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APPLICATIr`Y FOR CONSTRUCT'ON PERMIT <br /> G,t� TO BE COMPLETED IN BLACK INK—PLEASE PRINT � <br /> � v <br /> BUILDING DEPARTMENT HEA7ING SYS7EM: ❑GAS i,7 ELECTRIC ❑ <br /> 259-8810 <br /> I I DEMOLITION 17 COMBINATION i_I BUILDING I !MECHANICAL ;)('PLUMBING ;"1 SIGN <br /> �WNER MAl1.qU0PES5 CRY 11F PNONE <br /> �Qu�3£N �'�9.✓i <br /> TENANT NAILpDOREuS CITY 21P PMONE <br /> �if�E�c�i7 �.v�iF;� y.r'r c �/ot Si.i�c s.- fv£�c��i w�1 9��oi .�?lJJ3� <br /> ARCNITECTOflDEnIGNER Mr11LqDDRE55 CIiY ZIP PMONE <br /> GENERAL CONTRACTOR M�I�ADDRE55 CITV ZIP PMONE SiRTE LICENSE 1 <br /> MECMANICAL CONTRACTOR M�.l AOORESS CITV ZIP PNONE STATE LICENSE 1 <br /> PIUIIBING CONTRACTOR MAIL ADURE55 CITY ZIP r� PMONE STATE LICENSE• j O��'�� <br /> OE'�f �LU�16i-✓� +029in/ ttf�,•�+•v�F. 30�( 9.f' ,�� .� C. F!/��fFIT �IeS' � <br /> LONTq�CT PRICE OF WORK <br /> DESCqIBE WORN AND SOUARE FOOTAGE INVOIVED C�NUJT PE�:SON AND PMONE NO. <br /> i HEREBV CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br /> ' PROPpSEO USE OF BUILOING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGAIGFSGqIPTqNpFPRpPERN�SHOWNBFLOWOR�TiRCNTWOCOPIES) WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or B�aK pF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORI fY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGUUITING CONSTRUCTION OR THE <br /> PERFOR6IANCE OF CONSTRUCTION.THAT I AM AUT�ORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> PARCE�TA%I.O.NUMBER APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 7827 RCW AND 296200 WAC. <br /> CONSTRUCTqN LWN LENDER.AODRESS.TELE�HONE NUMBER A T <br /> o.f � Si. fNf<f T Lu.i �v .�/r t��y <br /> PRQIECf ADDRESS saN�ru <br /> wre <br /> CIiYBUSMESSlCFNSEND <br /> ��� MECHANICAL <br /> N0. TYPE OF RXTUpE ON ITEM FEE NO. TYpE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) /VC-NHNDLG UNITS-H.P. <br /> BATHTUB ; FORCED AIR SYSTEMS-B.T.U. M E.A. � <br /> UVATORY(WASH BASIN) UNIT HEATERS-B.T.U. M <br /> SHOWER CLOTHES ORYERS , <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN � <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY ; WATER HEATER � <br /> CLOTHES WASHER WOOD STOVE ; <br /> URINAL ' METAL FIREPLACE(WOOD BURNING) � <br /> DFINKING FOUNTAIN � FIREPLACE INSERT . � <br /> FLOOR DRAIN HEAT PUMP , <br /> BACKFLOW PREVENTERS ; GAS PIPING � <br /> ROOF DqAIN�RAINLEADERS EXHAUST FAN <br /> SINK(SERVICE-BAR,ETC.) ; ; <br /> �C <br /> � <br /> � —T <br /> SUB TOTAL E ; SUB TOTAL S <br /> PERMIT S � PERMIT 5 � <br /> TOTAL FEE S TOTAL FEE $ <br /> FOR OFFlCE USE ONLY: <br /> FRUNTSET&1CK REAPSEIBACK SIDESE7BACK PUNCHECNNUMBER i�EE RECEIPTNO. <br /> USEZONE LOTAREA VACANTSITE FEES VALUATION FEE <br /> !' ves ❑ No <br /> aur,om�� � <br /> �YPfO�LON51 ���STORIES OCqIWNC NOpflMlliWiUNi�S � <br /> tnoiv p�UMBING � <br /> . SIZEOF&OG. FIRESPPINKIERSREO'0 &1SEIAENT MECHANICAL � <br /> i', VES :"'1 NO __ <br /> OCCUPMlCY LOAD fIRE M�R1A REO'D MEIGNT LIMITATION ADDITIONAL PLAN CHECK � <br /> OTHER i <br /> REASON � <br /> �— <br /> S7ATE BWLDING SURCHARGE <br /> INTM(E AV PUNSAPPROViOBV CITY OF EYENEIT PUBLIC WORNS � <br /> LOCAL SALES <br /> DATE TAX CODE IS 3105 TOTAL <br />