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APPLICA`➢'I�.d FO� C09�iSTRU�`� a�6�9 ����91fl1'�' ��' <br /> TO BE CO�APLETED IN.BLACK INK—PLEASE PRINT <br /> � HEATING SYSTEM: !J GAS �ELECTRIC J. -- _ - _ _- __l <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> DEMOLITION COMBINATION ,�( BUILDING MECHANICAL PLUMBING SIGN <br /> plYllEfl ,/ n IAAILAO[)RESS GtY Z�P PNONE <br /> /�.C�� �/1�'1� rINTx25 /CsG9 /S�N g�. 9���.��;r Lvn c _�'2C�� 339- 11 S 7 <br /> ;cppryt ldAILAD�RESS CITV t PP PHONE <br /> S�tr-��� ---- <br /> nRCHIiEGTORDESIGN[R tAAILA0LRE55 CITY ZIP PHONE <br /> xr�i] CRY ZIP PHONE iIDTE LICENSE a � <br /> �� f,CllERALCONTRAC1pR IAAILADOFlE55 <br /> ^�.a 1� <br /> O"'�CL —...._ <br /> 4+ f�y I:�f.CHANiCALCONTRACTOR fdAI�A�DFE55 CiiV 21P PHONE StAiELICENSEP <br /> a�-3 co <br /> rx _ <br /> yL�i PLUTA�INGCONTRACTOP IdNLAD�Rif55 CIiY ZIP PHONE StATELICLNSEb <br /> z <br /> .� o — <br /> y'y c_nssoFwoaK <br /> "�-'J H"�-7 NEW AD�ITION X ALTERA�ION REPAIR DEMOLITION WOODSTOVE;FRPL INSERT BUILDING RELOCATION <br /> �H cor+lncr ren,/o�v n�:o aHon=uo <br /> � O� (;OtliRACT P�iiCE JF WOPN u r,D� � �'7�..-� L�x_.��(ub��- 3�� I�� T . <br /> H C7 �[SCR@E WORH ANOSOUARE FOOTAGE INJOLV- <br /> � �d Kr:p�c.: • a Ghfin�L, D�Rs wT� h c�nuaxk�a:, ,._) – <br />� �"� �a vaocoseouse �evi�owu r—� i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS �, <br /> H V �' '-rJc�2KS HC=17 L���Z��'�� "�FZ _ APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> � y z ��an�uesceianor�oF aaov�s�ror��:ae�o�vo;v,v*nc�� oua coaies� - PROVISIONS OF LAWS AND ORDINAfdCES GOVERNING THIS TYPE OF <br /> . WORK V11LL BE COMPLETED WIThI WHETHER SPECIFIED HEREIN OR <br />� H H ioT[S / e�or.K a.9a. _ o�� - � - NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �J fn � AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY . <br /> � ~ '/ LS OTHER STATE OR LOCAL LAW R�GULATING CONSTRUCTION OR THE <br /> C� t7 V1 _�_� YN ✓bll=ik3 �O� ����r'�— <br /> PERFOR�dANCE OF CONSTAUCTION. THAT I AM AUTHORIZED BY THE <br /> C" <br /> /, ��• OWNER OF THIS PRUPEHTV TO PERFORM THE 170RF FOR WHICH <br /> ,.zy� ��.I �A��PI`�.X'13�1 ��� ����'f APPLICATION IS MADE AND I CGfdPLV WITH THF. STAT= <br /> y p V1 T— CONTRAGTORS LAW 18.27 RCW ANU 296200 WA� <br /> — _ —__ W�+GrJ.. . <br />,i X .:,�1 � � //„Z.�j %! ._ - _ ___ <br /> i , <br /> f--. __ . ... <br /> . _ ----- _ _ . _ — <br /> I nRO:[cT nnnFEsc . .�., <br /> i �-..__._ �;- !� . . ___'_—__ _.._. . <br /> � . .%.r�� / � �/� / � �.l � JZ\_i .. '. . ,. . � <br /> I PLUMBING � IdECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br />' ��� I p C—.".HNULG UNITS—H P � <br /> VJATERCLOSET�?OILETI . ____. _________— - <br /> _` --.__ ._ ._—_._ <br /> ..__- , <br /> BATHTUB _ FONCEDPIRSVSTE�dS—B.T.U. b' E. . __ <br /> LAVATORVIW�+SHBASW) UW�HEA1-ERS—�T.U. 61 _ _. <br /> �s� � SHOWER CLOTHES DRYERS —�. <br /> � -- — _ _ VENTILATION F�N <br /> � KITCHEN SiNK 8 DISP � —� <br /> DISHWASHER RANGE HOOD _ _ _____ _ <br /> LAUN�RY TRAY � W�TER HEF�TER . <br /> �+m� WOOD STOI�E <br /> CLOTHES WASHER _ - I <br /> !� � METAI FIREPLACE 8 CHIMNEY <br /> LIRIIJAL � <br /> DRINKING FOUNTAIN PIREPLACE INSERT _ __ <br /> �r FLOOR DRAIN � HEAT PU!dP _ _ �. <br /> ' � ` BACKFLOW PREVENTERS � GAS PIPING _ � <br /> 0 ROOF DRAINS—RAINLEADERS �— EXMAUST FAN _ <br /> SINK(SERVICE—BAR,ETC.) __ <br />� �� � <br /> _— _ �--_ <br /> rd <br /> SUB TOTAL 5 SUB TOTFL S <br /> PERMIT S _ PERMIT S _ _ <br /> TOTALFEE S TOTALFEE 5 <br /> FOR OFFICE USE ONLY: yl s, �` `� <br /> Hi0'l15[iCACH RPMSEI3AGK SIDCS[iBAGN PL�pC11�CK1101Al1CR FE�f. � RIC[IPiNO <br /> - ��S�rs _3`�L�5 ,%9 �� (� 3�a <br /> u;t.1�` �orn�en vncnnrstt[ FEES VALUATION FEE <br /> t�� �, � �O euuuiNc �2 �i6D f�� '� O <br /> IYPEOfCOqfSdLIONFB�E IYPFOfC01151AtipFt occuoaN[v r;nml+:.ni�::��..,. -----'—-- r---- <br /> 4B0pi PLUl.131NG <br /> �n! -i� -3 . — - — - <br /> SZ"e OF(3LDG VOAf S�OFIES DASEI.IENT �f[CIIANICAL <br /> -'eJ �/�^ Z �J ADDI110NAL PLAN CHECK ��� <br /> CCCUPANGYLOAO FlR[SPPNKI[RSR[OD H[IGIITL4IIAITAiICN <br /> A N� �C) ,... __—_— SPRINHLER _ � <br /> r�ensouForvsrni�rRu_F�s . — ���� <br /> SIAiE 13U�LUING SURCHARGE � ' � <br /> u;rnrrr� � (�..nr+snaraoveonr CITYOFEVEREIT i�ut3ucwOr�Ks <br /> i ;-;i } ___ LOCAL SALES <br /> 1 r'- TAX CO�E IS 3105 TOTAL �■ <br />