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APPLICATIO" FOR CONSTRUCTI �N PERMIT ���� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEM� ❑GAS ❑ELECTRIC l7 <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> � DEMOLITION ' I COMBINATION BUILDING MECHANICAL XF�LUMBING SIGN <br /> �O�jEq MRIL A�OPESS Cltt LIP �+ PNDNE <br /> -c�2CS�v�G G�i-f'F- /G � o ,0�.�. oY,C �2 J --1 a O 3ST- va s�'.3 <br /> TENANT M�ILAD�RESS GITY ZIP �NONE <br /> ARCMITECT OR DES�GHER MAIL ADDRESS CITY ZIP PMONE <br /> GENEFALCONTRACTOH MAIIADORESS CITV ZIP PHONE STA7EUCENSEI �.�'-k�9/J <br /> �jr'���J �SJnXi"t' IS`'i0"'7 i�11Y1 �J�' �� (�[Ll.��-Y'1cJ1� `Z�,�,'�.3 �oS�-�S7�J# 1� 1� � <br /> MEGHANICALCONTR�CTON MAILADURESS LITV ZIP PHONE STp1EUGEN5E1 <br /> PLUMBINGCONTRACTOR MAILADORE55 CITY ZIP �HONE SIATEUCENSE• <br /> fr�P2,sv� �LE Pt�"mBinJC� <br /> CUSS OF WOR1c <br /> yXNEW I�I ADDITION ' i ALTERAi ION REPAIR DEMOLITION WOODSTOVE/FRPL INSERT BUILDING RELOCATION <br /> CONTACT PERSON RND PHONE N0. <br /> CONTRRCi?RICEOFWORN ����C---� <br /> DESCRIBE WOHK ANO SOURRE FCOiRGE INVOIVED <br /> PROPoSEL`USEOFBUILDING � HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> APPLICATION AND KNOW THE SAI,�E TO BE TRUE AND CORRECT.ALL <br /> LEGRL OESCRIPiION OF PROPERtt ISHO'NN BELOW OR ATTRCH FOUR COPIEFI PROVISIONS OF LAWS AND ORDINANCES GOVERNING TH{S TVPE OF <br /> WOfiK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> ioi s�ocK aF NOT. THC- GRANTING OF A PERAAIT DOES NOT PRESUME TO GIVE <br /> AUTHORITV 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 BV THE <br /> OWNER OF THIS PROPEFiTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> ��� �-i 320 A•Y S�; �v�rz�L- x � �.�,�—/� - C�-�c-v-ti S'�.�-�. <br /> SIGNI.iUA[ ���� <br /> PR0.IECT ADORESS <br /> Orv ei15 vE55l�CENSE No <br /> PIUMBING MECH�INICAL <br /> Np, TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) N�:—NHNDLG UNITS—H.P. <br /> BATHTUB FORCEDAIRSYSiEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M � <br /> SHOWER � 1 CLOTHES DRYERS ' <br /> KITCHEN SINK 8 DISP VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> LAUNDRYTRAY WATER HEATER <br /> � CLOTHES WASHER — WOOD STOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACE INSERT � <br /> FLOOR DRAIN HEAT PUMP ' <br /> BACKFLOW PfiEVE1JTERS GAS PIPING <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) <br /> � � �.� c.-.�� �nG. O _ <br /> SUB TOTAL 5 � ; — SUB TOTl�L 5 / <br /> PERMIT 5 PERMIT 5 /�� � <br /> TOTAL FEE 5 TOTAL FEE $ 30 ' <br /> FOR OFFICE USE ONLY: <br /> PRONT SETBRCK FEAR SETBACK SIDE SETBALK <br /> PLAN CMECH NUMBEq FEE RECEIPT NO <br /> USE 20`!E LOT ARER VFCANT SITE x� EES� VALUATION FEE <br /> BUILDING <br /> tYPLO°WN75.RlLOWABIE T'PEOftONSi.ACiORI o[Cuv�ntv RoO�bH[uw4uN'�rs /� �a <br /> �°^�° ' PLUMBING <br /> SRE OF BLDG. NO.OF Si0RIE5 BASEMENT MECHANICAL ✓ � <br /> OCCUPANGVLOAD FIRESPRNKLENSAE00 HEIGHTIIMITATION <br /> ADDITIONAL PLAN CHECK <br /> SPRINHLER <br /> REASON FOR SPFINKLERS <br /> STATE BUILDING SURCHARGE <br /> MTANEBY PlANSFPPROVEDBY CITYOFEVEREIT PUBUCWORKS <br /> LOCAL SIILES <br /> TAX CODE IS 3105 TOTAL y�;o� <br />