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APPLICATI4.� FOR CONSTRUCT. �N PERMIT ��<<P« <br /> ihe Evorgreen TO BF.COMPLETED IN INK-PLEASE PRINT � <br /> CITV OF <br /> eve rett HEA7ING SYSTEM: G GAS ❑ELECTRIC ❑ � <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> DEMOI�ITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> OW�V�/1� �!/Y'MAILFODR���{Gt ��N/ WII�"\ �V�NI _1VP(N9 �J I���7V <br /> {/V� <br /> TFNANT �PESS CITV ZIP PHONE <br /> ��a. �� <br /> A�`�TORDESIGNER`�1�MAILA 0�55 �812 �}ewi'1 CIT�• �� Z�� ���IPHONE ����I <br /> i�; ��i.�r <br /> G�RA��CT0�1�ILAUDR��k � r� � �� Z�P PHONE UCENSE� <br /> MECMANI ALCONTRACTOF �LADDR � Z�P PNONE UCENSER <br /> PLUMBINGCO4TRACTOR MNLADDRESS CITV 7.IP PHONE LICENSEs <br /> CLASS OF WORK .- <br /> �. NEW ' ADDITION '� � ALTERATION �. REPAIR � . DEAIOLITION , .� WOODSTOVEIFRPL INSERT '.�-� BUILDING RELOCATION <br /> � G� CONTACT PERSON ANO P ONE NO. <br /> CONTR CT PRICE OF WORK <br /> DESCRIBE RK AND$�ARE FOOTAG INVp/�EO �J� ��� w r^ - �I — <br /> / ij� �r{�% �{��i <br /> PqOPO5EDU5E0 aw��yG� I HFREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> ` APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEG�L DESCRIPTION OF PROPERTV�SHOWN BELOW OP AnACH FOUR WPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILI BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �ot e�ocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROV�SIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNEH OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> � . APPLiCAT�ON IS MADE AND i COMPLY WITH THE STATE <br /> CONTRACTORS lAW 18.27 RCW AND 296.200 WAC. <br /> SIGNFTUREOFCONTRACTORORAUTHORREOAGENT DATE <br /> � P X �— <br /> APPLICA 5 GITV BU E55 LiCENSE 1 ,AND BUSINESS NAME <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � !VC—A/HNDLG UNITS—fI.P. � <br /> BATHTUB ; FORCED AIR S`.'STEMS—B.T.U. M E.A. ' <br /> LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M � <br /> SHOWER ' CIOTHES DRYERS ' <br /> KITCHEN SINK 8 DISP VENTILATION FAN � <br /> DISH WASHER RANGE HOOD <br /> LAUNDRV TRAV _ WATER HEATER <br /> CLOTHES WASHER � WOOD STOVE � <br /> URINAL ' METAL FIREPLACE&CHIMNEY ' <br /> DRINKING FOUNTAIN FIREPLACE INSERT � <br /> FLOOR ORAIN HEAT PUMP ' <br /> BACKFLOW PREVENTERS � GAS PIPING � <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN ' <br /> SINK(SERVICE—BAR.ETC.) � <br /> � <br /> � <br /> � � <br /> SUB TOTAL 5 ; SU8 TOTAL S <br /> PERMIT S PERMIT S � <br /> TOTAL FEE $ ' TOTAL FEE $ ' <br /> FOR OFFICE USE ONLY: <br /> FRONTSETOAL1�K REAnPSETBACK SIOES�E/TBACK PLANLME/���/ FEE RECEIPTNO <br /> ZJ !��' 27 ' (li <br /> usezor+e ' � LOTAREA VACANTSITE FEES VALUATION FEE <br /> Nv BUILDING SZ'� .�� ' ob <br /> lYPEO(LONiSAIIOWFBIE iVP:OVCONSTACiUAL u.cuo�ytr xo0vb.snun6u4u5 � <br /> � 9Y1 i YS"i � PWMBING � <br /> �Y�� G , <br /> SI2EOFBLDG. NO.OFSTORIES BASEMENT MECNANICAL � <br /> la� � l uD � <br /> OCCUPRNCYl0A0 fIRESPRNHLER5flE0'D HEIGNTLIMITATION ADDITIONALPLANCHECK i <br /> �� n �/ <br /> W OTHER � <br /> HEASONFORSPR�NKLERS � r <br /> STATE BUILDING SURCHAtiGE c� <br /> INT�KEBV PLr1N5AP1'POVED�Y CITYOFEVERE7T PUBLICWOPKS � <br /> / LOCAL SALES <br /> l v� � � E TAR CODE IS 3105 TOTAL � ;!�� <br />