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APPLICATIC-1 FOR CO�ISTRUCT`lN PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: GAS !J ELECTRIC � 1 <br /> 259-8810 <br /> I DEMOLITION I I COMBINATION ' BUILDING ✓MECHANICPL PLUMBING ! SIGN <br /> OWNER MFRADDRE55 CITY ZIP PNONE <br /> C�va �al� 2Sib Pnna�,�e� C�P�s'� 9k�o3 .�JS-43SS <br /> 7EN4NT MAILAD�RESS CITY ZIF ^NONE <br /> ARCHITECTOR[]ESIGNER MNL��Uf1ES5 C�TY 21P PNONE <br /> GENER4LCONTRACTOR MFIL�ODRE55 GTY 21P PHONE STAT[LICENSE• <br /> MECMANICALCONTRACTOR A1�ILAO�RE55 CITY 21P PHONE SiATLLICF.NSE� <br /> L�erqn�.. 5}a}e S�rn P,o. (3ox �s�� e�<<<f} 9�zof 2r�•3iiv FvF� GS-5�2�1C� <br /> PLUA1 GCONTFPCTOR MAILAO�RE55 CITV 21P PMONL STATELICENSEn <br /> CONTRACi PRILE OF WOfiK <br /> z`1�O. dv <br /> OESCPIBE 1YORN AND SOU�RE FOOTAGE INVOLVED CONTACT PERS�AND PHOt NO <br /> �t �Fl���a 'T�- 2Sz- 3�I �f <br /> ' C��.� Oti7 �PS7 1 '1M �d C7�SJ Y I WT <br /> i HEREBY CERTIFY THAT I HAVf_ READ AND EXAMINED THIS <br /> anoaosEo use oF OILDIN APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> �o� `� ���C PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGALOESCRIPTIONOFPROPERTYISNOWNBELOWOf1ATT�CNTWOCOPIES� WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or BLOCK oF NOT. THF. GRAN7ING OF A PERMIT DOES P OT PRESUME TO GNE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> � PERFOR6IANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> PARCELTA%ID.NbIdpER APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> CONSTRUGTIONLOFNLENDER.AODRESS.TELEPHONE NUMBER /� <br /> x �o�+ ��'u-"'� lU-j3 , `J�� <br /> PROJECT ADDR�SS s:c�+nmc o�ie <br /> a�S� Q�Q Y� P W �rtvous:��rs;rcc�.scro <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � A�C—A�HN�LG UNITS—H.P. <br /> BATHTUB i / FOflCEDAIRSYSTEMS—B.T.U.y��l(Efj. <br /> LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M <br /> SHOWER � CLOTHESDRYERS <br /> KITCHEN SINK 8 DISP VENTILATION FAN <br /> DISHWASHER � RANGE HOOD <br /> LAUNDRY TRAY / WATER HEATER <br /> CLOTHES WASHER � WOOD STOVE � <br /> URINAL ; METAL FIREPLACE(WOOD BURNING) <br /> DRINKING FOUNTAIN � FIREPLACE INSERT <br /> FLOOR DRAIN � HEAT PUMP <br /> BACKFLOW PREVENTERS .'L GAS PIPING ; <br /> ROOF ORAINS—RAINLEADERS EXHAUST FAN � <br /> SINK(SERVICE—BAR, ETC.) <br /> SUB TOTAL S _ SUB TOTAL 5 �� <br /> PERMIT S PERMIT S �_ <br /> TOTAL FEE S TOTAL FEE S �' <br /> FOR OFFICE USE ONLY: <br /> FNONTSETBAGN qEARSEIDM1CK SIOES[TpACK P��NCNECKNU\IPCR FEE RELEIPTNO. <br /> L <br /> usezoNe �ornaen VACANTSITE FEES VALUATION FEE <br /> -� YES � NO BUIIDING <br /> iYPEOttOHST. NO.OFSTORIES ocav��6r r,00�U:�!v✓:;r•.�.is — <br /> ���'P PLUMBING <br /> SIZEOFBLOG. FIR[SPRINNlER5RE0'D B�SEl.IENT 61ECHANICAL <br /> f : YES NO <br /> OGCUP�NCY LOAD FIRE ALARM REOD HEIGNT LIMRATION AD�ITIONFL PLAN CHECK � <br /> OTHER � <br /> NEASON —�— <br /> STATE BUILDING SURCHAFGL <br /> i�lIAKl:[1V PLANSAPPROVEDBV CITY OF EVEREIT PUBUC WOflK$ <br /> LOCALSALES <br /> i,,,,E TAX CODE IS 3105 TO7AL <br />