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APPLICATIO.. FOR CONSTRUCT�JN PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> U DEMOLITION I-1 COMBINATION I 1 BUILDING Ll MECHANICAL I_I PLUMBING I I SIGN <br /> OWNER IMI�ADDRESS CITV ZIP PNONE <br /> ���MiR l91?KL ,��c�of ��t"��A Ks.c �vE E�f 9�U J �S� -D�9 / <br /> 7ENANT MALAUDPESS CIiY ZIP PlqNE <br /> �RCNITECTORDESIGNER M�IL�DDRESS CITV ZIP PHONE <br /> QENEMLCONTfUCTOR MAILADWiESS CITV ZIP PHONE STATELICENSE/ <br /> �iUJ7� �� nf I'�7�� <br /> MELHNIICALCANTMCTOR MAILADDRE55 CITV ZIP PHONE ST�TELILENSE� <br /> PLUMBINOGONTMC70R MAILADORE55 CITY ZIP PHONF STATELICENSE� <br /> CIASS OF WORM <br /> (1 NEW I l ADDITION I_I ALTERATION I I REPAIR I. �I DEMOLITION 1 I WOODSTOVElFRPL INSERT : ! BUILDING RELOCATION <br /> � � CONT�CT PER AND PHONE NO <br /> CONTMCT PIi10E OF WORK - � L% � <br /> DESCRIBE WORK AND SOU�RE FOOT�GE INVOLVED <br /> �, �� - 9�a <br /> � pno eouseoFew� � HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> � _� � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> : �cra pesc qNOF VROPEflTY(SHOWN OW OR ATTACH FWR COPIES� PROVISIONS OF LAWS AND ORDINANCES OOVERNING THIS TVPE OF <br /> �. WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or a�.ocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE � <br /> j AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW RECaULATING CONSTRUCTION OR THE <br /> ' PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> j OWNER OF THIS PROPEfiTY TO PERFORM THE WORK FOR WHICH <br /> . APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br /> i CONTRACTORS LAW 1827 RCW AND�9F.200 WAC. <br /> I <br /> � <br /> X <br /> SK✓I�TU E '� <br /> PRQIECTIIDDRESS ���-}G� "y � <br /> . �� CIlVBU5MES1l�CEN5EM0 <br /> ��i p��Mp MECHANICAL <br /> I Np, n(pE pp pXTUpE OR fTEM FEE NO. TYPE OF EOUIPMENT FEE <br /> � WATER CLOSET(TOILEn � A/�A/HNDLG UNITS—H.P. � <br /> . g,�,7}{7�g ' FORCED AIFi SYSTEMS—B.T.U. M E.A. ' <br /> � LAVATORV(WASH BASIN) UNIT HEATERS--B.T.U. M I <br /> SHOWER ' CLOTHES DRVERS ' <br /> KITCHEN SINK 8 DISP � VENTILATION FAN ' <br /> T <br /> DISHWASHER � RANGE HOOD � <br /> . LAUNDRY TRAY ; �VATEFi HEATER <br /> CLOTHF.S 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 /> RWF DRAINS—RAINLEADERS � EXHAUST FAN � <br /> , SINK(SERVICE—BAR,ETC.) � <br /> , I <br /> � � <br /> � � <br /> � � <br /> � � <br /> Sl'B TOTAL S ' SUB TOTAL $ ' <br /> PERMIT E � PERMIT $ � <br /> TOTALFEE S ' TOTALFEE S ' <br /> FOR OFFlCE USE ONLY: <br /> pqpNT$ET&1CK REARSETBACK SIDESETBACK PUNCHj�K�N�M�R FEE RECEIPTNO. <br /> �� �- t�C� ° <br /> USEZONE LOTARE� VAC�NT3�TE FEES VALUATION FEE _� <br /> � BUIL�ING � <br /> iVPEOFCONfS.ALLOW�pIE ttPEOFLONST.�CTUAL ��w �OaowEuiNGUNrtS � <br /> taWv p�UM81NG i <br /> a•a. <br /> SIZEOFBLOIi. NO.OFS70HiE5 BASEMEN7 MECHANICAL ' <br /> oCGUPANCY lOA[ PIRE SFRNKLERS REO'D MEIGHT LIMITATIOH ADDITIONAL PLAN CHECK 2 i <br /> i <br /> SPRINKIER � <br /> RFASpN FOR SPRINKLERS <br /> STATE BUILDING SURCHARGE 0 <br /> INTN(E BY PV NS APPROVED BY CITY OF EVEHEIT PUBLIC WORKS i <br /> L LOCAL SALES � _ <br /> /►h TAX CODE I5 3105 �T�� ; <br />