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APPLlCATIO�1 FOR CONSTRUCTrON PERMIT `'`""`'" <br /> m�e��,y,�x,,, <br /> TO BE COMPLETED IN INK—PI.EASE PRINT � <br /> CITY OF <br /> eve rett HEATING SYSTEM' GAS ❑[LECTRIC ❑ — <br /> BUILDING DEPARTMENT <br /> 259-8810 SIGN <br /> DEMOLITION COMBINATION BUILDING MECHANICAL �PLUMBING <br /> C�TV 2 P P 0 6 <br /> OWNER MAILApD�iE55 /� r --� ' C/ <br /> � �1 `Il _ �/ �7 `, .�' , r (,� , 1� � <br /> ��n, Z�p PHONE <br /> [NANT MRILPOONESS <br /> qRCNRELiON�E5IGNER M�iIA�DRE55 <br /> UTY 21P VNONE <br /> GErv[RALCONTRAGTOR MAILRODRE55 <br /> CITV IIP PHON[ LICENSE� <br /> M[CNANIULCONIRAGTOR MAILADOAL55 <br /> GiY 21P PNONE LICENSE• <br /> o�� PLUAIBINGCONiPAGtOfi MMLApDRE55 CITY Z�P PHONE IICENSE• <br /> � C ��, „ ,� , T i��/�, F '� ��,.�, �A�,z �� u �l`�-a�� q ����c�c�r, l'�»tJz9�y'c?�I.>��1 <br /> CLRSS OF WONK <br /> ,�y y� � NEW ADDITION � ALTERATION REPAIN DEMOLITI N WOODSTOVE:FRPL INSERT BUILDING RELOCATI N <br /> � ryTq�iPER50NAN ONENO <br /> � �� � �`-�j `=� " � � c� •1 ``'C _ <br /> y ri -� �'l _ <br /> F� O CONLPALi PNICE OF W0l1N C <br /> y `� DESCRIBE WORB PND SOt1AP[FOOIRGE INVOlVEO <br /> "��NH ` " � C� <br /> '^� I HEREBV CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> � �� ^caoroseo use oF euaon+ �\ <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORNECT.ALL <br /> tl� PROVISIONS OF IAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> C7 �ecnioescamrior+oFPaoveu*risHom+eeiowoaenacHFouncoai¢s� yyOFiK WIIL BE COMPLETED WITH WHETHER SPEGFIE� HEREIN OR <br /> � �C7 �ot e�oc� aF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> p AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> • 4']• O OTHER STATE OR LOCAL LAW FEGULATING CONSTRUCTION OR THE <br /> zy� PERFORt.1ANCE OF CO�JSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> 9 ON1NEFi GF TNIS PFOPERTY TO PERFORM THE WORK FOR WHICH <br /> t" Z APPLICATION IS MADE AND I COMPLY W�TH THE STATE <br /> �"� y CONTRACTORS LAW 1827 RCW AND 29fi.200 WAC. <br /> g �' <br /> H RE OF WNiRAGiOR ORAUTNCRIZED AGENI OATE <br /> OCy <br /> ��� X � � J � ` ���-� <br /> �,��/� � <br /> y�y CROJECTA�OPE55 qP ICANTSCITVpU5ME55UCEN5E Y.NpBU51NES5NAME <br /> 1 �-'�l � ' ,—' \ <br /> � PLUMBING � MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM <br /> FEE NO. TYPEOFEOUIPMENT FEE <br /> WATER CLOSET(TOILET) NC—A�HNDLG UNITS—H.P. <br /> � FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> 1 BATHTUB <br /> � LAVATORY(WASH BASIN) UNIT HEATEHS--B T.U. M — <br /> � SHOWER CLOTHESORVERS <br /> � VENTILATION FAN <br /> � KITCHEN SINK 8 DISP <br /> DISHWASHER RANGE HOOD <br /> LAUNDRYTRAY WATER HE�TER <br /> ' ._� WOODSTOVE <br /> I L� CLOTHES WASHER <br /> URINAL METAL FIREPLAC[8 GHIMNEY <br /> FIREPLACEINSERT <br /> �� ORINKING FOUNTAIN HEAT PUMP <br /> FLOOR DRAIN - <br /> �� I_1 , BACKFLOW PREVENTE7S __ GAS PIPING <br /> � ROOF DPAINS—FIAINLEADERS EYHAUST FAN <br /> S:^1K(SERVICE—BAR,ETC.) <br /> ' 1=' _ <br /> SUBTOTAL $ SUBTOTAL $ /� � <br /> ,_t�' — PEHh11T S PERMIT 5 .'7 �— <br /> � � TOTALFEE S TOTALFEE 5 <br /> FOR OFFICE USE ONLY: aer,eirt r+o. <br /> FRONiS[TOALK REPRSETBACN <br /> SIDESETOAGN PLANCNECKNUMDER FEE <br /> USE20NE ���pAEA <br /> VALANTSITE FEES VALUATION FEE <br /> BUILDING <br /> ivVEG�LONISAIIOWABI[ ivFEd�LONSi.ALipAL o:�pouor xOpovrtwa�ux�s FL�MBING <br /> SRE OF BIDG NO OF STORiES BPSEMENi MECHANICAL <br /> OCLUPANCVLOAD FlRESPPNKLERSPE00 NEIGMiLIMITATIOY <br /> ADOITIONPL PLAN CH�CK <br /> OTHER � <br /> REPSONFOPSPPMRLERS <br /> S7ATE BUILDING SURGHARGE <br /> INiPKEOV PLANSPPPROVE�BV CITYOFEVEflETT PUBLICWORKS <br /> LOCALSALES <br /> TAX CODE IS 3105 rorn� <br />