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_ _ _ . <br /> ; <br /> t <br /> APPLICATI�.: FOR t:ONSTRUCT�JN PERMIT e�e��it i <br /> (he Everg�een TO BE COMNLETED IN INK—PLEASE PRINT � <br /> CII V OF <br /> eve rett HEATING SYSTEM: '�GAS 0 ELECTRIC ❑_ '� ♦ <br /> BUILDING DtPARTMENT ','�� <br /> 259-8810 <br /> I DEMOLlTION I_: COMBINATION BUILDING MECHANICAL L, pLUMBING ; SIGN " !'� <br /> OWNER MAILAOORE55 CITY ZIP PHONE � - <br /> 1om M�F)i �1.�, Sbo7 [��fS� S�rh 5b.29u 33y-oa�a� <br /> TENANT MAILA DRESS CITV ZIP PHOflE <br /> . '. f:�;'YJ <br /> . RRCHITECTORDESIGNER MAILAODRESS QTY ZIP PHONE � �"�'� <br /> . � ,:'f'f-. <br /> - 2:1.::.!...v%r <br /> ' GENERALCONTRACTOR MAILADDRESS CIN ZIP PHONE LICENSE� � ���;,� <br /> � U l.�l irJG� <br /> MECHANICAL CON7BACTOR MAIL ADDRESS CITV ZIP PHONE �ICENSE N ,.;��:���� <br /> 'ry <br /> PWMBING CONTRACTOR MAIL ADDRE55 CITV ZIP PHONE LICENSE� -"� <br /> �'•, <br /> '.:::.,�--' <br /> , CLASSOFWOHK / � <br /> , l"e <br /> : ❑ NEW L_, ADDITION i�LTERATION ✓�REPAIR � . DEMOLITION ! 1 WOODSTOVEIFRPL INSEqT 17 BUILDING RELOCATION - � <br /> � d LONTACT PERSON AND PHUNE NO. <br /> CONTRACT PRICE OF WOR� <br /> �C <br /> DESCRIBE WORK ANO SOUARE OOTAGE INVOLVEO <br /> t � • • <br /> PROFOSEDUSEOFBUI�DI �� I HEREBY CERTIFY THAI� I HAVE READ AND EXAMINED THIS � <br /> . _R�n �-a � �� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECt ALL <br /> ; LEGALOESCRIPTIONOF PROPERTY�SHOWN BELOW OR ATTACH FOUR CCPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF i <br /> ` /G� I 1 WORK WI�L BE COMPLETED WITH WHE7HER SPECIFIED HEREIN OR <br /> t �oT a�ocK .�� oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> � AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> [1 nd Z���p vem�n'} C o�a � � OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> ; AJo�i�jn., fo �Utl'o��e� pppLICP.TIOh IS MADE AND I COMPLY WITH THE STATE <br /> .. CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> `L µ Q SIGNATUREOLCGNTflACTOFORAUTNORIZEOAGENT DATE y .�; _ y� <br /> � PROJECTADO ESS <br /> �/ ,� i h � � r pPPLICA�/BUS�ICENSE .RNJ Bl1SINE55 NAME <br /> (e <br /> � PLUMBING MECHANICAL <br /> ' NO. TYPE OF F�%TURE OR ITEM FEE NO. TYP�OF EOUIPMENT PEE <br /> � WATER CLOSET(TOILET.) � — A/C—WHNDLG UNITS—�!.?. ; <br /> —,— <br /> BATHTUB ; — FGRCED AIR SYSTEMS--B.LU. M E.A. <br /> � LAVATORY(WASH BASIN) � UNIT HEATERS—B.T,U. M ; , <br /> . SHOWER � CLOTHES DRYEaS <br /> ` KITCHEN SINI(8 DISP — VENTILATION FAN � � ��� <br /> DISHWASHER -- RANGE HOOD �� <br /> _ LAUNDRY TRAY WATER HEATER <br /> . CLOTHES WASHEF � WOODSTOVE ; <br /> , URINAL METAL FIREPLACE&CHIMNEY �— <br /> DRINKING FOUNTAIN FIREPLACE WSEFiT ; � <br /> FLOOR DRAIN � HEAT PUMP T <br /> .. BACKFLOW PREVENTERS ; GAS PIPING ' <br /> ' ROOF DRAINS—RAINLEADERS � EXHAUST FAN � � <br /> SINK(SERVICE—BAR,ETC.) ; � <br /> � — <br /> T'� <br /> I � <br /> I <br /> I � <br /> SUB TOTAL $ ; .- SUB TOTAL § � <br /> PERMIT $ PERMIT $ ; <br /> TOTALFEE $ ; � TOTALFEE $ <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBACK REFR SETBACK SIDE SETBACK PLAN CHEGH NUNBER PEE RECEIPT NO. <br /> usezor+e LOTAREA vncnNrsirr: FEES VALUATION FEE <br /> BUILDING a�67J2� U � O s <br /> iVPFOiCON15AI.LOWABIE tVPEOFCONSTpCiIIAI atuvu,[r NoovowEuwGmms � — <br /> �� _� ap°3 � PLUMBING �Ob <br /> i <br /> . SRE OF BLOG. NOAF STORIES DASEMENT MECHANICAL i <br /> � �XI 57�4• � �° � - <br /> OGCUPANCYLOP� FIRESPRNKL'cF5RE0'U HEIGMTLIMRAiION ��P�NCHECK �8' i � <br /> � �V OTHER i <br /> REASON FOR SPRINHLEflS <br /> STATF BUILDING SURCHARGE ; sd <br /> INTANE f3Y PLANS APPROVEL`0V CI i Y OF EVEREIT PUBLIC WORKS � . <br /> LOCALSALES <br /> � 9�g TAX CODE IS 3105 TOTAL ,� I ao <br />