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APPLCCATIOI. FOR CONSTRUCTI H PERMIT � <br /> TO BE COMPIETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SVSTEM: f�GAS ❑ELECTRIC ❑ � <br /> 259�8810 <br /> DEMOLITION �� COMBINATION /BUILDING MECMANICAL PLUMBING SIGN <br /> pyM[p M�1�00RE55 pTY ZiG PNCNE <br /> � Hn'RI �O.tllll 3�1.�G� �iMG(�l'7PV �J tGl'� �iAeJl c�743�79'/5 <br /> *cr��Nr j u�a�ooa[ss cm zw crwr�E <br /> A�e,VL <br /> .xw*tc*onoEs�crrtn 4�s.00ncss cm zw rw+[ <br /> -l�ri � f c�..�t. �l/?<. S �- /�..`RiuL,�ii 4A�ar .�5� s�7b _ <br /> GENER0.UTIIR�CTOF MAIM(IR65 GRl ZN P�qME ST�LFLILENSf• <br /> L c .. (Ro� .+J 3d?c r,;,t��u�e�— 9.E�a/ a5a7Y74 <br /> uEc«.nwr.ic .ni.non M�cwouEss J �'m zm v��ont surticcvsE. <br /> r. � =�:+a � f,»�f/ 9Aaa� as�-�6o4 <br /> PWMPMG P�Lip1 MG4�001165 ,� LpY - I�P PIICNE SUiEIRCNX• <br /> � , � � .1/ �72•r/ 05774^4. <br /> cwsa n. . <br /> . NEW �DDITIDN ALTERATION �EPAIR OEMOLITION WOODSTOVE'FqPLINSERT BUILDINGRELOCATION <br /> LONi.�Li FEfl$CM ANO P1bN[NJ <br /> fp11R�C1 pRICE Of Wq1Y � ` <br /> MSC��B[�WUM.NDSW�FE�00i�G[mv0.KD � ����.✓ � N � �G <br /> � � i I �Dm��f'.:,. � P l ��iva.�nM'�,_�L <br /> v seou,eaeunome 1 NEREBY CERTIF� TNAT I HAVE READ AND EXAMWED TXIS <br /> I , `{.� �9�w.c. �f'f�G APPLICATION�ND KNOW TNE SAME TO BE TRUG AND CORREGT.ALL <br /> iEG��oECn�vtqr�o�rnorearvis�wvroe oeett�Ce�wuto>h5i F'ROVISIONSOFLAWSA400R�INANCESGOVERNINGTHISTVPEOF <br /> ,�� � � � WORK WILL BE COMPLETCD WITH WHETNER SPEqFIED NEREIN OF <br /> �0* +d' aia�,P. �R or �,114LpL_ • NOT THE GRANTING OF A �ERMIi DO[5 NOT aRC5l1ME TO GIVE <br /> /� � AUTHOFITV TO VIOIATE OH CANCEL THL PROVISIONS OF ANY <br /> ���`_ � h ��� �p O7H[R STATE OR LOCAI LAW RFGULATING LONSTRUCTION OR THE I <br /> PEfliORMANCE Of-CONSiflUCTIGN.THAT I AM AUTMORIZEO BV lHE <br /> 1 � 1 4 { OWNER OP TN!S PPOPERTV TO PEAFORM THE WORK FOR WMIGH <br /> APPLICATION IS MADE AND 1 CO�APLV WITH TME STATE I <br /> LONTRACTORS LAW 10 27 RCW AND 29G.700 WAC. I <br /> ��r .a '�. C � � ��ff / � / <br /> ��i��c. �/�����_=��'(.Z"s�/ G/� <br /> PPOJCL1EpD�65 J � <br /> _ y�s ,�,�,a �-r., <br /> PLUNBINO � MECHANICRL� <br /> NO. TYPEOFfl%TUXEOPITEM FEE NO. TYPEOFEOUIPMENT FEE <br /> � WATERClOSET�TOILET) AC—ANNDLGUNITS—NP <br /> BATNTUB FORCED AIR SVSTEMS—B T.U. M E A. ----���---+++---_ <br /> 1 LAVATORY�WASNBASIN� _ i UNITMGATERS—BSA. M � <br /> SHOWER ' CLOTHESDRVERS <br /> KITCPEN SMK 6 DISP � V[NTILATION FAN <br /> DISHW�SHLR RANGE HOOD <br /> LAUN�RY TRAV WATER MEATEfi <br /> � CLOTHESWASNEH WOODSTOVE <br /> URIN�L METAL FlREPLACE 6 CHIMNEV <br /> DRINKING fOUNTAM FIfiEPLACE INSERT � <br /> FLOOP ORFIN HEAT PUMP <br /> --� <br /> BACKFLOW PREVENT� 5 GAS?IPING ' <br /> qpOF DRAINS—RR LEADERS E%HAUST FAN —� <br /> SINK�SERViGE AR.ETC.) <br /> / __ <br /> / SUB TOTAL S � SUB TOTAL 4 <br /> PERMIT E PERMIT $ <br /> TOTALFEE S TOTALFEE S <br /> FOR OFFlCE USE ONLY: � <br /> iRONISE �Ck HE1115EtB�CR � SIpF.'+EiBECG PI�NCNECGNV4BER fEE AWEI^iN0 <br /> - �- Q - que - - .�Gi�/i �ac �3 G�33.79 <br /> uscra+e m*�nu vec�nisi c FEES VALUIITION FEE <br /> ���BU�I[lMG !S JOJ � I / <br /> 1vRU[ONiS�IIONMLt IY%q[Ox91CtUAl Ptowrtr xsdtw!u:rsur�x — -- J <br /> _ . / i /� PWMIfING - - <br /> 'V V <br /> 6VECfPlO.'a NOOiSiORIES BASEMENI MWHANICRL <br /> 17 � 8 so,rT. � 1'e S <br /> OCNPANCvIW� 1�RCSPP/ry4 F.PSnE00 NEqMZilx.�n/.�pN �O�ITION�LPUNCNEGK -�J <br /> �Q A(D ./ SPRINKL[fi —� <br /> 11E�SON FOP SPPMNlFP4 � <br /> SLAiE BOILDING SUHCNAqGE <br /> iv*r.kenr erraoveoer CITYOFEVEflETT runucwoaKs <br /> / <br /> LOCIIL SI1LE5 ' <br /> ��� TAXCOOEIS310fi rot�� -;�� ;('l; <br /> r _ � <br />