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APPLICATIC�1 FOR CONSTRUCT�'��I�REi���'�"'� <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT �',' f <br />FEs - � � � : ` <br />....... ................ ..................................... <br />BUILDING DEPARTMENT HEATING SYSTEM: ❑ GAS ❑ ELECTRIC ❑ � � <br />259-8810 PuL•lic VJorks Dept. <br />! 1 DEMOLITION i-i COMBINATION I l BUILDING !; MECHANICAL 17 PLUMBING � SIGN <br />ONNER MAILADDRE55 CITY iIP PHONE � <br />355 - <br />TF':ANT MAII ADDRE55 CITV � ZIP PHONE <br />�. t.� F LooRs s� i� mc� � n�1�� ��.;�tf 9s2v 3. 355 -(��� <br />/$GH1IECTORDESIGNER AIAILADDRE55 CITV ZIP PHONE <br />P\YaENERALCONTRACTOR MAILADDRE55 � ..�+e CI�� � A 98�0� �f/� pt7� 7�4b AmL�NSE� <br />AMERIUIN IJ�ont � 8ox 31 1/��N�/�!Z �f I�lbI�LIBB <br />MECM�NCQCONIA�GTOR MAILADDFE55 CITV ZIP PNONE STATEIICENSE� <br />N/,� <br />PIUMBINGCONTRACTOR MAILADDRESS CITV 21P PHONE STATELIL'iNSE1 <br />N /� <br />CUSSOFWORN j�EMOVE �cISTIN(o tR��CE W/NEIt� <br />� 1 NEW !'. ADDITION x ALTERATION I� I. FEPAIR I� DEMOUTION [ I WOODSTOVE/FRPL INSERT ; � BUILDING RELOCATION <br />CONTRACTPRIGEOFWOflK I �SOO'eO �NTACTPERSONANDPHONENO. <br />Eus+� .1Rco� . AmEg� ��ti A/�nJ <br />DESCRIBEWORKANDSOU�PEFOOTAGEINVO�VED LISTIA I/L/�l </L�/ / <br />PROPOSED USE OF BUILDING <br />BELOW OF ATTACH FOUR COPIES) <br />�oT °�3 a�uK oC� D-I]�oF <br />L, <br />� LI/�J Il-[I[) <br />ts� �� / Y <br />-�06 �2l� � 2a5 <br />BATHTUB <br />UVATORY(WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOii DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS—RAINLEADERS <br />SINK (SERVICE—BAR, ETC.) <br />SUB TOTAL $ <br />FOR OFFlCE USE ONLY: <br />FRIXJTSETBACK REAR: <br />USEZONE <br />TYPE 0 N75. �LL01 <br />SIZE Of BLDG. <br />OCCUPANCYLORD <br />REASON FOR SPRII <br />INTAKE BY <br />GM�TXtM l <br />� s <br />TYFE OF CONST. aCNAL <br />NO.Of STORIES <br />FIRE SPRhKLERS RE� <br />M <br />SIOE SETBRCN <br />, 20(� � � 27 ' %S�`�(o <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIG 'S OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />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 FlEGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTV TO PERFORM THE WORK FOFl WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CJNTRACTORS,LAW 1827 RCW AND 296200 WAC. <br />X `�/1/ ' ��-2"� <br />Sp 5-� i� l ActT AA oi�3 9e/ <br />CIttBU5ME55lKEM5E <br />MECHANICAL <br />NO. TYPE OF EGUIPMENT FEE <br />A/C—A/HNDLG UNITS—H.P. <br />FORCED AIR SYSTEMS--B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />JVATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN � <br />SUB TOTAL S <br />PERMIT $ <br />TOTAL FEE $ <br />'�L/��/�'�E� FE�G/ R/ / L/ / <br />VACANT SITE 1 <br />��� BUILDING <br />accur,mcr xo.aorrtwx urvrts <br />cnao PLUMBING <br />BASEMENT <br />CITY OF EVEREiT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />MECHANICAL <br />ADDITIONAL Pli1N CHECK <br />SPRINKLEfl <br />STA1�E BUILDING SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />