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�.. <br /> APPLICATIG.�1 FOR CONSTRUCTr�N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEM: GAS O ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259-8870 <br /> C� DEMOLITION I i COMBINATION i 1 BUILDING �l MECHANICAL ❑ PLUMBING � ] S�GN <br /> OWNER MAILADDRE55 CITY ZIP PMONE <br /> � CCd..SI.�SAJ L� T I ►'A�JAutCiJl�iZ. E1102r'T� 1�'�7 �3�(fC -�175 / <br /> NANT MAILADDRE55 CIN ZIP PMONE <br /> ARCHITECTORDESIGNER MRILADDRESS CITV 21P PHONE <br /> GENER�LCONTRACTOR MAIIADDRE55 CITY Z�F PHONE S�ATE��� <br /> i�-�• �% <br /> MECH/JJICALCONTflACTOR MAILADOHE55 GTv ZIP PHONE STATELICENSE� <br /> � .���,�� r✓. ��� ��� zl�ol Q1�'G'�T AcIF L-1lEXc'r� 9f1.?o! �sfi��5'� od 6 ���R' <br /> PL BINGCONTFACTOR MFIL�DDRE55 CITV ZIP PHONE STATELICENSE� <br /> CLASS OF WOpK <br /> �._I NEW � � ADDITION C i ALTERATION f..I REPAIR L 7 DEMOUTION f_1 WOODSTOVE/FRPL INSERT ❑ BUILDINf3 RELOCATION <br /> CONTACT PERSON AND PNONE NO. , <br /> CONTRACTPRICEOFWORK I „ a aO <br /> DESCFlIBE WOHI(AND SOUARE FOOTAGE INVOIVED <br /> ��i � �/ � � �' <br /> ' PflOPOSEDUSEOFBUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> _ .�t S/�E �` APPUCATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> LE6AL DESCRIPTION OF PROPERTY(SHOM?l BELOW OR ATTACH FWR CAPIES� PROVISIONS OF LAWS AND OFiDINANCES GOVERNIN(i THIS TVPE OF <br /> WORK WILL BE COMPLETED WITH WHElHER SPECIFIED HEREIN OR <br /> �or e�acK � NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO 61VE <br /> AUTHORITY TO VIOIATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGULAT1NCi COMSTRUCTION OR THE <br /> PERFORMANCc OF CONSTflUCTION.THAT I AM AUTHORIZED BY THE <br /> �� OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE , <br /> n � CONTRACTORS LAW 1827 RCW AND 296. WAC. <br /> ���.1 <br /> �oo r �,o,J.n u� c�J �� e�'��iT �lG . x _ ` -/ - 9 <br /> PROJECiADDRESS <br /> �0^�'07 � ' wh <br /> ' LRV BU9ME35 LICENSE NO. <br /> - PLUMBINO MECHANICAL <br /> Np, TYPE OF flXTUNE OR ITEM FEE N0. TYPE OF EOUIPMENT �E <br /> WATER CLOSET(TOILE� � PJC�AMNDLG 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 /> � � CLOTHES DRYERS ' <br /> SHOWEF <br /> KITCHEN SINK 8 DISP � VENTILATION FAN � _ <br /> ' DISHWASHER � RANCaE HOOD ' <br /> . LAUNDHYTRAY ; WATERHEATER � <br /> CLOTHES WASHER � WOOD STOVE ' <br /> URINAL ' METAL FIREPLACE 8 CHIMNEY ' <br /> � DRINKING FOUNTAIN � FIREPUCE INSERT � <br /> . FLOOR DRAIN � HEAT PUMP � <br /> BACKFLOW PREVENTERS ; GAS PIPING . � <br /> ROOF DRAi�S—RAINLEADERS � EXHAUST FAN ' <br /> � SINK(SERVICE—BAR,ETC.) � � <br /> , ' <br /> � <br /> � i <br /> � � <br /> SUB TOTAL 5 ' SUB TOTAL S � <br /> PERMIT S � PERMIT S � <br /> TOTALFEE S TOTALFEE S ' <br /> FOR OFFICE USE ONLY: neceirr r+o. <br /> PUNCHEC�MBEg, FEE <br /> FRONT SETBIICN REAR SETBACN SIDE SETHRCK �a <br /> USE ZIXJE LOT AREA VACANT SITE <br /> FEES VALUATION �E <br /> BUILDING � ' <br /> i <br /> TYPEOFCONTS.�ILOWPeLE TYYEDFCONS7.ACTUAL aaqa r xoorowFtuxGuxits P�UMBINCa � , � <br /> i <br /> i <br /> SIZE OF eLDG. NO.OF STONIES BASEMENT MECHANICAL � <br /> i <br /> � <br /> A�DITIONAL PLAN CNECK � <br /> OCCUPANCY LOAD FIRE SPRNKLERS RE�'D HEIGHi IIMITAiION � <br /> SPRINKLER � <br /> flEA50N FOR SPRINNLERS � <br /> STATE BUILDING SURCHARGE ' <br /> INT�NE BY PLANS APPROVED BY CITY OF EYEREIT PUBLIC WORKS � <br /> LOCALSALES ; <br /> TAX CODE IS 3105 TOTAL � <br />