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r _ .�-..- ._ ..-. _- ��� <br /> I <br /> " API��LICATIC"'! FOR CONST�RUCT'- 1N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: U GAS_�ELECTRIC ❑ _ <br /> 259-8810 <br /> ❑ DEh10LITION � COMBINATION f 7 BUILDING 7 MECHANICAL ❑ NLUMBfNG ❑ SIGN <br /> OWNER MFILADDR;'SS CITV 2'P PHONE ^ 1 �`�/\ <br /> TEN�TP'SV� NAIL�� �1 W I'rW� �. LV.�� PWRE%J71 LI �ft.{DJ��� <br /> �� <br /> AF�HITECT OR OESIGNER MFI�OD�RE55 CITY ZIP PHONE <br /> c�� ?�� ��Z•IG�f.� <br /> GENERALCONTRACiOR MAILPDDRESS CIN ZIP PHONE STATEIICEN5EI��GL <br /> ��_TU{�R �aui5 12�N6 �t: ,tiurc� �oo �t.� .w� i�aNa <br /> A7 CMANICAL CON RACTCR MRIL ADDRE55 CITY 21P PMONE STRTE LICENSE t � _^PI <br /> T1fJ4I'�v <br /> �hd.Gd�Y I�RyCS P.o, bd�C �920� �6oR[l.E �IA�A �j AI 8 0 ?,�FS•°hbo 3�9�t o <br /> �PWMB�NGCONTRACTOR MRILADDRE55 CITY ZIP P ONE STATEVCENSE�Q�=�F,� <br /> �WA �lQi;�i3R 2814�i <br /> CANTPAGTPRICEOFWORK ,/ /�/?�� i_LMf .I_I� <br /> � �' '3 _ J�L �� �, 1/'1� 10� <br /> I <br /> � .,HIBE WOR�N�SOU�FE FOOTAGE INVOLVED OONTACr pEF50N AND PHONE NO. <br /> Ir� ' salc � �?ss� <br /> I � , , i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSED USE F awi ING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> O � `j PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGRLDESCRIPTIONOFPROPEPTY�SHOWNBELOWORATTACl/TN'OCOPIES) WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �oi e�ocK oF qUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> /�' � OTHER STATE OR LOCAL LAW REGULATING CONSTflUCTION OR THE <br /> —rfyC�.—�— PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF HIS PROPEFTY TO PERFORM THE WORK FOR IVHICH <br /> APPLICAT O IS MADE AND I COMPLY WITH THE STATE <br /> PARGE�TA%I.D.NUMBER ONTRA TORS AW 1B.27 RCW AND 296.200 WAC. <br /> �. CONSTRUCTION LORN�ENDER.ADDR SS.TELEPNONE NUMBEfl <br /> -a� - <br /> PROJECT ADDRESS s N o�re <br /> li 'MESSIICENSEND <br /> PLUMBIN6 C ANICAL <br /> Np, TYPE OF flXTURE OR REM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) � !UC—lUHNDLG UNITS—H.P. � <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M � <br /> SHOWER ' CLOTHES DRYERS ' <br /> KITCHEN SINK&DISP � � VENTILATION FAN � <br /> . � — DISHWASHER � RANGE HOOD ' <br /> ' � LAUNDfiY TRAY ' WATER HEATER ` <br /> '� CLOTHES WASHER � WOODSTOVE � <br /> � URINAL ; METAL FIREPLACE(WOGD BURNING) ' <br /> ' DRINKING FOUNTAIN � FIREPLACE INSERT � <br /> '� FLOOR DRAIN � HEAT PUMP i <br /> � � BACKFLOW PREVENTERS I GAS PIPING � <br /> ; ROOF DRAINS—RAINLEADERS 1'"� EXHAUST FAN � <br /> � ' SINK(SERVICE—B�:R,ETC.) � 4 1 � <br /> � � � <br /> � <br /> I� <br /> � � � <br /> I , — � <br /> j� � � . � --- — —— - � <br /> � <br /> I � SUB TOTAL 5 ' � SUB ' <br /> ' . PERMIT $ R IT $ � <br />' � TOTALFEE 5 TOTALFEE $ ' <br /> FOR OFFICE USE ONLY: - <br />� - ' � FPONT SFTBACK REAR SETBACK SIDE SETBACK PLAN CH K NUMBER FEE � RECEIPi-NO. ,�_� <br />' 333� �/�3 � 3� <br />� . USE ZONE LOT AREA VRCANT SIiE FEES VALUATION FEE <br /> � � ❑ YES ❑ NO BUILDING ' � <br /> � � 7VPEOFCONSi. NOAFSTOFIES a[urr.ua rvo.oroxtuiNtw�nS <br /> �9pp° PLUMBING � <br /> �- 1 N�. + 62 .�' ----�— <br /> SIZEOFBLDG. FIRESPRINNLERSREO'D BASEMENT h1ECHANICAL � <br /> /�1� 'TI '��j yG YES ❑ NO � <br /> �� ADDITIONAL PLAN CHECN i <br /> yPANCVlOAO FIREALANMREO'D HEIGNTLIMITATION <br /> i <br /> --�' i� OTHF.fi i <br /> REASON �{� <br /> , ' STATE BUILDING SUFiCHARGE � <br /> i <br /> INTAKEBV PLANSAPPROVEDBY CITYOFEVERE7T PUBLICWORKS —� <br /> �M LOCAL SALES <br /> DATE � �� ,�, TAX CODE IS 3105 TOTAL �� ; g� <br />- <br />