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APPLICATIQ"'1 FOR CONSTRUCT�N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEA7ING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> 259-8810 <br /> ❑ DEMOLITION ❑ COMBINATION [7 BUILDING [ l MECHANICAL I_7 PLUMBING ❑ SIGN <br /> OWNER MAILADDRESS QTY IIP Q PMONE <br /> .SoucJll �i�PE�7�/ ��D N�cKc�SG+� .SEI}rTLE 9k��/ 0��6 —L�y—997/ <br /> TENANT MAI�pODRESS CITV ZIP PHONE <br /> l��r'S� As- �,�-�s 30� Pck�,� ��ao l3�Dc S�.r-rrc� 9�ig9 2o�-u�i- 9�sb <br /> RRCHITECTORDESIGNER MAILADORESS CITV ZIP PHONE <br /> �C P�Rrx� crL}- /2i9 Wc3��.'-� /Vv S��c 9�«�9 �b - z�S -933L <br /> GENERRI WNTR CTOfl MA'l ADDRESS CITY ZIP PHONE STATE LICENSE� � <br /> ,���{samc.asc�� /tUrriPJtJ <br /> MECHANICALCONTPACTOR MAILAODRE55 CTV 21P PHONE SIATEUCENSE� <br /> PIUMBING CIXJTRACTOR MAIL ADDRE55 CITV ZIP PMONE STRTE LICENSE I <br /> � CONTR�CT PRICE OF WORK �O <br /> �p0, (�ct-Gi , —� <br /> DESCRIBE WORK ANO SOUAqE FOOTAGE INVOIVED CONTACT PEHSON AND PHONE t10. <br /> �( earo0c'z. J2E37fiu�irJi — �fFLE �/«ifs2+si 3OG �4'v/ — �€S� <br /> i HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSED USE OF BUILDING � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> ' R{;J�.12,.{+J f FROVISIONS OF IAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> � :EG�LDESCRIPTIONOFPROPERTV�SHOWNBEIOWOR�TTACMTWOCOPIES) WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �� �or �3o e�ocK 7's� oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> P PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH TNE STATE <br /> PAPCEL T I D.NUMBER CONTRACTORS LAW 18.27 RCW AND 2962pp WAC. <br /> � �f d+tS?/S�� /�^� q <br /> i GIXJSTR IONL A E D R.�D ESS,TELEPHONENUMBER Y �� /1 '/t/� ��� /Q���a� <br /> ` V\ � � <br /> i PROJECT ADORESS scru*une or,re <br /> OS ��E �� � CITYOUSINESSLiCENSENG <br /> , PLUMBINCi MECMAHICAL <br /> � ►q. TYPE OF FlI(TURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILEn � A�C—NHNDLG UNITS—H.P. � <br /> BATHTUB ; FORCED Alfi SYSTEMS—B.T.U. M E.A. ' <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M � <br /> SHOWER ' CLOTHES DRVERS ' <br /> KITCHEN SINK 8 DISP � VF.NTILATION FAN � <br /> DISHWASHER RANGE HOOD <br /> LAUNDRV TRAY ' WATER HEATER ' <br /> CLOTHES WASHER � WOOD STOVE � <br /> URINAL ' METAI FIREPLACE(WOOD BURNING) ' <br /> DRINKING FOUNTAIN � FIREPLACE INSERT � � <br /> FLOOR DRAIN � HEAT PUMP ' <br /> BACKFLOW PREYENTERS � GAS PIPING � <br /> qOOF DRAINS--RAINLEADERS � EXHAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) Z � � <br /> � � <br /> , � <br /> SUB TOTAL $ ; SUB 1'OTAL $ <br /> PERMIT $ D� PERMIT $ � <br /> TOTAL FEE $ ' TOTAL FEE $ ' <br /> FOR OFFICE USE ONLY: * /�3�Z ��GL�C.�i <br /> FRONT ScTBACK REAR SET&�CK SIDE SETBACH PUN GNECN Nl1MBER FEE — RELE�PT 110.� <br /> � 9Zu% <br /> use zorie LOT nflEA VACMIT SITE FEES VALUATION FEE <br /> ❑ YES ❑ NO gU1LDING � —� �JQ ' <br /> lYPEO�CONST NOAFSTOHIES o[tUwxtr uoMUttwNGUMnS i <br /> �"_ 11^ G�y��Vj� �9 ° uO G�� PLUMBING � <br /> ��Fi rw r�..��G <br /> SIZE OF BLDG FIRE SPRINNlEHS REO'D BASEMENi MECHANICAL � <br /> ,.��iIJ, �F .T. � � l�YES n NO 1 <br /> OCCUPANCV LOAD FIPE ALARM REOD HEIGNT UMITATION A�DITIONAL PLAN CHECK <br /> i <br /> '�j Y�f OTHER i <br /> REASON <br /> .���� �(�� STATE BUILDING SURCHARGE ���� <br /> INTAKE BY PLANSAPPROVEDBY CITY OF EVEREIT PUBLIC WORNS i <br /> �IN LOCAL SALES \�r, <br /> o,,,E � Z� TAX CODE IS 3105 TOTAL 6 <br />