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e <br />APPLICATIO'' FOR CONSTRUCTI'�N PERMIT <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT � <br />� <br />BUILDING DEPARTMENT I_ <br />259-8810 <br />DEMOLITION I I COMBINATION <br />�RCIIII[Ci Oq DGSIGNFR <br />crnena eournncion <br />5DL <br />n+[cnnNiCni coNtnnCto <br />.anit nouRF.55 <br />____�-� <br />�.ma nooness <br />MAII p�UliE55 <br />61N� pDDRE55 <br />nir�ii 11VVIII:IJ <br />' �"YYJ <br />�.+minoones; <br />co�P�,E OF WOfiN <br />fif/ <br />DESCRiBE WOfiN �NU SOU4RE fOpi�GE INVOLVEU <br />HEATING SYSTEM: I„J GAS U ELECTRIC IJ <br />I i BUILDING �MECHANICI <br />—crtv zn, — <br />� ��E E/�GA�- <br />���� zm <br />CIIv Tlp <br />GIiY $Ip <br />cnr zir <br />A�GlCS__�-,-QG1K-S.3JL3__J <br />cnv nr <br />�� . � <br />CONiqCT PGfi50N �ND PIIONE IJO <br />rqorpC[D uSE or ouIIDINc <br />„ i.eon�nesemm�orvorrnorcmv�si�owNA[towonnrtna�rwocoriesi <br />io� oiock oF . <br />rnnr,�i. rna i o ruueinFn <br />GON51nuc11orltenNLGNOEn. <br />NO. <br />LAVATORY (WASH BA; <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWqSHER <br />LAUNDRYTRAY <br />CLOTHES W�SHEF <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />SINK <br />SUB <br />FOR OFFICE USE ONLY: <br />�rnoursetoncK nennsemncK <br />U5G ION[ LO7 Mf:rl <br />nri ar co�vst r�o oF stonies <br />S�:L OF OLDG fIRG SPf1iNKLCRS RFOD <br />OCCUPr1NGVl04D FlqEALN1M1lf1[Ofl <br />��EASON <br />iN�nkeov ��inr�snarnovcuiav <br />onie <br />NUId�f.R <br />0 <br />)TAL $ <br />f $ <br />FEE 5 <br />�� �rWMeING SIGN <br />PHONE <br />:� '4 ._ 9$2 _o� <br />PIIONE <br />PIIONG <br />PI101lE <br />iE�2 <br />PIIONC <br />srnie uceNse. <br />SiAIE UCENSE • <br />�� . Qa�ts <br />sinie uceN;e. <br />�'1�1 /T�7�][ S�I �a �IO _ <br />=LLNS� <br />i HEREBY CERTIFY THAT I HAVE' REAC AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME �O BE TRUE AND CORRECT. qLL <br />PROVISIONS OF 1.qWS AND ORDINAI.CES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WNETHER SPECIfIED HER[IN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIV[ <br />AUiNORItY TO VIOLAT[ OR CANCEL THE PROVISIONS OF ANY <br />OTHER S1ATE OR LOCAL LAW REGULN iNG CONSTRUCTION OR THE <br />PERFORAfANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER Of THIS PROPERTY TO PERfORM THE WORK FOR WHICH <br />APPLICATION IS MADE �ND I COM�LY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 2��,200 WAC. <br />1'� <br />SNIt �m ___ � <br />r <br />0�11 <br />CItv11U5iW SGu[nva un — — . <br />TYPE JF EOUIPMENT FEE <br />NC—A'HNDLG UNIiS—HP <br />FORCGD AiR SYSTEMS—E3.T.U. M EA. <br />UNITHEAIC-RS—B.T.U. M —� <br />CLOTHESDRYERS <br />VENTIL�TION fAN <br />RANGE HOOD ---�- <br />WATER HEATER <br />WOODSTOVE <br />METAL FIREPLACE (WOOD BURNING) ��� <br />FlR�PLACEINSER7 - <br />HFAT PUMP --'�- <br />GAS PIPING <br />EX1IAUST FAN <br />smesr.rnncK �rinNc��tc NUMmn <br />�: i <br />.�._Y.!C.� <br />vncnrut sne FEES <br />I 1 YES I I NO <br />UUILDINC <br />or.rurnrx.r xnermttuui,irnic ._ <br />r.n�r — <br />PLUh1UING <br />❑45EMEH1 <br />�' YES I I NO �`��f,HANICAI <br />HEif.ln uAtlinllON �D�ITIONAL PLAN CI IECK <br />OTHFfi <br />sTnre oui�oiNc, suiva�nnce <br />CITY OF EVEREiT runuc wor�Ks <br />LOCALSALES <br />TAl( CODE IS 3105 TOTAI <br />SUB TOTAL $ <br />PERMIT $ <br />TOTAL FEE S <br />� <br />