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r. ,,1 <br /> APPLICATION FO�� CONSTRUCTIVN PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT � HEATING SVSTEM: U GAS ❑ELECTRIC � N�US � <br /> 259•8810 <br /> ! ' DEMOLITION COMBINATION .� BUILDING MECHANICAL PLUMBINO SION <br /> OVMiR M�II�DOPESS CITY IIP PHONE <br /> �' Q��i�►� eo. , ia.6ea�. 37d7� n/, ot-� � � IiS'v�GC.�'�• 9PI�.�1 31��--JP7�' <br /> TEN/�NT M�II�DDRESS QTY ZIP PNONE <br /> S� d <br /> �RCHRECTdiDESIONER MAR�DPRE55 GTY 21P PNONE <br /> A�sr�d �. �ie�,c'— y� � ,qvc w., �vcns�r-�w�s, 9PZ�Y zlo�vi72 <br /> OENEMLCONTRACTORi M�ILMDRE55 CITY IIP PMONE STATELICENSEI <br /> p�us r�r •u. ,4usri ar»>NZ <br /> MEGH/JIICQCONTRACTOR M�ILADDRESS dTY IIP PIIONE STATELIGENSEI <br /> PLUMBMOCANTRACTdI MAILAODRE55 CRY ZIP P110NE 6UTElICENSEI <br /> ClAS80F WOIIK <br /> I I NEW I � ADDITION �. ' ALTERATION � REPAIR DEMOLITION WOODSTOVE/FRPL INSERT � BUILDINO RELOCATION <br /> CONUCT PERSON�ND PHONE NO <br /> CpJTMCTPRICEOFWORK �S nn(1 �NAtiQ �5�6.�'IQOR,f/Gf ZlL-�,I�Y7 <br /> �IESCRIBE W011N AND 90U�NE FOOTAO INVOLVEO <br /> �r.�. ti�p /yo'uN . <br /> I HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> Q�)Cf'/y��pl CM jsl�✓L . APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEf3ALDE8CRIPTqNOiPROPERTV�SNOWNBELOWORATTACMFWRCOPIE6� PFOVISIONSOFLAWSANDORDINANCE560VERNIN�3THISTVPEOF <br /> WJRK WILL BE COMPLETED WITH WHETHER SPEC�FIED HEREIN OR <br /> �ot BIOCK ov NOT. THE aRANTING OF A PERMIT DOES NOT PRESIIME TO 61VE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> � _ OTHEF STATE OR LOCAL LAW qEGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION. THAT I AM AUrHORIZED BV THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOFi WHICH <br /> APPLICATI7N IS MADE AND I COMPLY WITH THE STATE <br /> CONTHACTO��S LAW 18.27 RCW AND 296200 WAC. <br /> z.J .�• �'��*'�''�• /Of 3e�9/ _ <br /> a1p1ECTADORE68 5 run o�t[ <br /> 3ODf W. CA�/Nb /�� �V�R.�f�" arvnusrvessiwerKEra -- <br /> p��J�Mp MECHANICAL <br /> N0. TYPE OF flIITURE OR ITEM FEE N0. TVPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � NC—AMNDLG UNITS—H.P. � <br /> BATHTUB FORCED AIR SVSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M � _ <br /> SHOWER ' CIOTHES DRVEHS <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN <br /> DISHWASHER � RANGE HOOD <br /> LAUNDRYTRAY ; WATEH HEATER <br /> CLOTHES WASHER � W(�D STOVE � <br /> URINAL ' METAL FIREPI.ACE 6 CHIMNEV � <br /> DRINKINd FOUNTAIN � FIREPLACE INSERT <br /> FLOOR DRAIN � HEAT PUMP � <br /> � <br /> BACKFLOW PREVENTERS � OAS PIPINO ' <br /> ROOF DRAINS—RAlI1LEADERS � EXHAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) ; <br /> � � <br /> � ' <br /> SUB TOTAL S ; SUB TOTAL S <br /> PERMIT S PERMIT S � <br /> TOTALFEE S _� TOTALFEE S �_ <br /> FOR OFFlCE USE ONLY: <br /> F110NTBEiBACK REAR6ETBACK SIDESETB�CN PUNGHE KNUMBER FEE AECEIPTNO. <br /> 9/ 1 gO fa <br /> use¢owe l0T�RE11 ��C�NT SITE FEES VAlUAT10N FEE <br /> —� <br /> BUILDING y�dt/— � Oo <br /> 11PFOfLONT5�I.LOWABLE 7YPFOfLON5G7�L1UAL o[cuMKr iqqvMtiiNUUNit6 i <br /> n�nr € n'��1�` �� PLUMBING � <br /> g�ppg�pp. NO.OF6tORIES B�SEMENT MECHANICAL � <br /> — � <br /> OCCUP/�NCYLWIO fIREBPRNKLERSPEO'U MEIOHTLIMITA710N ADDITIONALFUNCHECK ay� i 3O <br /> i <br /> SPRINKLER � <br /> REA80N FOR fiPRINKlER9 ' <br /> STA7E BUILDINO SUFlCHAROE I�jj <br /> MlTAKE BY PLAN P VEU BV CITY OF EVEREIT PUBUC WORKS � <br /> LOCAL SALES � <br /> TAl(CODE IS 3105 *oT�� G3 � �o / <br /> ✓ <br />