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APPLICATIC�1 FOR CONSTRUCT"lN PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: - GAS ❑ELECTRIC �) <br /> 259-881 D � <br /> ❑ DEMOLITION IJ COMBINATI�1, �L'I BUILDING ❑MECHANICAL i7 PLUMBING ❑ SIGN <br /> ONNER M LADDRE55 <br /> CITY ZIP P!.ONE <br /> � S,L�i n� C � C E�JEQ�' If �,�� ��� .�oti � <br /> TENANi MAILAO�RESS GTV ZIP PMONE � �� � � <br /> gELLA- �oSA- , 7�03 �p(, u E�� r�li. Lcq <br /> ARCHIiECTORDE(S�IGNER � MAILAO�RE55 GIT�Y, 21P PHONE <br /> SK n IJL�Ll//�//l��r 7CNl� F +=�7 <br /> GENERRLGONTAqCTOR MARRODRESS CITY ZIP PHONE STATELICENSEI <br /> _S,Cc�Tnat� L �►, E Ee�r?, cva zob Z�i43s�/ <br /> MECH�INIGALCONTR�CTOH RIL�UOPE55 QTV 21P PHONE � STATEUCENSE• <br /> �JE�� ii S� •iMFi �3�o cEo�� �d�e�iTwy �ar�v3u E��,es���� ��F <br /> PLUMBINGCONTRACTpR MARADDFESS CITV 21P PHONE '� STRiEIICENSE• <br /> CO�[lRACTPRILEOFr'ORK � 0� �� �I' / / <br /> �� V <br /> � <br /> OESCRIBE WORK AN�SOUARE FODTAGE INVONED CpNTACi PERSON AND PHONE NO. <br /> — S- ..4 ,— d, �oN, �� /'/J�— as1, 3 <br /> I HEREBY CERTIFY T4AT I HAVE READ AND EXAMINED THIS <br /> PROPOS USE O_F 6UILOING APPLICATION AND KNOW;!+F SAME TO BE TRUE AND CORRECT.ALL <br /> r PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEG�LDESCRIPTIONOFPROPERTV�SHOWNBELOWORATTACNTWOCOPIES) WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �oi B�ocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE Ofl LOCAL LAW REGULATING CONS7RUCTION OR THE <br /> PERFORMANCE OF CONSTqUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WOqK FOR WHICH <br /> PARLELTA%I.O.NUMBER APPLICATION IS MADE AND I COMPLY WITH THE STA7E <br /> CON�ORS L W 18.27 RCW A 1' 96.200 WAC. <br /> WNSTRUCTIONLO�NLENDER.ADDHESS,TEIEPHONENUMBER �/ <br /> PRWECT D ESS i ( /�J� <br /> s�crver�nE onrc <br /> tn�ruswcsSucfNSEr+o <br /> PLUMBING MECNANICAL <br /> NO. TYPE OF flXTURE OR REM FEE N0. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILET) NC—NHNDLG UNITS—H.P. <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) UNIT HEATE�iS—B.T.U. M <br /> SHOWER � CLOTHESDRYERS � <br /> KITCHEN SINK 8 DISP � VENTILATION FAN � <br /> OISHWASHER � RANGE HOOD , <br /> � LAUNDRY TRAY WATER HEATER �� <br />� CLOTHES WASHER � WOODSTOVE <br /> URINAI METAL FIREPLACE(WOOD BURNING) <br /> DR�NK�NG FOUNTAIN � FIREPLACE INSERT � <br /> FLOOR DRAIN HEAT PUMP , <br /> BACKFLOW PREVENTERS ; GAS PIPING <br /> ROCF DRAINS—AAINLEADERS � EXHAUST FAN <br /> SINK(SF.RVICE—BAq,ETC.) � <br /> � � <br /> � � <br /> � � <br /> _ SUB TOTAL $ ; SUB TOTAL S � <br /> PERMIT $ � pERMIT $ <br /> TOTALFEE $ TOTALFEE S <br /> FOR OFFICE USE ONLY: <br /> FRONi5E18ACK REARSETBRf,N SIDESETBACN PLANCII@QKNUMBER FEE RECEIPTNO. <br /> 7�✓Z7 <br /> USE ZONE LOT AREA VACANT SITE FEES VALUATON FEE <br /> ❑ YES ❑ No eu��owc � <br /> � <br />, h'PEOFCON51 NO.OFSTORIES ottuwH[r MonroNTluNGUMrtS <br /> caWP pLUM81NG � <br />�I S2E OF BLOG. FINE SPPINKLERS FEO'U BRSEMENT MECHANICAL i <br />� ❑ YES ❑ NO <br />� - OCCUPANGY LOAD FIRE ALARM FEOD I/EIGHT LIMIfATION ADDITIONAL PLAN CHECK i <br /> OTNER i <br /> REASON <br /> i <br /> STATE BUILDING SURCHARGE � <br /> INTAKEBY NLANSAPPqOVE�BY CITYOFEYEflETT PU�IICWORKS � <br /> JNA LOCAL SALES <br /> onre 2 � TAX CODE IS 3105 TOTAL <br />