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- - <br />�� . .,,,�. <br /> I .. , <br />' APPLICATIO�_� FOR CONSTRUCT�N PERMIT �� <br /> � TO BE COMPLETED IN BLACK INK—PLEASE PRINT ��T <br /> -- <br /> _ __ - - - <br /> � HEATIN�SVSTEM: J GAS J�LECTRIC J �. <br /> 6UILDING DEPARTMENT L----- -- - <br /> 259-8810 <br /> � n � J DEMOUTION COMBINATION BUILDING MECHANICAL __ _ _ PLUMbING _ SIGN <br /> J� pWMEN MAII ApUflC55 LIiV Oi' PMOhI <br /> a � /JI • ����r�i � 'i �/11..1'�C �T filFJ17 ?�1., __ �S,g- ��-,'��-� <br /> r.3 y TENANi MAiI�DDRE55 ���� ' <br /> I� �M �qCMilErlpqDESK.NER 1AUL�DDRE55 CITY tiV PNONE <br /> K n <br /> H 7C <br /> � M � OENENLL CONTR�GTOR ' Y� /�DNE55 L�I3Y - Z�P ) G E ST�iE LICEHSE• <br /> (AH �� /J,.� - �/ e/ I �� i����L���U/�/��/ � i ����1��� <br /> xx 'b�[.QHnNIGLGONTRALIOR M�IIeDOHESS CIiV IIP P�qNE STQEL�CENSEI <br /> H <br /> Rl O� <br /> ON 19uM��NGCONiMGTOR MAI�AD�RESS CIIV 71P I'HONE STATELICENSE� <br /> � � g - _ <br /> Q� � C1A55�f WORN <br /> `L y� . NEW ADDITION ALTFRATIOW FiEPAIR DEMOLITION x WOODSTOVEiFRPL INSERT_ BUILDING RELOGATION <br /> Cy CONIACT PERSON�N�PMONE NO <br /> F-i H —__- <br /> fyy C�NfRACTPPICEOFWORN _ --- "-- " <br /> Y <br /> V H DI�SCRi8EW0liN�N�50U�REfO01eGEiNV0.VED <br /> ���' � ;/kJ015 SJ'�'�E l�F�!/ r�LiC' <br /> � �' rnoros[ouseaem�owc i HERE�Y CERTIFV THA7 I HAVE READ AND EXAMWED iHIS <br /> y y � �•�iC�d��� �-rl������ ,�',;����Y� �� APPLICATION ANO KNOW 7HE SAME TG BE TRUE ANU CORRECT.ALL <br /> y �� ,tr.i�E nirrror+ovanoPFn*v�SHowr+BeiowcnnTucHrour+c�aies PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTVPEOF <br /> WORN WILI BE COMPLETE�WITH WHETHER SPECIFlED HEREIN OR <br /> io� pLOCN ov NOT. THE GRANTING OF A PCRMI7 DOES NOT PRESUME TO GNL <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER SiAiE OR LOCAL LAW REGULATING CONSTFiUCTION OR THE <br /> PERFORMANGE OF CONSTRUCTION.THAT 1 AM AUTHORIZED 8V THE <br /> . OWNER OF THIS PFOPERTV TO PEPFORM THE WORN FOR WHICH <br />� x= . , --- APPLICATION IS MADE AND I COM1IPLV WITH THE STATE <br />� }F ��;�, � CONTRACTOFS LAW 1827 RCW AND 296200 WAC. <br />� ���[aw —-- <br /> F .z ` --- — i -� . � � . <br /> '` ' �.,'��-<111'�":- � ��1�!1 - � ��>� <br /> -- �-" � ------ ---- „ <br /> pno�EcrAnD9Es5 - �w-ci �� � <br /> r �2�1 /C �/I.0 f/L S� t� Y%- r.- ,.. — ----- <br /> �.� PWMBIN6 MECHANICAL <br /> C� NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILET) A C -A�NNDLf;UNIiS u P. <br /> '... ._ _—___ ___. _.--___ - <br /> , j ', _ BATHiUB _ __ _ _______ __ -- _FORCED AIR BVSTC�dS B t U M EA�_ y-.. <br /> � LAVATORV(WASH BASIN) U1JI7 HEATERS- �T U M <br /> SHOWER f,LOTHES DRVERS <br /> � VENTILATION FAN <br /> 1 �� _ KITCHEN SINH 8 DISP ---- ---r-- <br /> � , DISHWASHER RANGE HOO� _ _ _ _'�. ._ <br /> � LAUNORV7RAV WATER HEATEq �_. __ <br /> I �� __ CLO7HES WASHER _� _ WOOD STOVE — _��r_- <br /> � � UPINAL METAL FIREPLACE 8 CHIMNEV <br /> � FlREPLACEINSERT <br /> DRINKING FOUNTAIN <br /> � FLOOR DRAIN _ HEAT PUMP _ _ <br /> ' � BACKPLOW PREVENTERS . _ _T_ GAS PIPING ___ <br /> I EXHAUST FA!J <br /> � I ' ' FOOF DRAINS-RAWIEADEfiS _ _ - � - <br /> I � SINK�SERVICE-BAR,ETC.I _ _. --. - -� �� <br /> — <br /> _ _ <br /> I .__—i_ -- _ . <br /> l�I�1 - . -- --- - -----� � <br /> ---- -- <br /> , - <br /> .. SUB TOTAL $ ' ..SUB TOTAL_ $ ; <br /> _.. __ __...__ __- __._--___— - � <br /> — ---�—��— PERMIT $ <br /> -- P[RMIT S _------ -----�--- <br /> aI� -. -___ _ _—_ —.. .__ . . _. -- TOTALP[E S <br /> TOTA� FEE S I <br /> FOR OFFICE USE ONLY <br /> --��--- - ---- _. -_ -- -----� irzcro����o <br /> . . pRONI.:f1UAlK� Il1�N'.IIOn(N SIDI $FIIIPCn �.I�'lCIIICNNIIMH{n {If <br /> ��.5� `/`/ <br /> usE lonc m���.a� vecua sne FEES VALUATION PEE <br /> ❑UII UWG � <br /> IYPFOICONISe11UW�Bl1 1CVF0(f,UHSIfGipAl rc�i �F�r Na��� :. , . .. . . .-- � . <br /> P�ufdPINC � <br /> ..____ . _ ... ._.__ . <br /> SIZE Of BLDG NO Of SiOR�ES BASEMENI � �q t.114NICAL � JO I <br /> __—_ <br /> --- nI�UI110NI! PLPNCIIf[�.M � <br /> OGCUG�NCYlOAO FlRESPRNNlFR5RE0'0 NE�GIrtIIMrtGrii�'� __ . . - - <br /> �ll'111NKLER <br /> — ___ . . . . . ___._. <br /> RE�SONlON SPRINNLERS <br /> :Ini I 11J�1 UiNG SURCINHGF � <br /> ._— '—___. _ _. __- _ . __. - _ _ . <br /> �r�ieKe er Pur�s�P�no��n n. � CITY OF[VEREIT rum ic woaKs '' <br /> � LOCAL SRLES <br /> TAX CODE IS 3105 TUTp� ? " <br /> ---- --_ - --- <br />