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APPLICATIC^i FOR CONS7'RUCT^)N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />HEATING SYSTEM• ❑ GAS ❑ ELECTRIC ❑ <br />BUILDING DEPARTMENT � <br />2 -6810 <br />I. DEMOLITION I 1 COMBINATION I_ BUILDING � i MECHANICAL I I PLUMBING i I SIGN <br />OWNER � MAILA�DRE55 CITY 21P PHONE <br />ZIP <br />AqCHITECT OH DESIGNEfl MAIL AODRESS CITV ZIP PIIONE <br />GENERRL CONTRRGTOR MAIL RDDRESS CIN 21P PHUNE STATE LICENSE I <br />�.5,�,�! BC,t�o.n�.l �81�$ /IS�.A�r.,UF• 1_K Si�,�:,�;,=_ GRAN'f'S6-lD6Bti <br />MECHANICAL CONTR�CTOfl MAIL.IDOR°SS GIN =1P PHONE STATE LICENSE I <br />PLUMBING CONTRACTOR MAIL AO�RESS GTY ZIP PHONE STATE UCENSE / <br />CLASS OF WORN <br />Ik NEW I�l ADDITION I I ALTERATION <br />CONTFlACT <br />DESCRIBE � <br />��u.e S, �� b,S� h., k.s �- S <br />PROPOSED USE OF BUILDING <br />LEGAL OESCRIPTKKJ OF PROPERTV �SMOWN BELOW OR ARACH <br />�OT��` BLOCK �� OZ <br />PROJECTADDRESS • - <br />PLUMBING <br />NO. TYPE OF flXTURE OR � <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDFlYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLUOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS-RAINLEADERS <br />SINK ISERVICE-BAR. ETC.I <br />SUB TOTAL $ <br />PERMIT $ <br />TOTAL FEE $ <br />REPAIR }Q DEMOLITION I I WOODSTOVE/FRPL INSERT I I BUILDING RELOCATION <br />CONTACT PERSON AND PMONE NO. <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AN[1 CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETfiER 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 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 COt,IPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br />X R,�� �P�, p.�_. sr—.zy- p� <br />SiGNAiUPf OAE <br />CIIY BUSMf55 LICENSE NO <br />MECHANICAL <br />FEE NO. TYPE OF EOUIPMENT PEE <br />A/C-AIHNDLG 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 />; WATER HEATER ' <br />� WOODSTOVE � <br />METAL FIREPLACE 8 CHIMNEY � <br />� FIREPLACE INSERT ; <br />� HEATPUMP � <br />; GAS PIPING ' <br />� EXHAUST FAN � <br />FOR OFFICE USE ONLY: <br />FRONT SETBACN REAF SETBACK SIDE SETBACK PLAN CNECK NUMBEP <br />USE ZONE <br />iYPE OF CONTS. ALLOWABLE <br />SRE OF BLDG. <br />OCCUPANCYLO�D <br />REASON FOR SPRINKLERS <br />INTANE BY <br />LOTAREA VACANTSITE FEES <br />OUILDING <br />TYPEOFCONSi.AL10AL OCtU>av[r HOOronEwHGUNrts <br />°PW° � PLUMBING <br />NO.OFSTORIES BASEMENT MECHANICAL <br />FIRE SPRNKLERS REO'D HEIGHT IIMITATION ADDITIONAL PLAN CHECK <br />SPRINNLER <br />STAiE BUILDING SURCHARGE <br />PLANS APPROVED BY CITY OF EYEREIT PUBLIC WORKS <br />LOCALSALES <br />TAX CODEIS 3105 TOTAL <br />SUB TOTAL 3 <br />PERMIT $ � <br />TOTAL FEE $ <br />FEE RECEIPTHO. <br />VALUATION FEE <br />i <br />i <br />i <br />i <br />i <br />