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APPLICATIC ' FOR CONSTRUCT'�1N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLE PRINT <br /> � HEATING SYSTEM: �GAS J ELECTRIC J <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> �MOLITION COMBINATION i BUILDING MECHANICAL ' PLUMBING SIGN <br /> O�Yl�ER MRIL�DDRE55 CITY ZiP PMONE <br /> t�wt�s A, b��G ��Sra<� � ccv,,sr <br /> �Wf MAILPD�RKS LiTY 21P �MONE <br /> � ��� �� �� s� `3����Ea GUA. rrsdl2 ?rla���o z <br /> ��ECt0�DE5�GNE, A!AILA�DRESS _ piY ZIP PHOLE <br /> GENERALCONTqAGiOR� M1IAILADORE55 GTV ZIP PHONE STATEUC[NSE� <br /> MECMANICALCONTPACTOR MAILADDIiE55 GITY ZIP PHONE SIATELICENS_� <br /> IJDRTN PR�� /���iti�G <br /> PLU�'BINGCONTRALTOP M4iLr1DDRE5S CITY ZIP �MONE 51/TEIICENSErt <br /> �, A� K, <br /> CONTRACi PF�CE OF WORK <br /> DESCRIBE WORK AYO SOUARE iOOTAGE INVOIVED CONTpGT PERSON PND PHONE N0. <br /> � �SiDF_ L� <br /> I HEREBY CERTIFY THAT I HAVE READ AND [XAMINED THIS <br /> PROPOSED USE OF BUILDING APPUCATION AND KNGW THE SAME TO BE TRUE AND CORRECT. ALL <br /> PROVISIONS OF LAWS AND ORDIN4NCE8 GOVERNING THIS NPE OF <br /> LEG�LOESCRIPTIONOFCPOPERTV�SM0IYNBELOWORFTiACHTLY0G0�E51 L� NOT THELGRA T N6 OF AD ERMITJDOES NOT PRIE3UMEETO GIOVE <br /> iot� e�ock oF �7U`� �-3�- / � qUTHORITY TO VIULATE OR CANCEL TNE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORAIANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY TNE <br /> ) OWNER ')F THIS PflOPERTY TO PERFORM THE WORK FOR WHICH <br /> ,,CC,C( C- �G�=� �y qppLlCAiION IS MADE AND I COMPLV WITH THE STATE <br /> PABLEL iF%10.Nl1MB'iR CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> CONST(iUCT10NLOANLENOER,A�DRE5S.7ELEPHONENUMOER <br /> - 3-`i <br /> PROJECT ADDRES$ `" °�" ���� -— <br /> a 7 � L r nus�x[ssucrrvsv:o <br /> PLUMBING t CHANICAL <br /> NO. TYPE OF FIXTURE OH ITEM FEE O. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) NC—A'HN�LG UNITS—H.P. � <br /> BATHTUd FORCLD AIR SVSTEMS—B.T.U. M E.A. ' <br /> 3 LAVATORY(Y1�SH BASIN) UNIT HEATERS—B.T.U. M � <br /> / SHOWER � CLOTHES DRVERS <br /> KITCHEN SINK 8 DISF VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> LAUNDRYTRAY WATER HEATER <br /> CLOTHES WASHER WOOD STOVE �_ <br /> URINAL / METAL FIREPLACE(WOOD BURNING) O <br /> DRINKING FOUNTAIN FIREPLACE INSERT �_ <br /> FLOOR DRAIN HEAT PUMP ' <br /> BACKFLOW PREVENTERS GAS PIPING � <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN I <br /> SINK(SERVICE—BAR.ETC.) <br /> _ ✓ <br /> X <br /> SU8 TOTAL 5 SUB TOTAL 5 <br /> PERMIT S PERMIT 5 <br /> TOTAIFEE S TOTALFEE 5 —�— <br /> FOR OFFiCE USE ONLY: <br /> FRONTSET�K REARSETB�CK� SiDESEiBACK �/ Pl4NLHECK JUt�1BE1� �EE � AECEIP�S/ � /� <br /> � <br /> � s . / , y�,�� 3 0 <br /> usezor+e I LOTFREA vncar+ ttr FEES VALUATION FEE <br /> � �- YFS �� NO yUILDMG '�(p /p� ti 3l� <br /> IVPEOFCON51 NOOFSTORIES o,'.'< � na['ov:fiu',;,���*s �7 <br /> � '� n � � PLUh1BING / �� <br /> !, �i- �, <br /> SREO�LS�fi FIRESPFI4NLEPSFEO'D OP=�MENT MLCHANICAL l> , <br /> I S?�u F �M -: vEs � — <br /> OCCUPANCV LOAD FIqE AI�A�A REO D HEIGHT L!6�ITFTION ADDITIONAL PLAN CHECK <br /> � �Q �J Z� OTHER � �Q � <br /> REASON <br /> STATE BUILDING SUFCHARGE � � (J <br /> WtAKE 0� PLANS�PPAOVEDBY CITY OF EVEREIT PU�IIC WORKS (/ i <br /> `J LOCAL SALES <br /> oAre � c� TAX COOE IS 3105 TOTAL J 7;�r(j <br />