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APPLICATI�..N FOR CONSTRUC'� �ON PER�Il��` <br /> CITY OF EVEREIT• BUILDING DIVISION � <br /> '1200 CEDAR STRFET• E4ERETi, WA 98201 •259-8810 <br /> ❑ DEMOLITION rl COMBINATION f 1 BUILDING MECNANICAL fl PLUMBING I� SIGN <br /> PROJECT ADDRESS <br /> yGi2 v��� �R �� <br /> oWNER MnlLqoon[55 clrv ]��P rupuF <br /> �ic9µ� �Mitff� �f�CIZ U�cuJ DR z`�x-ie��203 ' ZSZ - 335 'J <br /> TENANi MAllA0DPE55 GiY IIP PIIONE <br /> J <br /> ARCIIIT[CTOROESIGN[q MAiLR��RE55 CItY ZiP PHONE - <br /> GENERALCONiPPCT04i MARqDp6E55 CiLY :iP Pu04[ <tqtELIC[NSE� <br /> Ar_� <br /> MECNANICALCONIRACTOq MAIIADpREiS CIfY 21F PMON[ STPTEUC[NSE• ���— <br /> �g.�c N�a-ritiGzvc PoeoX�-s�f �r�r� �uo 9��5 Zo�-$'31-68o��c-_f�C;�4-2�/�SMrf- <br /> PlU'dBINGCONn— 14Ci— O� MAILADDPE55 CItY ZiP PN04E STALiIICENSE� <br /> WNiqRCIPRICEOPWORK ��a!' <br /> � HEATING SYSTEM: �AS fl ELECTRIC fl <br /> DESCRIOE WORK�ND SOUARE FW IAGE INVOIVED CONTALL PEf;50Y AND PMONE NO <br /> ��F�, R�=-n2or-�r T�vs�r+u ��.u.� �orZD ZoG-$31 -�800 <br /> �i.(dqt1�:' u� �= Z-a <br /> �'„�n.l�� ���— I HEREBV CERTIFY �NAT I HP,':E READ AND EXAMINED THIS <br /> fMYV � APPLICATION AND KNON'THE SAME TO BE?PUE AND CORRECT.ALL <br /> PROi'OSEDUSE OF BUILUIN3 ppOVISIONS OF LAWS AND ORDINANCES GOV[RNING THIS TVPE OF <br /> WORK WIIL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> ieca�oescaiPrioNOFr�oreaTvlseowr+eEtowonannc�+Twocories) NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> tor e�xrc oc. AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW HEGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORILED BY Thl� <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCELi�%ID NUMBE CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> �05'7 �aU o50 �c��z �/1� � L. p] <br /> CONSTfiUCT10N LORN LEND[!i.RDDRESS i[LEPHONE NUMAFR x �� �(���;��C.V✓'t� Z -Z✓ �/ 7 <br /> SI � ntURE DnTE „ <br /> (�Z�{`//2_ <br /> cm ousir��ss uce�+s�No. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE:OR ITEM FEE NO. TYPE OF FI%TURE OR ITEM FEE <br /> WATER CLOSET(TOILET) � A/C—AMNDLG UNITS—H.P � <br /> BATHTUB � FORCED AIR SYSTEN�—B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) i HEAT PUMP i <br /> SHOWER UNIiHE�TEFS —B.T.U. M � <br /> KI7GHEN SINK 8 DISP CLOTNES DRYCRS i <br /> DISHWASHER � VENTILATION FAP <br /> LAUNDRYTRAV ; � RANCEHO00 � <br /> CLOTHES WASHER WqTER HEATER —i— <br /> URINAL WOOD STOVE ' <br /> DRINKING FOUNTAIN i METAL FIR[PLAC[(WOOD BURNING) i <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BUP.NING) � <br /> DACHFLOW PREVENTERS i GAS FIREPLACE ; <br /> SINK(SEfiVICE—6Af1.ETC.) GAS RANGE �— <br /> Z GA�PIPING ' <br /> EXHAUST FAPI i <br /> —�— <br /> i <br /> � — i <br /> i <br /> SUBTOTAL S � SUBTOTAL 5 �OU <br /> PERMIT S i PERIAIT S J �pO <br /> TOTAL FEE S � _ TOiAL FEE S _ti�� <br /> FOR OFFICE USE ONLV: �j��30rj <br /> fRONTSEipACK N[ARSFTAACN SIDESEtpRCK PIANCHECKk9V�fR lEE���� R[CFPTNO. <br /> osEzorve ioTm�Ea vncavtsire FEEo VALUATION FEE <br /> flYES fl NO OIIRDING � <br /> i <br /> HEIGIRUMIT�TION NOOFOW[ILiNG SIZ[O�BIOGRI. i <br /> UNItS PLUMItINO � <br /> OCCIIPnNGV NO OFSiDF:[5 OCCUPPM IOAp PG.SE!lENL MECHANC'pL i <br /> GROUP - <br /> ❑VES Il NO - i <br /> FlRERLRRMRE00 R[ASON ADpIt10NALPUNGHfICK i <br /> T <br /> onien � <br /> FIPESPPINKL[PREO'� RERfON - � <br /> � 3THiE OUItDIhC.SUf�CHAi1G[ i <br /> rrvEOFcoNST. aurisarvnoveoav CITYOF�VERETT ruauc�vonKs ' <br /> LOCALSALES <br /> onie TAX CODE IS 3105 TOTAL I <br />