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r � <br /> APPLICAYI4�� FOR CONSTRUCT�JN PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> C l-�j <br /> BUILDING DEPARTMENT HEATING SYSTEM: GAS ❑ELECTRI(: ❑ <br /> 259-8810 <br /> f_I DEMOLITION i I COMBINATION I 1 BUILDING l MECHANICAL I I PLUMBING i:l SION <br /> O/WNYER � 1 M�ILADOR'E1SS CITV ZIP �y(� PHONE <br /> yF'fL ' �/'�"� �02.71A 1� 1J1T+�� l�� S�l� ]5 �1L —IDZ�� ��� 1�1Q�� <br /> hNANT MAILADDRE55 CITV ZIP PM E <br /> ARCHITECT OR DESIGNER MAIL AUDHE55 GTY ZIP PHONE <br /> GENERALCONTAACTOR MAILADDRE55 CITV ZIP PNONE STATELICENSEI <br /> MECHMlIC/�LCpNT1UCTOfl MAILADDNESS CITY ZIP PMONE STATELICENSE/ <br /> _�' 7� L-�Prr...�G. ,�H� �� �-,�32C� PfL.�I[,-,Ta�-t, �trdLL3 �-l3S�to�l� �a � �uw.�.. <br /> PLUMBMGCIXJTR�CTOH IMIL�DDpESS CITV ZIP i PMONE SUTELICENSE� <br /> CUSS OF WORN <br /> 1 � NEW I_� ADDITION C I ALTERATION i_I REPAIR i I DEMOUTION f I WOODSTOVEiFRPL INSERT I i BU'IDING RELOCATION <br /> CIXJUCT PERSON�ND PHONE NO. <br /> CONTMCT PRICE pF WORK <br /> OESCRIBE NR7fIK AND SOUARE FOOTAGE INVOLVED <br /> PROPOSEDUSEOFBUILOING i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> IEdLL DESCRIPTh7N OF PROPERTV�SMOWN BELOW OR ATi�CH FWR COPIES� PROVISIONS OF LAWS AND ORDINANCES OOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or e�xK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTHUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMf'LY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> x Z.— �1-9-�f <br /> PROJECTADDRESS SicN�tu O�tc <br /> 4"Lv ��re��,E�.�E�� <br /> ' ��0� MECHANICAL <br /> � NO. TYPE OF FlXTURE OR fTEM FEE NO. TVPE OF ECUIPMENT FEE <br /> WATER CLOSET(TOILE� � A/C—/VHNDLG UNITS—H.P. , <br /> BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> , LAVATORV(WASH BASIN) � UNIT HEATER�B.T.U. M 55 K � <br /> ' SHOWER � CLOTHES DRYERS � <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN ; <br /> �� DISHWASHER � RANGE HOOD , <br /> LAUNDRYTFAY ; WATERHEATER <br /> � CLOTHES WASHER � WOOD STOVE , <br /> � URINAL ' METAL FIREPLACE 6 CHIMNEV � <br /> � DRINKING FOUNTAIN � FIREPUICE INSERT ; <br /> � FLOOR DRAIN HEAT PUMP � <br /> BACKFLOW PRE:VENTERS ; GAS PIPING ; <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) ; � <br /> � ; <br /> � , <br /> � , <br /> SUB TOTAL S ' SUB TOTAL S ' <br /> PERMIT $ � PERMIT $ � <br /> TOTAL FEE $ ' TGTAL FEE S � <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBACK PEARSETBACK SIDESETBACN PUNCHE NNUMBER FEE RECEIPTNO. <br /> USE20NE LOTAFEA VACMlTSITE FEES VALUATON FEE <br /> BUILDING i <br /> 7YPEOLCONiS.ALLOWlLLE TYPEOiCON57pCIDAL aCUPMtY MaqNrtlUNGUNits i <br /> cnao � PLUMBING <br /> SIZE OF BLIXi. NO.OF STORIES BASEMENT MECHANICAL � <br /> OCCUVANCY LOAO FIRE SPRNKLEflS REO'D HEIGHT LIMITATION ADDITIONAL PLAN CHECK � <br /> SPRINKLER � <br /> REASON FOR SPRINKLERS <br /> i <br /> STATE BUILDING SURCHARGE ; <br /> INTAKE BV PUNS PPPROVED BV CITY OF EVEREIT PUBLIC WORKS � <br /> LOCALSALES ' <br /> TAX CODE IS 3105 �TAL I <br />