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APPLICATIC^1 FOR CONSTRUC7''_�N PERMIT � <br /> ' ..;,,TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEAT.ING SVSTEM: U GAS ❑ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> I l DEMOLI ON L I COMBINATION i I BUILDING I i MECHANICAL �l PLUMBIN(i I_i SIGN <br /> 'VAlER�,',.�$�J� f1� MAILtADOPE55 CITV �� ZIP PHONE — <br /> e G�S CITV IP O PMONE <br /> TEN�NT MAILMDRE55 <br /> �RCHITECTONDESIGNER MAILADDRESS <br /> CIT' ZIP PHONE <br /> GENERµC�ONTMCTOR MAILADDRE55 <br /> CITY 21P PMONE ST�TELICENSE♦ <br /> U ��� Z�p PMONE STATELICENSEI <br /> MECHNIICM.CONTM�T� MAIL/�DDRE55 <br /> PLUMBING CONTMCTOR <br /> MAILADDRE55 CITY ZIP PHONE STATELICENSE• <br /> CUSS OF WORK <br /> ❑ NEW ❑ ADDITION I-! ALTERATION Dl REPAIR i I DEMOLITION I 1 WOODSTOVE/FRPL INSERT I 1 BUILDING RELOCATI N <br /> CONTACT PF.RSON AND PHONE NO. <br /> CONTRACT PRICE OF WORK <br /> DESCPIBE WONK AND SWPRE FOOTAGE INVq.VED <br /> � � O i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSE SEOFBUILDING <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORREC . <br /> S�rQ� pROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> LEGALOESCRIPTIONOFPROPERN�SHON'NBEL WORA7TACHFWRCOPIES� yyORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE�'�J OR <br /> �oT�'0� �� r,M 1111dF � NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> aa��-�.� <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> p �aS$ 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 THE WORK FOR WHICH �. <br /> S 6Fk �� • � APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 7827 RCW AND 296200 WAC. <br /> SWq o <br /> � � �_ <br /> Z� pN�T E D�� <br /> PRO.IECTADDRESS . <br /> CItV BUSMESS IILEN>E NO <br /> PLUMBINO MECHANICAL . <br /> FEE N0. TYPE OF EOUIPMENT �E <br /> . pq, TYpE OF FlXTURE OR REM , <br /> � � WA?ER CLOSET(TOILET) � NCrA/HNDLG UNITS—H.P. , <br /> �TM�B � FORCED AIR SVSTEMS--B.T.U. M E.A. � <br /> � LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M ' <br /> SHOWER ' CLOTHES DRYERS � <br /> � KITCHEN SINK 8 DISP � VENTILATION FAN ' <br /> DISHWASHER � RANGE HOOD ' <br /> LAUNDRY TRAY ; WATER HEATER � <br /> CIOTHES WASHER � WOOD STOVE ' <br /> URINAL ' METAL FIREPLACE 8 CHIMNEY � <br /> �RINKING FOUNTAIN � FIREPLACE INSERT ' <br /> FLOOR DRAIN � HEAT PUMP � - <br /> BACKROW PREVENTERS ; GAS PIPING ' <br /> ROOF ORAINS—RAINLEADERS � EXHAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) � ; <br /> i � <br /> � <br /> , SUB TOTAL S ' <br /> SUBTOTAL $ � — � <br /> PERMIT $ � PERMIT S � � <br /> TOTALFEE $ ' TOTALFEE $ ' <br /> FOR OFFlCE USE ONLY: neceivrNo. <br /> FRONT SETBACN RERH SETBACN SIDE SETBACN PLAN CHECK HUMBER <br /> IEE <br /> 39 6 yALUATION FEE <br /> LOTAREA VALANTSITE FEES <br /> USE ZONE / � <br /> BUILDING � <br /> oµ�r NoOiDWFItiNGUx115 � <br /> TVPEOFCONTS.ALLUW�BLE iYPEOFCONST,ACNRL � � <br /> � I -n� � �" ° ' � PLUMBING ' <br /> wv yN... � <br /> i <br /> SIZE OF BLOG. NO.OF STORIES BASEMENT_ MECHANICAL <br /> 7� G I NV � <br /> 5'1 ' ADDITIONAL PLAN CHECK ' <br /> OCCUPANCYLOAO FIPESPRNKLERSREO'D HEIGNTLIMITATION � <br /> 4 Na � <br /> SPRINNLER ' <br /> i <br /> REASON FOR SPRINKLERS STATE BUILDING SURCHARGE ' <br /> IN(�KEBY PLt•NSAPPROVEDBY CITYOFEVEHEIT PUBLICWORKS � <br /> LOCAL SALES ; <br /> +� 'y� J M TAX CODE IS 3105 TOTIIL �s�,� <br />