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��'�LIC�'i°f�,.� FOR COIdSTFilJC7 .JN PERMIT �� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT "m' <br /> �., . . �y <br /> is <br /> BUILDING DEPARTMENT HEATING SYSTEM: . GAS ❑ELECTRIC J <br /> 259-8810 -- <br /> DEA"OLITION COMBINATION BUILDING � � <br /> o.�nea (/MECHANICAL PLUMBING SIUid <br /> rnna nooaess �Ty <br /> �B_%�Y o__.m�.l�� ��s���,4v�=�P_ S'Fan�"� 9,�i�� D - -- <br /> Ti_I: �f MAILADpRESS CIIV \��^ ����_ <br /> -�P PHONE <br /> ����SIniECTOR0E51GNER MpILAD�RESS <br /> ��� Z�P PHONE � <br /> GF.r![Rn�CONTRFCTOR lAAILA��RESS <br /> ��ry Z�P PHONE <br /> STATE LICENS-- <br /> ldECHANIC�CONTRACTOR lAAILqODP.ESS — <br /> `� \ \�n.U� �. �,a�DF T`-'�� � CITV ZIP PHONE - - <br /> �� l U� SiATE LICENSE q <br /> ---.�r. .�L �%a �'�' <br /> �W�IBINGCONTRACTOp MAILADORE55 � �a ��35'� �� � -lj :',,_ :.�, <br /> CITY ZIP PHONE . ' <br /> SiAiF�ICENSE a <br /> CLASS GF WORK <br /> �W . ADDI710N . ALTERA710N . REPAIR DEMOLITION ' WOODSTOVE�FRPL INSERT . BUILDING RELOCP:i ION <br /> CONTAC7 PERSOIJ ANO PMONE NO -- <br /> CONTRFCT PRICE OF WOFK <br /> DESCFIBF WORK AND SOUARE FOOiAGE INVOLVED � <br /> 7�`— <br /> PROPOSED USE OF BUILDING <br /> s-����. _ i HEREBy CERTIFV THAT I HAVE READ AND EXAM1IINED �i�i.; � <br /> � �W�+�r N f �PPLICA710N HND KNOW THE SAME TO BE TRUE AND CORRECT. ;�,LL � <br /> �ecn�oeseamtioNOF PaoPearv�sHowN eeiow q qTTACH FOUF COPIES� PROVIS�ONS OF LAWS AND ORDINANCES GOVERNING THIS TYP� rif= <br /> �`�T I �"' etocK oF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIPJ G,i <br /> NOT. THE GRANTING OF q pERMIT DOES NOT PRESUME TO Gi�tC � <br /> _ AUTHORITY TO VIOLATE OR CANCEL THE PROVI51pNS OF �PJ��/ <br /> !— OTHER STATE OR LOCAL LAW HEGULATING CONSTRUCTION OR TI!G <br /> PERFORMANCE OF CONSTRUCTION. THAT I hM AUTHORIZED BY Tf ii- <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHIC:i; <br /> APPLICATION IS h1ADE AND I COMPLY WITH THE STA7E � <br /> _ CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> liiOJEGTAD�qE55 y �'��y� , <br /> � S^j' � ' �� .c <br /> PLUMBING �:irv nusirv=.ss�icemse no — <br /> NO. TYPE GF FIXTURE OR ITEM MECHANICAL <br /> FEE NO. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILE7) A/C—A�HNDLG UNITS—HP. ' <br /> BATHTUB — � <br /> LAVATORY(WASH BASIN) � FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> SHOWER ' UNIT HEATERS—B.T.U. M � <br /> ' � CLOTHES DRYERS ��— ' <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN -- , �� <br /> DISHWASHER � <br /> LAUNDRY TRAY I RANGE HOOD �. <br /> CLOTHES WASHER � WATER HEATER <br /> URINAL ' WOOD STOVE � <br /> DRINKING FOUNTAIN � METAL FIREPLACE 8 CHIMNEV � <br /> FLOOR DRAIN FIRF.PLACE INSERT � . <br /> BACKFLOW PREVENTERS HEATPUMP <br /> ROOF DRAINS—(iAINLEADERS ' � GAS PIPING � <br /> SINK(SERVICE—BAR.ETC.) � EXHAUST FAN <br /> i <br /> � I <br /> 1 <br /> --r— <br /> — SUB TOTAL 5 <br /> -- PERMIT g SUB TOTqL S <br /> TOTAL FEE 5 PERMIT g <br /> TOTAL FEE S <br /> FOR OFFICE USE ONLY: + <br /> - FFONTSETBACK REFRSETBACK � <br /> SIDE SETBACK PLA6 CIiECK NUIdBER FEE RECEIPT NO <br /> USEZONE LOTAREA VACANTSITE � � <br /> FEES VALUATION FEE <br /> iYPEOFCONiS.ALLOWA�LE 7YPEOiWNSiACiIIAI BUILDWG � <br /> oceuvum xoo:or.uu•;em:.is <br /> GPIXIr — <br /> PLUMBING <br /> S¢E OF9LDG. NO.OFSTOflIES BASEMENi __. <br /> MECHANICAL <br /> cCCI1PANGYLOAD FIRESPRNKLERSREO'0 HEIGHTLIMRATION AD�ITIONALPLANCHECK , <br /> f1E�:50N FOR SPAINNI.ERS SPRINKLER ' <br /> STATE BUILDING SURCHARGE � <br /> INTANE BV PLqNS�PPqOVED BV <br /> CIi`i OF EVEREiT PUBLIC WORKS <br /> LOCAL SALES <br /> TAX COOE IS 3105 TOTAL <br /> — — � _ <br /> :., �_ . ._. _ — <br /> �. . <br /> . ., . <br /> , .,� _,., : , . , .: . <br />