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� APPLICATIO : FOR CONSTRUCT: �N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> �EATING SYSTEM: U GAS ELECTRIC ❑ —� <br /> BUILDING DEPARTMENT <br /> 259-6810 <br /> I , DEMOLITION COMBINATION ,i�UILDING MECNANICAL PLUMBING SIGN <br /> OWNER M�ILADDRE55 J.P/�.. CITV ZIP PHONE �� <br /> � i� c 5ou�r IA�Io z;�,A,�s�, ��� �e�7 yo'aoo� 353 �'S <br /> NRNT MAILADORESS CITV IIP PHONE <br /> pRCNIiECTOflDES�GNER MAILRO�RESS CITY ZIP PHON[ <br /> GENERALCONTRACTOR MRILADORE55 CiTY Z�P PNONE STRTEUGENSE� <br /> QL✓�t-��/�i <br /> MECHRNICRLCONTRRCTON MAILPDDNE55 CITV 21P PHONE STATEUC[NSE� <br /> PWMBINGCONTRACTOR MRILR�ORESS CITY ZIP PHONE STATELICENS[� <br /> GlAS50F WORN� � <br /> . I NEW /nuDITION ALTERATION � REPAIR MOLITION WOODSTOVE.'FRPL INSEFiT BUILDID�.G RELOCATION <br /> � CONTAGTPERaONAN�PHONENO <br /> CONTRRCT PRICE OF WORN ��/\ ���y��'�a`7 3 5 .3 � .� 2� <br /> �)UESGRIBE WOPK AND SOUFRE FOOTqGE INVOLVEO <br /> 1� <br /> a,��Jt a u...,.�r� <br /> PROPOSEDUSEOF9UIl�ING I HEREBY CERTIFY THAT I HAVE REAO AND EXAMINED THIS <br /> X � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGRLDESCRIPiIONOiPROPERTY�SMOWNBELOWORATTFLNFOUPGOPIES) PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTVPEOF <br /> WORK WILI BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �oi BIOLN oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PP.OVISIONS OF ANY <br /> 5 � ` OTHER STATE OR LOCAL LAW REGULATING CCNSTRUCTION OR THE <br /> PERFOFiMANCE OF CONSTRUCTION.THAT I AM AUTNORIZED BV THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND—F—COMPLY WITH THE STATE <br /> �j R /0 y 91 CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> ��'/ z - 3 ,�.1 � s �= X ot�-.u.� ,�,,;, !l ,.�� �-i d -9 z <br /> aaaecr nooaess �J��eAC W `1 02 0$ s�;."„u�" �—� �•�� <br /> Lirv 9VSMFSS VCFNSC NO <br /> PLUMBINQ MECHANICAL �• ' <br /> NO. TYPE OF Fq(TURE OR ITEM FEE NO. TVPE OF EUUIPSIENT FEE� <br /> WATER CLOSET�TOILET) NC—/vHNDLG UNITS—H.P. / � <br /> BATHTUB ' FORCED AIR SVSTEM1IS—B.T.U. M E.A. <br /> LAVATORV(WASH BASIN) �— UNIT HEATERS—B.T.U. M <br /> SHOWER CLOTHES DRYERS <br /> KITCHEN SINK 8 DISP VENTILATION FAN <br /> DISHWASHER RANGE HOOD _ <br /> LAUNDRY TfiAY ; WATER HEATEFl <br /> CLOTHES WASHER � WOOD STOVE <br /> URINAL METAL FIREPLACE 8 CHIM Y ' <br /> DRINKING FOUNTAIN FIREPLACE INSERT _ __� _ <br /> FI.00R DRAIN HEAT PUMP ' <br /> BACKFLOW PR ENTERS GAS PIPING <br /> ROOF DRA1 —RAINLEADEFS � EXHAUST FAN <br /> SINK(SE ICE--BAR,ETC.) � <br /> � <br /> � <br /> SUBTOTAL S SUBTOTAL $ <br /> PERMIT $ PERMIT S <br /> TOTALFEE 5 TOTALFEE 5 <br /> FOR OFFICE USE ONLY: -3,�' y'T � <br /> FRONTSETBALK REARSETBACK SIDESETBALH P�ANCNECNN ^y�R FEE RECEIPiNO <br /> Ckl��j i r.K t 1��T I N ��rJ 9 3�1� '`/v� 700"�3 <br /> us xor+ �oranea MCANTSii[ FEES VALUATION FEE <br /> BUILDINC�S�� � �'y ' t�7 <br /> iVPFOtGONiSALIOWABIE tVP(0lC01°t�AGi1l�lFyl ���� L\:N�'fAb YOO��NF:U4G04��5 I <br /> � t� '� w r�NTi.GT�'/ �c�c IO °LUMBING U i <br /> ---�-- <br /> IZ[ F L NOOFSiORi[5 BASEMENT N0 MECHANICAL <br /> OCCUPRNCYLOAD FIRESPFNNIER R qD HEIoMiIIMRATiON ADDITIONALPI.ANCHECK <br /> y� 1 <br /> � AJ R ��"� �� � ` SPRINKLER <br /> R[ASONFORSPRINNLERS �V / <br /> ,�y.�� + ���Y'f�'� ���',�� STATE BUILDING SURCMARGE fp !.5�4 <br /> (i�� IT�R <br /> INTAK[BY P:.ANS APPROVED BY CITY OF EVEREIT PUBLIC WORNS <br /> LOCAL SRLES <br /> .�/ 'y JM TAX COOE IS 3105 rorn� p ; ,� <br />