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� \ <br /> a APPLICAT11.�1 FOR CONSTRUCI .ON PERMIT � <br /> �� TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING FiYSTEM: GAS ❑ELECTRIC `,�/S�Aii✓S"TeAN fLiu/ <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING �}RECHANICAL XPLUMBING SIG.� <br /> ONT:E"'� MAI�ADDRE55 GITY IiP PHONE <br /> /'/io✓idenrse Ikw;tnl 9/6 P�;fi•r �'rv�cYf N/R: 96�'�0l .2o6 -�S�� 7/.�3 <br /> TENANT � MAIL ADDRESS CITV ZIP PHONE <br /> s,..y e <br /> RRCHITEGT OR DESIGNEP MRIL A��PESS QTV ZIP PHONE <br /> �?eT�s�( �varA ti,�,i� y�ob NoYr a✓� ��ru2rr wsa , YPjo/ .�0 6-Jts'9-aF6a <br /> GENERAL CONTRRCTOR MAIL ADDRE55 � GTV 21P PMONE STATE IICENSE t <br /> Ner✓/a,✓d coNjT BaX 9S� ,�r,�.�*�� �v q- 9fi�0 6 J a G � j Sy�9/9/ <br /> MECNRNICAL CONTRRCTOR M�IL ADDRE55 �ITV Z1P PMONE STRTE UCENSE R <br /> D/Aro�+o s' P/b�_ P�/Yr� . RvX 6� 8����M�� wA- 9��1-7 0�0! 7Jy3lOe D/hNoQ-PATP<E <br /> PLUMBINGCONTRACTOR M�ILA R SS CI V ZIP PMONE STATELICENS[� <br /> S/FNG <br /> CUSS OF WORN <br /> ' � NEW XADDIT!ON �(ALTERATION REPAIA DEMOLITION WOODSTOVE/PRPL INSERT BUILDING RELOCATION <br /> fANTACT PERSON AND PNONE N0. <br /> CONTRACT PRICE OF WORK <br /> DESCRIBE WONK ANO SOUARE FOOTRGE INVOLVEO <br /> PFOPOSEOUSEOFBUIl01NG i HEREBV CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> �j�/�� j� ch APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEG�L DES FIPTION PFOPERTY(SHO ee�o R RTTACH FOUR COPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERN�NG THIS TYFE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEFEIN OR � <br /> LOT _ BLOCK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> .4UTHORITY TO VIOLATE OR CANCEL THE PqOVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTiON OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> � OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> � APPLICATION IS MADE AND � COMPLY WITH THE STATE <br /> CONTRACTORS LAW 78.27 RCW AND 296200 WAC. <br /> X ��� �/�i� <br /> (�i1�"i„'� h'��'f�YSL. <br /> PROJECT AOORE55 siaver'� or.rc <br /> fivP/,�d Fo� "/a�/9� <br /> �,,.a�s�,�sz�,�E�sE�a <br /> PLUMBING MECHANICAL <br /> NO. T1'PE OF FlI(TURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> 3 WATER CLOSET(TOILET) / �� A,�C—A,�NNDLG UNITS—H.P. 7 <br /> BATHTUB FORCED AIR SVSTEMS—B.T.U. M E.A. <br /> / LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M ; <br /> SHOWER Qp LOTHES OFYERS <br /> KITCHEN SINK 8 DISP ; V TILATION FAN <br /> DISHWASHER RAN HOOD <br /> LAUNDRYTRAY WATER TER <br /> _� CLOTHES WASHER o ej p � WOOD STO <br /> URINAL � p� METAL FIREPLA 8 CHIMNEV <br /> DRINKING FOUNTAIN � � �rat FIREPLACE INSER <br /> FLOOR DRAIN /,j,��O's HEAT PUMP <br /> BACKFLOW PREVENTERS ; O GAS PIPING <br /> ROOF DRAINS—RAINLEADERS � E%HAUST fAN <br /> p SINK(SERVICE—BAR,ETC.) ;p-O GO ��..F cr/.. <br /> S lw ,�r� ee �F' f/6 o s , ra <br /> j v� !' JS J'v C'ON r <br /> ..3 c r� �' s�c-o sJ 6 <br /> r- ���./ �d'� <br /> SUB TOTAL $ O ; /"e SUB TOTAL $ <br /> PERMIT $ p � � PERMIT $ <br /> TOTAL FEE $ ' Pb TOTAL FEE $ � <br /> FOR OFFlCE USE ONLY: <br /> FRON7 SETBACK FEAR SETBACK SIDE SETBACN PLnN CMECK NUMBER FEE RECEIPT NO. <br /> L <br /> USE ZONE lOT APFA VpCqNT SITE FEES VALUATION PEE <br /> BUILDING i <br /> TYFE Of CONi5.AILOWABi.E TYPE OF GONSi AGiOAI atuvextv No IXUvfLLiNG uNrtS - <br /> enouv � pLUMBING ' <br /> SIZEOFBLDG. NO.OFSTORIES BaSEM[NT MECHANICAL i <br /> pCLUPANCY LOA� FlRE$PRNNLERS REO'0 NEIGH7 LIMITATION ADDITIONAL PLAN CHECK i <br /> SPRINKLER � <br /> FEASON FOR SPRINKLER$ � <br /> �— <br /> STA7E BUILDING SURCHhRGE <br /> INTANE BV PLf�NS RPPRpVEO BV CITY OF EV[RETT PUBLIC WORK$ <br /> LOCAL SALES <br /> TAX CQDE IS 3105 TOTAL <br />