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APPLICATIC^l FOR CONSTRUC7''bN PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEM: 0 GAS ❑ELECTRIC ❑ �, � v/_ <br /> BUILDING DEPARTMENT <br /> 259-B810 <br /> DEMOLITION COMBINATION ✓BUILDIHG MECHANICAL PLUMBING SIGN <br /> OWNER MAILADDRE55 CITY ZIP PHONE <br /> L iJ9f}rtN 57iz/tJ c/f r �SIb W�r�h�.�/_= RdE�crr yG ,� � i5z o82� <br /> TEN�NT MAIL ADDRE55 CITY ZIP PHONE <br /> ARCNITECTORDESIGNER MAILADDRE55 CITV ZIP PMONE <br /> ,� �j Pr ` �'1"�'.�i U/'> lA/� 7 lq � - 03�y <br /> GENERALCONTRAGTOR MRILAD�RESS CITY Z�P PNONE STATEUCENSE• <br /> � //V�11�E <br /> 1 �nM�,K<iT�4�GN-� I 51D ���=r�io�-�= r'di:�tr J¢zv i 7 6�-v'azu cw��� sz _ <br /> MECHRNIGQCONTRAGTOR MAILAODRESS GITV ZIP PHONE STATELIGENSE/ <br /> PLUMBMGGONTRAGTOR lAFILADDRESS GITV IIP PHONE STATELICENSE• <br /> ClASSOF WORK <br /> L JEW ' ! A�DITION ' ALTERATION REPAIR �� DEMOLITION � WOODSTOVE/FRPL INSERT i] BUILDING RELOCATION <br /> CONTACT PEPSON RND PHONE NO. ? <br /> CONTNACTPRICEOFWORK ,(JUO G /J) .L' /'I (yTnA!(OHY� �S7 -OS=-�I r-rL�/y l�M <br /> OESCRIBE W011K ANO SOUARE FOOTRGE INVOLVEO <br /> C o^�s72vvT Wonl; Hci� i -� ,Vc n-• 55`� S .� <br /> PROPOSEDUSEOFBUILDING i HEREBY CERTIFY THAT I HAVE FEAD AND EXAMINED THIS <br /> woh�f H�r� U'Od0`✓CK k��'�' APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> LEGAL�ESCRIPTION OF PROPERTY�SHOWN BELOW ON ATT�CH FOUR COPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �ot z-5d Z y eiocK �Z/ oF R r�G '�'G'r0 F I/1 NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> p/J 7p �/iUyFl�- q 5 /'h�r PL-A-Y OTHER STATE OR LOCAL LAW REGULATIN(1 CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORI2ED BY THE <br /> �Gd �✓LI� � liU G C/' /�L�T OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> �r.` z �r o �2 ay if ��Nc�„5,� w� <br /> x�` �7uc.�-�i- �i�u,r.�..r/t� //�//9) <br /> PRQIELT�DDRESS SmNetunE oeiE <br /> i 5! � !ti� r � C E�F r�' C�iYBU5ME55lILENSE NO <br /> PLUMBINO MECMANICAL <br /> NO. TYPE OF FlICTURE OR ITEM FEE NO. TYPE OF Eq11PMENT FEE <br /> WATER CLOSET(TOILET) A/C—NHNDLG UNITS�I.P. � <br /> BATHTUB ; FORCEO AIR SVSTEMS--B.T.U. M E.A. ' <br /> UVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M � <br /> SHOWER CIOTHESDRYERS � <br /> K!TCHEN SINK 8 DISP � VENTILATION FAN ; <br /> OISHWASHER RANGE HOOD <br /> LAUNDRYTRAV ; WATER HEATER ' <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEY � <br /> DRINKING FOUNTAIN FIREPLACE INSERT � <br /> FLOOA DRAIN HEAT PUMP � <br /> BACKFLOW PREVENTERS ; GAS PIPING ; <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN __ <br /> SINK(SERVICE—BAR,ETC.) ; � <br /> � <br /> � <br /> � <br /> – , � <br /> SUB TOTAL $ ; SUB TOTAL $ <br /> PERMIT $ PERMIT S � <br /> TOTALFEE $ ' TOTALFEE $ <br /> FOR OFFICE USE ONLY: ' � � <br /> FRONTSEiB4CK REAPSETBACK SIOESETBACR PLANCNECKNUMO F FEE RECEIP NO <br /> � � bAR� u.� ' 39 7.�3 5g� p�0/�/ <br /> use zorve �OT ANFER� �AC NT SI7E FEES VALUATION FEE <br /> �� W BUIIDING �j � � <br /> iVPEOiCONiSAILOW�BLE TYPEOfCONSTACiORI ocaveHCv xorvovrtwxauxns � <br /> _� _ J f900 PWMBING I <br /> SREOFBLDG. NO.OFSTORIES BASEMENT � <br /> MECHANICAL <br /> 55o sr �� ; <br /> OCCUP�NCY LOAU FIFE SPPNKLENS R[O'D MEIGHT LIMITATION ADDITiONAL PLAN CHECK i � <br /> � I�/O �� / SPRINKLER <br /> REASON OR SPRINKLERS <br /> STATE BUILDING SURCHAPGE i <br /> INTRItE BV PUNS APPROVEO BV CITY OF EVEREIT PUBLIC WORK$ T_ <br /> LOCIIL SALES � <br /> 3 TIU(CODE IS 3105 TOTAL . <br /> /�� �' <br />