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APPLICATIOp'�FOR CONSTRUCTI'"'N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEA'fING SYSTEM: J GAS �al ELECTRIC J —� <br /> 259-0810 <br /> DEMOLITION ' COMBINATION n BUILDING i MECHANICAL i i PLUMBING f I SIGN <br /> /OIYNER M�IL ADDPE55 n CITV ZIV PIIONE <br /> 4�tZ��n �n/�.nef� �f��l �',��v�yv� �v:/�1� ��Z('7� z52 �SCU <br /> 1ENANT AIAILADOFE53 / CITY ZIP PHONE <br /> A/P�CMItECTCRDE/5IGNER MNI.�D�RE55 / CITY q ZIP PMONE <br /> �iI�IA�l4i:� �7t�Iz�� �rr�l. 3L1�'l �.-./�,� ��r ��c��l�' 1��11� <<%L � �$�Z �.�h'�/ /������U/77[i�' <br /> � GENERAICONiRAC10R lAAILADDRE55 CITV 21P PHONE STATELICENS:M <br /> RIECIIANICALCO4iR�CiOR MNLAODRE55 CITY ZIP PHONE STATELICENSE� <br /> PLUMBINGCONTRACTOR 61NLr1DDRESS CITV ZIP PHONE STATELICENSE� <br /> CONTFlACT PRiGE OG WORK <br /> � ��5, �,�c� `lf� 5�13 ✓1�... << e2a S,>,< I-( �ti r -�,3a�r <br /> DESCRIBE WORN AND SOUAHE FOOTAGE INVOLVEO WNTACT PERSON AND PNONE NO. <br /> l�y sF <,F Nc, s;; Iv ,. /� h�•,,,� w! �t`r-co�7 <br /> / � <br /> i HEREBY CERTIFY THAT I HAVE RFAD AND EXAMINEO THIS <br /> PROPOSEDUSEOFAUILf)ING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.AlL <br /> S�� . i - .r I i �� /�nt ' PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGAL CRIPTIONOFP PEPTV�SMOWNBELOWORATTACMTIYOCOPIE51 WORK �NILL BE COMPLETEO WITH WHETHER SPECIFIED HEREIN OR <br /> �or e�p�K oF NOT. THE GRANTING OF A PERMIT OOES NOT PRESUME TO GIVE <br /> AUTHOR�TV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> (,I ti 7 S� ZC I�I„r, y4 g OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORAIANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br /> /7I��1I!�Sef„ ��r/l„ �;, ��'I � OWNER OF THIS PROPERTY TO PERFORM THE N/ORK FOR WHICH <br /> � � 1"" H APPLICATION !S 61ADE AND I COMPLY WITH THE STATE <br /> PARCELTA%ID NUMBER � <br /> / i i�� � _ u a CONTNACTORS LAW 1827 RCW AND 296200 WAC. •//� ([/ <br /> CONSTRUGTIONLOANLENOER.ADDRESS.TELEPNONE NUMBER —� /���9/ <br /> � <br /> (� <br /> PROJECTADDRESS � �... scN+r nc ���-� n.�c �� <br /> /�1e. .�� cnr nus��+css��re r:su:o <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FIIRURE OR ITEM FEE NO. TYPE OF EUUIPMENT FEE <br /> � WATER CLOSET(TOILET) A�C—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 /> SHOWER � � CLOTHES DRVERS <br /> i KITCHEN SINK 8 OISP VENTILATION FAN <br /> 1 DISHWASHER � RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER � <br /> I CLOTHES WASHER � W000 STOVE <br /> URINAL METAL FIREPLACE(WOOD BURNING) � <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PU�AP � <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN � <br /> SINK�SERVICE—BAR,E7C.� <br /> � <br /> SUB TOTAL S SUB TOTAL 5 <br /> PERMIT 5 � PERMIT 5 <br /> TOTAL FEE 5 TOTAL FEE 5 <br /> FOR OFFICE USE ONLY: o°� 9S.�I S <br /> FPONTSETBACK REARSETBACK SIUESEIOAC�N PIANGMECKNlIMO R FEE RECEIPT, "1 <br /> ' � ' S c/�Lv.7S �p,�s,:/ <br /> uSezoN �ornae� V4CANTSITE F ES VALUATION FEE <br /> �, C Ejpp . . VES � . NO Bl11LDING � '� � �J <br /> 7VPEOiCON51 NO.OFSI0PIE5 n'ryru.�. i,pp�ryy�<<��„u�.n <br /> _ I �:'� � PWMBING a �QU <br /> 512EOF Lo� FIRESPRINKLEHSREO'D 9GSE�AENT <br /> 1 O(�f S f 'r' . �. YES �� NO MECHANICAL � �Q�� <br /> Sf Gqa Q <br /> OCGUPaNCv LonD FIRE ALRRIA RE00 ��EiG��T unninnort, ADDITIONAL PLAN CHECN ;� �7 <br /> OTHER ��� � (�J <br /> REASON <br /> SiATE BUILDING SURCHAfiGE C ;S�) <br /> rtltnNEPY PLANSAPPROVEDBY CITYOFEVEREIT PUBLICWOflKS ,1O � �L� <br /> LOCAL SALES <br /> �A,e TAR CODE IS 3105 TOTAL ��-��� � �. '`� <br />