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I <br />APPLICATILA FOR CONSTRUC7.JN PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />BUILDING DEPARTMENT <br />HEATING SYSTEM: ❑ GAS Ad ELECTRIC ❑ <br />J <br />259-8810 <br />DEMOLITION CONdINATION <br />BUILDING <br />MECHANICAL <br />PLUMBING I I SIGN <br />OWNER MAIL ADDRESS <br />CITY <br />ZIP <br />PHCNE <br />Cc L T soN, ��- J-54d T)Zo <br />9/lf -9a/= <br />5f 5.("j. <br />GUA <br />9F120•Z/ <br />TENANT MAIL ADDRESS <br />sfllog 43 4Roy6_ <br />CITY <br />ZIP <br />PHONE <br />3 3- /3G3 <br />ARCHITECT OH DESIGNER MAIL ADDRESS <br />CITY <br />/i( <br />ZIP <br />PHONE <br />$9Xr�g -,/o7 <br />GINCocL) <br />Aftr/4760 <br />WA, 99075 <br />3-5,48-31?1.57 <br />GENERAL CONTRACTOR MAR ADDRESS <br />CITY <br />ZIP <br />PHONE <br />STATE LICENSE <br />oUiu&,e_ <br />PLUMBING <br />MAIL <br />PHONE STATE <br />PHONE <br />CLASS OF WORK <br />1 1 NEW +ADDITION I ] ALTERATION REPAIR I DEMOLITION WOODSTOVEFRPL INSERT BUILDING RELOCATION <br />TT <br />CONTRACT PRICE OF WORK �QJ�-- ��+' �l V <br />CONTACT PERSON AND PHONE NO. <br />LE45 C4!21 AIJ �s3 -1363 <br />DESCRIBE WOR" AND SQUARE FOOTAGE INVOLVED <br />i of BEDRzom sP cE <br />PROPOSED USE OF BUILDING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW A D 296.200 WAC. <br />, <br />> <br />LEGAL DESCRIPTION OF PROPERTY ISHOWN BELOWOR ATTACH FOURCOPIESI <br />LOT BLOCK OF <br />1;0G NoFrill //$ }vSET OF THE u-e57' f 35. 85 T"EET <br />77= 7i/E z-115T 62 •,60 7-667 of T11'6 smorWd-45r <br />�U/�Q7E� O� tN� xY77HaLs% QcIA�'TE+`� o <br />MITHWEST Qu4al"C- ' of «C7/0 13, <br />PROTECT ADORES rzFa7 -7ffBIW o F <br />^^^ <br />IS, nn , BAY <br />CITY RUSINFSIUICINSEND <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />BATHTUB <br />I <br />A/C -A HNDLG UNITS-H.P. <br />- <br />FORCED AIR SYSTEMS-B.T.U. M E.A. <br />_ <br />_ <br />LAVATORY ^NASHBASIN) <br />I <br />UNIT HEATS S-B,LU <br />_ <br />SHOWER _ <br />AYERS <br />KITCHEN SINK 8 DISP <br />VENTILATION FAN - L&fte <br />DISHWASHER <br />I <br />RANGE <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />I <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE A CHIMNEY <br />C- J_KIIJG FOUNTAIN <br />, <br />FIREPLACE INSERT <br />' <br />FLOOR DRAIN <br />HEAT PUMP <br />T <br />BACKFLOW PREVENTERS <br />; <br />GAS PIPING <br />ROOF DRAINS-RAINLEADERS <br />EXHAUST FAN <br />SINK (SERVICE -BAR. ETC.) <br />SUB TOTAL $ <br />SUB TOTAL $ <br />PERMIT $ <br />PERMIT $ <br />TOTAL FEE $ <br />TOTAL FEE $ <br />FOR OFFICE USE ONLY: <br />FRONT SETDACK <br />REAR SETBACK <br />SIDE SUBAfA <br />PLAN CHECK NUMBER <br />(00 <br />FEE <br />RECEIPT NO <br />USE ZONE <br />LOTAREA _ _ <br />4 <br />TSIITTE / <br />✓ v <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />PLUMBING <br />�(�� f D <br />1 - <br />I <br />y <br />DF CDNT ALLDNABIE <br />Q . A/ <br />TYPE Of CONST ACTUAL <br />� <br />acEIIIAMY <br />c <br />Ia nRNFUlAG IMITS <br />1 <br />SIZE OF SLOG <br />NO OF STORIES <br />BASEMENT <br />MECHANICAL <br />I <br />ADDITIONAL PLAN CHECK <br />OCCUPANCY LOAD FIRE SPRINKLERS REOO HEIGHT LIMITATION <br />WA Nu <br />REASON FOR SPRINKLERS <br />SPRINKLER <br />I <br />STATE BUILDING SURCHARGE <br />�— <br />INTAKE BY <br />PLANS APPROVED RY <br />CITY OF EVE RETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />PUBLIC WORKS <br />—L- <br />TOTAL <br />