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APPLICATIC� FOR CONSTRUCT. �N PERMIT � <br /> TO BE COMPLETED IN BLACK INK-PLEASE PHINT <br /> HEAT�',.=SYSTEM: ❑GAS O ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> ❑ DEMOLITION i_-! COMBINL'T�.... Dl BUILDING ❑ MECHANICAL [_J PLUMBING C=1 SIGN <br /> OWNER MMLADDflESS CITV ZIP PHONE <br /> �4lh7EJ C nie�s� 4Y�o ��1Q 4 € �'�F.2Err wA YYaoB 33$ - ((47 <br /> 7EN,W7 MAILADDRESS CITV ZIP PXONE <br /> SA�E A BOV <br /> ANCHITECTORDESIGN R MAILAUURCSS CITV 21P PHONE <br /> �ENERALCONTMCTOR MAILADDRESS CITY ZIP PHONE STATELICENSEi <br /> D�J.�� <br /> � �'� MECHANIC0.CONTMCRIR M�ILADDRE55 CIN ZIP PNONE STATELICENSE� <br /> . �� PLUMBINGCONTMCTOH MAILADDRESS CITV 21P FHJNE STATELICENSE� <br /> , CLASS OF WORK <br /> � � ❑ NEW 6�ADDITION ❑ AISERATION IJ REPAIR i-1 DEMOLITION LI WOODSTOVE/FRPL INSERT I l BUILDING RELOCATION <br /> CONTACT P RSON D P O. <br /> � � CONTMCTPRICEOFWONK ` � ��$'62�0 33g.�i97 � - . <br /> . . � DESCRIBE AND SdI�RE FOOTAGE INVq.VED <br /> c���� S 26 �o-t 1'µb d�f <br /> ; �� ' � I P80POSEDUSEOFBUIILOING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS - <br /> i.`. Ofi T��O �" '� �'�'C"i6 �o✓t� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL - <br /> � � LEOAL DESCRIPTION OF PROPERT`I(SHOWN BEIOW O/fl A�TTACH OUR COPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF � <br /> I � � I �or�� eiocK �_ oF l>�+ (� �✓� NOT. THELGRA T�ING OF AD EHMITV O SENOT PRIESI ME O GIOVE <br /> i � _ � AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> ' � � C�� O EV�Y OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> � . � ����� PERFORMANCE OF CONSTRUCTION.THAT I AM A�THORIZED BY THE �. <br /> � OWNER OF TH�S PROPERTY TO PERFORM TNE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE � . <br /> � � CO ACl'ORS LAW 7 . CW AND 296200 WAC. . <br /> I .rae � <br /> X � 7� �UL 4' <br /> � ' 'N' PROJECTAD(NiESS s�cx�ruac o�}E . <br /> ' , f CITYBOSINESSLIGENSENQ � <br /> � ! PLUMBINO MECHANICAL <br /> � NO. TYPE OF PIXTURE OR REM FEE NO. TYPE OF E�UIPMENT FEE � <br /> WATER CIOSET(TOILE� � A/�A/HNDLG UNITS—H.P. � <br /> . � BATHTUB ; � FORCED AIR SYSTEMS—B.T.U. M E.A. i <br /> � LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M _�_ <br /> t SHOWER ' CLOTHES DRYERS ;_ <br /> `� KITCI iEN SINK 8 DiSP � VENTILATION FAN ___T_ <br /> � DISHWASHER � RANGE HOOD ' <br /> � LAUNDRY TRAY ; WATER HEATER ' . <br /> E � WOOD STOVE � <br /> � CLOTHES WASHER � <br /> " URINAL ' METAL FIREPLACE&CHIMNEY ' <br /> � DRINKING FOUNTAIN � FIREPLACE INSERT � <br /> . FLOOR DRAIN � HEAT RUMP ' <br /> BACKFLOW PREVENTEFS ; GAS PIPING � <br /> � ROOF DRAIN�RAINLEADERS � EXHAUST FAN �� <br /> ' SINK(SERVICE—BAR,ETC.) � , <br /> i ' <br /> � <br /> � <br /> � , <br /> 4 1 <br /> I <br /> 1 <br /> � SUBTOTAL $ � pERMIOT,AL $ � <br /> PERMIT $ � <br /> ' TOTALFEE $ ' TO?ALFEE $ ' <br /> FOR OHFICE USE ONLY: <br /> FPONTSETMCK REARSETBACK SIDESETB CK PUNCNECKNUMBER FEE RECEIPTNO. . <br /> � :175'.Sv <br /> ; usEzone �oT�a� vn T�i�� FEES VALUA710N FEE <br /> R - ' <br /> JV BUILDING O� O�i �� <br /> TYPEOFCONTS.ALIOWRBLE TYPEOFCONST.ACTIIAL atuav+tr Ho.ovow[uixGuuiis ' <br /> i <br /> ; 0°P ' 16 PLUMBING � <br /> � � <br /> 5¢EOFBLDO. No.OFS7oRl S BnSEMENT MECHANICAL � <br /> ' A � <br /> pprpp y�p�p FIRE SPRNNLERS RE�'D HEIGHT LI ITATION ADDITI'JNAL PLAN CHECK � <br /> �. NO 1 <br /> 1 SPRINKLER � <br /> qEASON f-0R SPRINKLERS �S/U <br /> STATE BUILDING S;IRCHARGE �_ <br /> ' INT�NEBV PLANSAPGROVEDBY CITYOFEVEREIT PUBLICWORKS � <br /> Ji1 LOCAL SALES � <br /> �� ,� TAX CODE 18 3105 TOTAL ; Sb <br />