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APPLICATIO� FOR CONSTRUCT[�N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEM: U GAS ❑ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259•8810 <br /> 17 DEMOLITION ❑ COMBINATION I l BUILDING I 1 MECHANICAL !�(PLUMBING f 7 SIGN <br /> OWNER MAILRDDRESS CITY ZIP PMCNE <br /> �K.��Slyr I.�e�E iNC. Ao 1�oY 7p0.3 EJEakTT WA Q0�7w� at1 •�a�N <br /> TCN�NT MAIL PDDRESS QTY ZIP PHONE <br /> ARCMITECT OF DESIGNER MAIL ADDHESS CITY ZIP PHONE <br /> GENERALCONiR�CiOR MAILAODRESS GIN 21P PHONF STATEUCENSEt <br /> MECMANICAL CONiRACTOR MRIL ADORESS CITV 21P PHONE STpTE U0.NSE� <br /> PLUMBINGCONTFACTpfi� �`^ NA��A,DDRE55 QTY ZIP PMONE STATEUCENSEI <br /> Cl flC/L/ j,.�rF wo qvP�+u! tvF�� IrA •I�o3 1fa•3sSY <br /> CONTRACT PRICE OF WORN • <br /> o�N + t����i s �tiic u c a• rc�y <br /> DESCRIBE WORK AND SOUARE FOOTAGE INVOW ED CON7ACT PERSON AND PMONE NO. <br /> �ra•aa�� <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSEO USE OF BUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> IEGALDESCRIPTIONOFPROPERTY�SHOWNBELOWORAiTACHTWOCOPiE51 NOT THELGRANTOING OF A ERMITJDOES NOT PRIESUME TO GNE <br /> ioT BLOCK oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> 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 /> . APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCEL TAX I.O.NUMBF.R CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> � CONSTPUG710N LOAN LENDER.ADDHE55,TELEPHONE NUMBER � <br /> , �/O' <br /> ' swN�tunE o�rE <br /> � PROJECT ADDAESS - <br /> LILY BUSME55 LiCENSF NO <br /> ' PLUMBING MECHANICAL <br /> Np, TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EUUIPMENT FEE <br /> 3 WATER CLOSET(TOILET) 11 � - NC--A/HNDLG UNITS-H.P. ' <br /> BATHTUB � ;� FORCED AIR SVSTEMS-B.T.U. M E.A. ' <br /> � LAVATORY(WASH BASIN) �� UNIT HEATERS-B.LU. M � <br /> � SHOWEH ' CLOTHES DFiYERS ' <br /> KITCHEN SINK&DISP � � � VENTILATION FAN � <br /> DISHWASHER RANGE HOOD ' <br /> LAUNDRY TRAY ; WATER HEATER <br /> CLOTHES WASHER � WOOD STOVE ' <br /> URINAL ' METAL FIREPUICE(WOOD BURNING) ' <br /> DRINKING FOUNTAIN � FIREPLACE INSERT � � <br /> FLOOR DRAIN � HEAT PUMP � <br /> BACKFLOW PREVENTERS � GAS PIPING ; <br /> ROOF DRAINS-RAINLEADERS EXHAUST FAN ' <br /> SINK(SERVICE--BAR,ETC.) � � <br /> � � <br /> � � <br /> � � <br /> SUB TOTAL S 77 � � �' SUB TOTAL 5 <br /> PERMIT $ � ^ PERMIT S � <br /> TOTAL FEE $ '" TOTAL FEE $ ' <br /> FOR OFFICE USE ONLY: FEE flECEIPT NO <br /> FRONT SETBACK REAR SETB4CK SIDE SETBACK PIAN LMECK NUMBEP <br /> �o�APEA VACANT SITE FEES VALUATION FEE <br /> USE20NE � <br /> ❑ YES ❑ NO BUILDING � <br /> iYPE OF CONSi. NOAF SiORIES OCCuvn4tv NC M DtiuuNGUNrts � <br /> cnouv PLUMBING � <br /> 52EOPBLDG. FIRESPRINKLERSREO'D BASEMENT MECHANICAL � <br /> G YES �! NO ' <br /> OCCUPANCY LOAD FIRE PLARM REO D MEIGHT IIMITATION <br /> ADDITIONAL PLAN CHECK ' <br /> OTHER <br /> i <br /> REA50N STATE BUILDING SURCHAflGE _ _ <br /> INTAKE BY PLANS APPROVED BY CITY OF EVEREIT PUBLIC WORKS � <br /> LOCAL SALES <br /> DATE TAX CODE IS 3105 TOTAL <br />