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APPLICATIC^l FOR CONSTRUCT`1N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING�YSTEM: ❑GAS CI ELECTRIC ❑ <br /> 259-8810 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑MECHANICAL ❑PLUMBING ❑ SIGN <br /> OWNEF MRILADDRESS GITv ZIP PNONE <br /> �I� � �. <br /> ,'J ,' i V'` L�: �„ r �;;J ��7I`l '✓� : '�tJ- �::, CP 'r.1 c� ✓ ._;. �J(' _ , .;��)' <br /> TEN�NT � IARILADORE55 G�Tv �IP PHONE <br /> � HrtECTOROESIGNER MM�A�DRE55 GITV ZIP PNONE <br /> GENER CONTR�IGTOR M�IL ADOPESS GTV ZIP PNONE STRTE LIGENSE� <br /> �111V1p� <br /> NECHFNICA CONTRRCTOR MRIL A�DPESS GTV bP PHONE STRTE LIGENS:t <br /> PLUMOINGCON rl�"OR 'UIIADDRE55 CITY ZIP PNONE ST�TEUCENSE� <br /> CONTP4CTPRICE WORK <br /> ��� <br /> �ESCRI3E WOfiN A D SOUARE FOOTAGE IIlVOLVED /��I CONTACT PERSON RN�PHONE IlO. <br /> LL'. ('E �iiNS"�••�1/ �'� .S� l.. .�'r� <br /> �i-� '�c!'� � 'r.. '�G�i�V.�� � r�X I ��{��'� 1�" <br /> i ,: r, tL r ��:" : <br /> C,.ati4(' � JI�" �C � I��' ln I �_6 iJr'(•� �fJ�", <br /> —(.SLS1 � � � ' i HEREBY CERTIFY THAT I HAVE R[AD AND EXAMINED THIS <br /> PROPOSED lISE OF BUILUf ' APPLICAiION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> `>� � I t'r+�"`� I �W e� �!(ti S PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> iecn�oe;c IPTIONOFPROPERtt�SMOWNBELOWORATTACMTWOWPlES� WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �Ot� BLOCK ��L� �SFp'��K �� NOT. THE GRAN^IJ3 OF A PER�AIT DOES NOT PRESUME TO GIVE <br /> I AUTHORITY TO VIOLATE OR CANCEL T.4E PROVISIONS OF ANV <br /> (fa(ciGC-l�F uJ SLIh d I VI�I�� OTHER STATE OR LOCAL L,CW REGULATING CONSTRUCTION OR THE <br /> � PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORI2ED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV \NITH THE Sl'ATE <br /> PAFCE�to.�uElgER�O/i �'� O(� CONTRACTORS LAW 18.27 RCW AND 295200 WAC. <br /> ..� L •r � / <br /> ' ' CONSTRUCTIONLOANLENOER.ADDRESS.TELEPMONENUMBER �,,,�� ��1�/ ��/J� / <br /> x ��'r"it y �� �7/zzl�/ y <br /> • PROI_JECT ADD E� � �, smn�*uee o.rc <br /> � � Yl �� J � � �� W � ;v`r_� � ci*vausw�ssuceNsera <br /> PLUMBMO MECMANICAL <br /> N0. TYPE OF fl7(TURE OR ITEM FEE N0. TVPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) NC—A/HNDLG UNITS—H.P. <br /> BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> LAVATOAY(WASH BASIN) � UNIT HEA7ERS—B.T.U. M ; <br /> SHOWER ' CLOTHES DRVERS <br /> KITCHEN SINK&DISP VENTILATION FAN //e}'I..1,0 � <br /> DISHWASHER RANGE HOOD � <br /> LAUNDRV'RAY ; WATER HEATER <br /> CLOTHES WASHER � WOOD STOVE � <br /> URINAL METAL FIREPLACE(WOOD BURNING) � <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN � HEAT PUMP � <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—HAINLEADERS E%HAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) ; <br /> �0. At-J ' <br /> i i <br /> i � <br /> SUB TOTAL $ ; SUB TOTAL $ <br /> PERMIT $ PERMIT $ i <br /> TOTALFEE $ ' TOTALFEE $ <br /> FOR OFFICE USE ONLY: <br /> FRONTSETOALN REARSETBRCH SIDESETBACN PLANCMECNNUMBER FEE HECEIPTp!O. <br /> C -��Sv'L <br /> USE ZONE LOT AFER VFCAM SITE FEES VALUATION FEE <br /> � 'YES ❑ N� BUILDING i Q(� <br /> TYPEOFCON57. NO.OFSTOqIES otN��Ntt xaaowFuiHGurvrts � <br /> �a�uP PLUMBING ' <br /> SI2EOFBLDG. FIRESPRINKlER5RE0'D BASEMENT MECHANICAI 1 O <br /> ❑ YES � NO <br /> OCCUPnNCV IOR� FIRE ALARM REO'D HEIGNT LIMITpT10N ADDITIONAL PLAN CNECK � <br /> OTHER ' <br /> REASON �-7� <br /> STATEBUILDINGSURCHARGE � ipL/ <br /> � <br /> INTANEBV PLANSAPPROVEDBY CITYOFEVERE7T PUBLICWORHS <br /> LOCALSALES � <br /> onre TAX CODE IS 3105 TOTAL �n �� <br />