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APPLICATIC 1 FOR CONSTRUC7 _ JN PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />HEATING SYSTEM: U GAS ❑ ELECTRIC ❑ <br />BUILGING DEPARTMENT <br />259-8810 <br />I I DEMOUTION I I COMBINATION I BUILDING I i MECHANICAL I I PLUMBING I! SIGN <br />OWNER MAILADDRE55 CITV 21P PHONE <br />ARCNITECT OR DESIGNER MAIL AODRESS CITY 21P PNONE <br />GENERALCONTRRCTOR MAILADDRE55 CITY ZIP PNONE �+ STATEIICENSE• <br />GY11N.1� S ��}�e�t�� �g�.g ��.s��tlt� IK�. �K. aS�r'�JCJ�s lT�l• •--Ci�y �Q�r rj <br />MECHANICALCIXJTR�CTOR MRILPODPESS QTY ZIP PNON[ STFTELICENSE• <br />PLIIMBINGCONTRACTOR MAILADDRESS <br />CITV <br />STATE LICENSE M <br />CLASS OF WORK <br />I�iJEW i 1 ADDITION i. I ALTERATION i! REPAIR I I DEMOLITION I 1 WOODSTOVE/FRPL INSERT i I BUILDING RELOCATION <br />CONTACT PERSON AND PHONE N0. <br />._. . _ n. / • IJ I1 /� ..._ ., <br />USE OF <br />LEGAL DESCRIPTION OF PROPERTV �SHOWN BELOW <br />LOT BLOCK OF <br />PRQIECT�DORESS <br />_S w. M�-1� <br />PLUMBING <br />NO. TVPE OP <br />� WATER CLOSET <br />9ATHTUB <br />LAVATORY(WAS <br />SHOWER <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAI <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />qOOF DRAINS—RAINLEADEFa <br />I HEFEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />FOUR COPIES� PROVISIONS 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 PRFSUME TO GIVE <br />AUTHORITV TO VIOLATE OFi CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAI� I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COI.IPLY WITH THE STATE <br />CONTRACI'ORS LAW 18.27 RCW AND 296.200 WAC. <br />X R� ��.n-�, ��-9z <br />SN'iN�tUR! DALE <br />MECHANICAL <br />i0. TYPE OF EOUIPMENT <br />qrC—A/HNDLG UNITS--H.P. <br />FORCED AIR SYSTEMS—B.T.U. <br />UNIT HEATERS-9.T.U. M <br />CLOTHES DRYERS <br />� <br />� RANGEHOOD <br />WATER HEATER <br />� WOOD STOVE <br />METAL FIREPLACE I <br />FIREPLACE INSERT <br />HEAT PUMP <br />; GAS PIPING <br />� EXHAUSTFAN <br />PEFMIT $ � � <br />TOTAL FEE $ ' � <br />FOR OFFICE USE ONLY: <br />FRONTSET6ACK REARSETBAGK SIDESE�BACN PUNC ECNNUMBER � FEE <br />� � S � � l' <br />O <br />USE LOTPREA �ACANTSIiE FEES <br />—1 D� BUILDING <br />TYPEO�CON75.ALLOWABLE TYP OFLONST.ACiIIAL o[Cuv�4cv xoOfvHEurvGUHrts <br />� _ LAWC � I PLUMBING <br />S¢EOFBLOG. �S�Z NO.O StORiEs Ba� 3T MECHANICAL <br />'►z5� sF � <br />ADDITIONAL PU1N CHECK <br />BY <br />FIRE SPflNNLEflS REO'0 HEIGHT LIMITqTION <br />�j%O 2$' SPRINKLER <br />STATE BUILDING SURCHARGE <br />PUNSAPPROVEDBV CITY OF EVEREIT PUBLIC WORKS <br />LOCALSALES <br />J� ����gt TAX CODE IS 3105 ror�� <br />� <br />TOTAL 5 <br />NIT 5 � <br />1L FEE $ ' <br />RECEIPT NO. <br />1AT10N FEE <br />r <br />� ' <br />i <br />i <br />i <br />'� i �G <br />T <br />1 <br />