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APPLICATIQ� FOR CONSTRUCT'�1N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEA9: ❑GAS ❑ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259-6610 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUlLDING ❑MECHANICAL ❑PLUMBING ❑ SIGN <br /> OWN°R � MPIL ADDRE55 CITY ' / ZIP PHONE <br /> .�.S��,v<<.� ZZZD fJr.u.d.4ve E�cret� 9820/ 339'- (3(og <br /> TENANT MAIL I10DRE55 CITY ZIP PMONE <br /> �lo�l /�ewt�l� ZzzO �r.t,uc� �ue �iP�et� 992U/ 339-OS 7D <br /> ARCHITECTOPDESIGNER MAILADDRESS CITV ZIP PMONE <br /> GENERRICONTRRCTOR IAAILADDRE55 GTV ZIP PHONE STRTELICENSEI <br /> `7cc>r-�-�- <br /> MECNRNICALWNTRRCTOR MAILAUDRE55 QTV ZIP PHONE STRTELICENSEt <br /> P�UMBINGCONTflRCTOR MAILRDDRE55 CITY ZIP PHONE STRTELICENSE/ <br /> CONTRRCT PRICE OF WORN <br /> DESCFIBE WORK AND SOU�RE FOpTRGE INVOIVFD CONTACT PERSON AND PMONE NO. <br /> �ustw�r�f- 'z"u,b wv� <br /> / <br /> i� .0 ��� !' � <br /> i HEFEBY CERTIFY THAT I HAVE REAC ANO EXAMINED THIS <br /> PROPOSED E ILDING APPL�CATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> LEGALOESCRIPT.IO/NOPPROPERT�Ve�SH2OWN�BELOWORATTFCNTWO�LO/PIES) WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> ior-�`'� e�ocK� oF --�JLi'GTJ NOT. THE GRANTING OF A PERMIT DOES NOT PFESUME TU GIVE <br /> 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 AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM TF+F WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY �..'`� THE STATE <br /> PRRCELTA%I.D.NUMBER CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> _Q <br /> CONSTRUGTION LOAN LENDER.ADDRESS.TEIEPNONE NUMBER ' A - /f �/ /� <br /> // / // <br /> 2zzo r.�Nc1 AVC «cL✓�ri <br /> PROJECT ADDRESS sarur —o�r� <br /> ci usinEssucENSEtq. <br /> PLUMBING CHANICAL <br /> NO. TYPE OF FlXTURE OH ITEM FEE 0. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILET) A/C—A/HNDLG UNITS—H.P. <br /> BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. ! <br /> LAVATORY(WASH BAEIN) � UNIT HEATERS—B.T.U. M ; <br /> SHOWER � CLOTHES DRYERS � <br /> KITCHEN SINK&DISP ; VENTILATION FAN ; <br /> DISHWASHER � RANGEHOOD � <br /> LAUNDRYTRAY ; WATER HEATER ' <br /> CLOTHES WASHER � WOOD STOVE � <br /> URINAL ' METAL FIREPLACE(WOOD BURNING) ; � <br /> DRINKING FOUNTAIN FIREPLACE INSERT ; <br /> FLOOR DRAIN � HEAT PUMP � <br /> BACKF�OW PREVENTEF? ; GAS PIPING ; <br /> ROOF DRAINS—RAINLE.\DERS EXHAUST FAN � <br /> SINK(SERVICE—BAR.ETC.) ; <br /> � � <br /> � � o�- � <br /> SUB TOTAL $ ; SUB TOTAL $ <br /> PERMIT $ � PERMIT $ <br /> TOTAL FEE $ ' TOTAL FEE $ � <br /> FOR OFFICE USE ONLY: 3� ��� <br /> FRONTSETBAC, REARSEIBRGK SIDESETB�CK PLANGNEC NUMBER FEE� �D RECEIPTNOn��� <br /> I • S S JZJ (%J <br /> USEZONE LOTRREA VACANTSITE � FEES VALUATION FEE <br /> � ❑ YES � NO BUILDING i ��� �/(� vJ� �` i',3(� <br /> TY{EOFCONSi. NO.OFSTORIES OCNosNt� NOMOWELux6uNrt5 � <br /> ( ,nouv 1 pLUMBING <br /> � � <br /> SIZE Of BLDG. FIRE SFRINKLENS REO'D BASEMENT MECHANICAL i <br /> i s '4 N� ❑ VES d�io , <br /> OCWPANCYLOAD FIREALARMREO'D HEIGHTLIMITATION ADDITIONALPLANCHECK i <br /> w <br /> .+� NO �� OTHER � <br /> RERSON � <br /> STA7E BUILDING SURCHARGE ' <br /> MTRNE PY PLANS APPROVEO BV CITY OF EVEREIT PUBLIC WOPKS � <br /> �,Jf� LOCALSALES <br /> DATE O�/�.��9c�/ TAX CODE IS 3105 ror�� ��L�, ; n;� <br />