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APPLICATI�;%,�1 FOR CONSTRUCT�;;�N PERMIT eVpfe« <br /> �M Ewro�«� Ta BE COMPLETED IN INK—PLEASE PRINT � <br /> CIiV OF } <br /> eVeretl HEATINOSYSTEM: �AS OELECTRIC O <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> "J DEMOLITION U COMBINATION ❑ BUILDINO % . MECHANICAL LUMBINO [J SIQN <br /> R ,a�µ � in � � /� a - � . <br /> � b <br /> TENANT � �DDNL CITY ZIP PHONE <br /> '�;�:1 ;`.'.li<' ilU;� .� , <br /> ARCNRECT011DEBpNER MA�LADONE6! C17Y 21P Fllplf ' ' '..!;:I.J !':rt�`i IiV • <br /> OENEfULCONTMCTOR MIILAOORElS CITV SIV PIIONE IICflMl1•,., •.•••. . . . <br /> .� :I ':.�.,-•.1• . . <br /> �7M CwW CON MCT R' E!H li I IIP , PMONE � M�� � <br /> V <br /> : CITV ' IIP PHONE � . '.L�I,j!I.t:.j �_.. 1 <br /> �xwewo ca�Tiucron r�nti�oo�as � <br /> -cwe oF waac <br /> NEW � ADDITION lJ ALTERATION CJ REPAIR C.; DEMOLITION Cl WOODSTOVFJFRPL INSERT ❑ BUILDINfl RELOCATION <br /> � CONTACT PERSON 11ND PlqNE N0. <br /> CONTRACT MICE OF WORN � . <br /> DE P Ef00T� VNvaV[0 � � � <br /> 1�1� <br /> v o oreu� I HEREBY CERTIFY THAT I HAVE READ J�ND EXAMINED THIB <br /> - ^ � APPLICATION ANO KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> 1E6111 DES6N� TION Oi P ENN IS Ow ON�Til1CN FWR COPiE31 PROVISIONS OF LAWS AND ORDINANCES OOVERNINO THIS IYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED MEREIN W1 <br /> �oT e�ocK a NOT. THE ORANTINO OF A PERMIT OOES NOT PREBUME TO OIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVI810N8 OF ANY <br /> OTMEA STATE OR LOCAL LAW FEQULATINQ CONSTAl1CTI0N OR 7ME <br /> PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTFiOAIZED BY THE <br /> ' OWNER OF TMIS PROPERTV TO PERFORM TME WORK FOR WH!CH <br /> APPLICATION IS MADE AND 1 COMPLV WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 298.200 WAC. <br /> 610NANRE OF CONTMCTOR OR AUTMONRED/WENT 011R <br /> P T � X cv�.�� �'�i.e�%e�� 9-��!-�i <br /> J , �� IVrLIC�Nf6CITVlUSMESSUClNSENO.�NDWlNEm,+y+�a <br /> ( � V <br /> \ <br /> PLUM! G MECHANICAL ' <br /> Np, TYPE OF flIfTURE OR REM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CIOSET(TOILETI � A/C—A/HNDL6 UNITS—H.P. � <br /> BATHTUB ' FORCED AIR S`.'STEMS—B.T.U. M E.A. ' <br /> UVATORV(WASH BASIN) � UNIT HEATERS—B.T.U. M � <br /> SHOWER ' CLOTHES OHYERS ' <br /> KITCHEN SINK 8 DISP � VENTILATION FAN � <br /> ' DISHWASHER � RANOE HOOD ' <br /> LAUNDRYTRAY ; WATER HEATER ' <br /> CLOTHES WASHER � WOODSTOVE � <br /> URINAL ' METAL FIREPLACE 8 CHIMNEY ' <br /> DHINKINQ FOUNTAIN � FIREPUCE INSERT � <br /> FLOOR ORAIN ' HEAT PUMP ' � <br /> BACKFLOW PREVENTERS � OAS PIPING � <br /> ROOf DRAINS—RAINLEADERS � EXHAUST FAN ' <br /> SINK(SERVICE—BAR,ETC.) � � , <br /> � <br /> � ' <br /> � ' <br /> � ' <br /> � SUB TOTAL S � SUB TOTAL i ' <br /> PERMIT f � PERMIT = � <br /> - TOTALFEE S ' TOTALFEE � ' � <br /> FOR OFFICE USE ONLY: <br /> iqpITSETlA�K PE�R6ETBACK BIDESETB�CK PIANCMECKNUMBER fEE ����T�• <br /> USEZONE LOTARE� v�cu�tsire FEES VALUATION FEE <br /> BUILDINO ' <br /> �rV[OICONry./LLIOWM�E tt1f01tp13T.ACiUAI � �a�«�U"�� � <br /> PLUMBINU � <br /> SRE OF BlDO. NO.O�STOHIES 8�45EMEN7 MECHANICAL 6 f ' e D <br /> OGCU7�NCv IOAD iiRE SPRNKIfPS REO'D HEIOMT LMARATION ADDIiIONAL PLAN CHECK i <br /> OTHER � <br /> RE�SONfORSPRMKlERS ' � <br /> STATE BUIL�INO SURCHAfiQE � <br /> �vr��e er VUNSAVPROVEDEY ��ry OF EUEREIT PUBIIC WOi1KS � <br /> LOCALSALES � <br /> TAX CODE IS 3106 TOTAI (, f ; e� <br />