETED IN BLACK INK-PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: GAS ❑ELECTRIC ❑ <br /> 259-8810 <br /> ' DEMOUTION COMBINATION ' BUILDING �(�AECHANICAL �PLUMBiNG � ` SIGN <br /> GTE��ER AIL/�ODRE55 CITY �ZIP PHONE <br /> �✓, �i 113 hP� A��' -���st� 4'�t�?_b � '� -���� <br /> r MAILADDPE55 CI ZIP PHONE <br /> ARCMITECT OR DESIGNER MAIL ADDRES$ CITY 21P PHONE <br /> GENERQCONTR�CTOR MAILADDRESS CITY ZIP PHONE STATELICENSE� <br /> MECNMlICALCONTRACTOR M�ILADORE55 CITV ZIP PMONE SiIRELICEHSEf <br /> PLUMBMG GONTiIAGTOP MAII ADDRE55 CITV ZIP PNONE STATE LICENSE� <br /> OF WORN <br /> NEW I I ADDITION ! � ALtERATION i I REPAIR ��_I DEMOLITION i I WOODSTOVE/FRPL INSERT I_7 BUILDING RELOCATION <br /> � CONT�CT PERSON AND PHONE NO. <br /> GONTqACT VRICE OF WOHK <br /> DESCRIBE �ND SW�RE FOOT�GE INVOIVED <br /> �� <br /> PROPOSEDUS oFeuiwrt+c i HEHEBY CERTIFY THAT I HAVE READ AND El(AMINED THIS <br /> �i APPLICATION AND KNOW THE SAME TO BE lAUE AND CORRECT.ALL <br /> LEWL DESGRIPTqN OF PROPEflTV(SHOWN BELOW OR ATT�CH FOUR COPIES) PROVISIONS OF LAWS AND ORDINANCES(30VERNING THIS T'PE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFlED HEREIN OR <br /> �or e�oac __ oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR IOCAL LAW REGULATIN(3 CONSTRUCTION OR TNE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY 1'O PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I C7MPLY WITH THE STATE <br /> CONTRACTORS UW 1827 RCW AND 288200 WAC. <br /> / <br /> s� ��� <br /> PHOJECT I�DDRESS R SGr4�ru w1E <br /> �II� _1� V � CT'lIIBME65 LICENSE NO <br /> ��S�Q ��A�AL <br /> ►q. TYPE OF FlIfTURE OR fTEM fEE NO. TYPE OF EOUIPMENT FEF. <br /> WATER CLOSEt(TOILET) � N�AMNDLG UNITS�i.P. <br /> g�7}�7Ug ; FORCED AIR SVSTEMS--B.T.U. M E.A. � <br /> UVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M � <br /> SHOWER ' CLOTHES DRYERS ' <br /> , KITCHEN SINK 6 DISP � VENTILATION FAN ; <br /> DISHWASHER � RANOE HOOD � <br /> LAUNDRYTRAV ; WATER HEATER ' <br /> , CLOTHES WASHER � WOOD STOVE � <br /> � URINAL ' METAL FIREPUCE 8 CHIMNEY � <br /> DRINKIN6 FOUNTAIN � FIREPLACE INSERT � <br /> � FLOOR DHAIN � HEAT PUMP ' <br /> � BACKFLOW PREVENTERS ; GAS PIPING I <br /> ' FOOP DRAINS—fiAINLEADEHS � EXHAUST FAN � <br /> SINK(SERVICE--BAR,ETC.) ; � <br /> ti � <br /> � � <br /> SUB TOTAL S ' SUB TOTAL t ' <br /> PERMIT S � PERMIT S � � <br /> TOTAL FEE E TOTAL FEE S <br /> FOR OFFlCE USE ONLY: <br /> FFONTSETB�CK REARSET&�CK S�DESETBAGK PIANCNEGKNUMBER FEE RECE�PTNO. <br /> � <br /> USE ZONE LOT�REl1 VACANT SITE FE S VALUA710N FEE <br /> BUILDING <br /> TVPE OF CONiS.QLOWABLE TYPE Of CONST.ACTIIRL ottUveNCY Na p�wFwNG UNrts i <br /> cnouv pLUM81NG � i <br /> SIZE OF BLDG. NO.OF STORIES BASEMENT MECHANICAL � <br /> OCCUPANCY LO�O FIRE SPPNKLERS REO'D MEIGNT IIMITAiION ADDITIONAL PUN CHECK � <br /> _ � <br /> SPRINKLER � <br /> HEASON FOR SPRINKLERS <br /> STATE BUILOING SURCHARCE i <br /> INTAKE BV PLANS APPPOVED BY CITY OF EYEREIT PUBLIC WORKS 1 <br /> LOCAL SALES � <br /> TAII COOE IS 3105 roT�� <br />