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6 <br />APPLICATIOI FOR CONSTRUCTkA PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT <br />BUILDING DEPARTMENT HEATING SYSTEM: LI GAS ❑ELECTRIC 0 <br />259-8810 / <br />IN COMBINATION GIRUILNe MECHANICAL 11PLUMBING SIGN <br />E� - wL AWREW L cnY Iw MCEE <br />ARCMrEC10R aSI,W" YA*AWRE55 CR'E Iw Pr <br />OFMPAICMIPACitq WAMKIR(SS cRV TIP %CEE SIAIE LCENY• <br />YECRWILN CWIIPK r(R YAA AIIURE55 CITY M M1RM. SIAA LKENSE• <br />NFW i AnDITION ALTERATION REPAIR DEMOLITION E WOOOSTOVEIFRPL INSERT BU'LC NO RELOCATION <br />Ca1rRELT MGE a NpW <br />C JxT PERSON NW wM?E MJ <br />UEGGpE[YAN1NAM SglAr1E EWUM WV Wt) <br />rllcEvafouAEa MIAOEn <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 LAY! REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR W141CH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONT5KTORS LAW 18.27 RCW AND 296. WAC. <br />ItrEK OEecNrrKW aProPFRry IaIaNN eeLEAraPurKNEdW calEsr <br />LOT xmx a _—_ <br />— <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIKTURF OR ITEM <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET ITOILET) <br />_FEE <br />A'C AMNDLG UNITS —HP <br />/ <br />BATHTUB <br />j^ <br />FORCED AIR SYSTCMS—B.TU. M E.A. <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS —BTU M <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK A DISP <br />VENTILATION FAN <br />DISHWASHER <br />I <br />RANGE HOOD <br />LAUNDRY TRAY <br />' <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE A CHIMNEY <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />_ <br />ROOF DRAINS—RAINLEADERS <br />EXHAUST FAN <br />SINK ISERVICE—BAR. ETC <br />SUB TOTAL <br />f <br />SUB TOTAL i <br />PERMD <br />A <br />PERMIT f <br />TOTAL FEE <br />f <br />/ <br />TOTALFEE f <br />cne ncm, C I IQc nul V. <br />Epa1i EFIlMCR <br />FEAR SEISACR <br />SCE Pf1BKN <br />M1AN GECrrMILMEP <br />67 <br />EEF <br />RECFIPTNO <br />_ <br />LrtE toxE <br />_ <br />I07 AREA <br />_ <br />VKANI Ent <br />FEES <br />VABIATION <br />FEE <br />811ILDM <br />EL01 rvwI NI SYAKL_ <br />114 61-1 /_TUN <br />N{�+artOPOW114.14n <br />1itl� <br />PI WEPEII <br />EIEf a0.W <br />NU aSTORE6 <br />WEWNT <br />MEGIUNICAL <br />ADDITYJHAL PLAN CHECK <br />CCCUMNLY IOAO FIRE SPPMlLP9 PFOO WKP(TLMITATICN <br />REAWR LOPS ARLIAS <br />SPRINKLER <br />STATE BUILDING SURCHARGE <br />NTMf SY <br />BANSAWNK)VFO SY <br />CITY DF EVEBFIT <br />LOCAL SALES <br />TAX CODE IS 5105 <br />PUBLIC WORI(S <br />TOTAL <br />