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APPLICATION FOR CONSTRUCT�JN PERMIT <br /> TO BE COMPLETED IN BLACK INK-PLEASE PRINT � <br /> HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> BUILDING DEPARTMENT i <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING MECNANICAL �UMBING SIGN <br /> �DRwD � ��`��P"�`�°DRE55 �og�! �ITH DP, S� E�E�� ��a�1° 3s3 - �6 � <br /> TENANi MAILAO�RESS CITV ZIP PHONE <br /> AFCHI7ECT OR�ESIGN[R MAIL ADDRESS CITY ZIP PHONE <br /> • GENERRL LONTRACTOF MRIL ADORESS CITY ZIP PMONE STATE UCENSE t <br /> MEGHANICALCONTRACTOR MAI�ADDRE55 CIN ZIP PHONE STATELICENSER <br /> PLUMBINC.CONTRACTOR MAILADDRE55 CITV ZIP PMJNE STATELICENSEt <br /> OG�J�L ,/L <br /> ClAS50F WORK <br /> I I NEW I �� ADDITION �� ! AUERATION �EPA�R DEMOLITION WOODSTOVE/FRPL INSERT ' i BUILDING RELOCATION <br /> CONiACT PERSON r1ND PHONE NO <br /> CONTRACT PRICE OF WORN <br /> OESCRIBE WORK AND SOUARE FOOTAGE INVOLVED <br /> �' 'U � i. � S�'� LiJ <br /> PROPOSEDUSEOFBUILDING / � HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> �� �/�2, APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT, ALL <br /> IEGALUESCFIPTIONOFPROPEPTY�SHOWNBELOWORATTACNFOURCOPIES� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> WORK WILL BE COMPLETED WITH WHETHEF SPECIFIED HEREIN OR <br /> ioT e�ocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> 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 /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> x ��� � �-a�loZ <br /> PRQIECT ADDRESS SiGN�i ontE <br /> ��08 o�f,C£S ��r.o�s���ss��«�sE�o <br /> PLUMBiNG MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � �' AiC—A/HNDLG UNITS—H.P. <br /> BATHTUB ; -- FORCED AIR SVSTEMS—B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M ; <br /> SHOWER � CLOTHES DRYERS � <br /> KITCHEN SINK&DISP ; .� VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY ; WATER HFqTER <br /> CLOTHES WASHER � WOOD STOVE <br /> URINAL ; METAL FIREPLACE 8 CHIMNEY � <br /> DRINKING FOUNTAIN � FIREPLACE INSERT ; <br /> FLOOR DRAIN HEAT PUMP � <br /> BACKFLOW PREVENTERS ; GAS PIPING ; <br /> ROOF DRAINS—RAINLEAUEAS � EXHAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) ' ' <br /> � <br /> � <br /> � � <br /> � � <br /> SUB TOTAL $ O �-- SUB TOTAL $ <br /> PERMIT $ O PERMIT $ <br /> TOTALFEE $ . p ; TOTALFEE S � <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBACK BEAR S TOACR SIDE SETBACK PLAN CHECK NUMBER FEE RECEIPT N0. <br /> �6 1J L <br /> USEZONE LOTANEA VACANTSITE FEES VALUATION FEE <br /> BUILDING i <br /> TVPEOFCON1S.RllOWABIE iYPEOfCONSTACTUAL OCcwsHtr Nooro�vFuniGwuts i <br /> tnouo � pLUMBING `�O �� <br /> 52EOFBLDG. NO.OFSTORIES BASEMENT MECHANICAL � <br /> OCCUPANGVLOAD FIFESPRNNLEFSPEOD NEIGHiLI�11TqTION ADOITIONALPLhNCHECK i <br /> SPRINKLER � <br /> REASON FOfl SPRINNIERS <br /> STATE BUILDING SURCHARGE i <br /> INTAKEBY PLANSAPPROVEDBY CITYOFEVEREIT PUBLICWORI:S � <br /> LOCALSALES ' <br /> TAX CODE IS 3105 TOTAL ,3d ��, <br />