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� � 1 � � � � <br />� � .1 A • ° � a s ���. � � i �r ; t <br />� :, .r . <br />• 1�. '�`1.� ' 1 f f. � � .rf .. 1. 4 J .. �r � • <br />��y:, ��. <br />for new <br />�'��i��"� <br />5hort P12Usubdivision <br />�� - �� �._ �_, �t <br />s �`-� ��°°---:. ; f � Y-.�:�-- ��� <br />iCANT; � Owne�f _ Owners Agent �'� Contractor <br />RA�TOR"�"�"���"�'��;� �"�`'��-_' ` .�,�,� <br />_ a ;. <br />Ex[sting Use of E3uiI� <br />Proposed Lise of 8E <br />Buildit�g type: ���"'�; <br />Tvpe of oroiect: <br />s <br />RRaPEarr r�x # P�Rtwi <br />e�t? 5�`1 QrJnc�c'3d.�5� � ����o��/I �' �" <br />lot No. (attach aopy o€ long iegal description) <br />Phone/E-maii �"�_�� _"" #�;,� � an°-��'�'"°,�,,� <br />Ciry/StateiLip r�— ��,.{,,.-i ="� ,�..�.. ;-..;�. <br />Contractor's Agen4 _ TenaM �m�sc p�ouiae ��ner or �ongom trom me owner m ao work in tne <br />State �ic. # ��..�~-�, �t-'� ��� ' Bus. Lic. # <br />g� : �� �'`-""'�� � ' PhanelEmaii `"�� , �?.., t `,:3,, � -� .f-i. �..�;«�-...✓ <br />CfJ(dTACT FDl2 PEfiMIT <br />� ��� � C°.���'�a� �w ;�,�' � ��.,_�,... <br />F'hanei�-mail `"' � _`� �--"� � "�� ;L..�, � � . <br />CLIMTRAGi PRiCE OF W43��a ���'`� <br />_ HEAT SOURCE: <br />�'amily ,� Dupfex Townhouse _ i�ulti-Family _ Commercial <br />�_ Addition_` RemodeB ____ Repair T:i. Sian Sorinkle <br />IPTION ()F W'CiRK {at#ditional spaca provided on fhe back) : <br />,�` ����_::�a�.�;�;�� .i`�� ��nv. �,� �`�,��"` <br />EG ANICAL PEIRMIT APPLICAT'. <br />7ype of Prajact; ,�New s�'Addn �Alteration �, R�pair <br />Shovsr Aiumber {#� of iixtures <br />1 A/C — air handiin� units <br />�orced air svsfiems <br />heater <br />Gas <br />fan <br />; Other <br />SP6tIPJKLE� / SU <br />vf Use <br />P�.U�ABING PERMlT P�'L1C�1itOt� <br />of Project: �htew TAddn _Alfieration _,_„Repair <br />Show �lumb�r {#j vf i5xtures <br />-- ioiiei <br />Kitchen sink <br />Water <br />Ftc�or drain <br />Grease trap <br />Rnofi drains <br />Medical Gas <br />OTher: <br />i hereby certify that I have read and axamined this eppiication and know the same to be true and corcecC All provisbns of laws antl ordi�anaes goveming this type of work will be comp <br />wifh whather specified herein ot nof. The granting of a permR does not presume to give authority to viotate or cance! the provision af any otber state or tocal law reguiating consVe�ctlon <br />That I am authorizod by the owner prope to perform the wotic far which apptica6an is made and i compfy wiih the State Contractors Law 78.27 RCW and 296.200A WAC. <br />u rized eature ate � ` <br />(Revised 8/2094) <br />