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- CONSTRUCTION `' � � �T <br /> . ,_ ;.,. <br /> PER1v11T APPLICATION <br /> COMBINATION • BUILDING • MECHANICAL • PLUMBING <br /> OWNLH - �. ...� . . ��n��r,..� J i r�y I..ni�, MML AUUNLbi �_ 21Y YMUN! <br /> �, . .� 1`. :l � � <br /> I�����c�t:h�V � lJS4�1y I; cndl� ('. i �.�lv • �.�.�,,,�.� r �,`, l.iil, 4�,cn�i..i , `11��,'C'1 , ., i � , <br /> ARCHITECI UH UESIGIIk�—{�pDHE55 /MONE ��ICkNSk NU <br /> GENIf1ALCONTRACTOR MAILAOURE55 VMpNE �ICENtiENV <br /> 1' �) L* ct('. i ' 1 � `,�,. t •\�> � ,_ �7 I� � <br /> MECMANI�q�CUNTRAG70N MAI� AO RE55 PHONE UGENSk NO. <br /> PLUMBINGCONTRACTON MAII AOORE55 VMONE �ICENSF. NU <br /> VLRMiT CLASSOf WO�K • '-----" <br /> ❑e�-�.C!OMBINATION <br /> LyuVILOING �VlUM01NG ❑MfCH/�NI�AL / �s,. <br /> ❑NCW QADDITIUN ❑AITCII/�fluN yJ1�U•N1� <br /> "_-_"_' __ �_ ._._ . _. __""__� <br /> VALVATIONUF WORK <br /> S I� � � � �- ❑DEGIOUSM ❑lENCE ❑S�GN ❑:�YiMM�N. Puol. <br /> DESC(ilOt�K "'--- <br /> r��-�c;C1F I <br /> PNUPOSEOUSE OTHERPERMITS ORAPPROVAIS <br /> �-L��n — � RE ZONE � SPECIAL USE <br /> LlG11L Ul:iCf11PTIUN OF YROPEFTY ISNOW BELOW UF A/TACN <br /> fOUPCUP�L�511 ' ,I ��� � l �VARIANCE .� SHORLINE <br /> LO1��1fi•`G,BLOCIf�OF_]_L.._t r-UEC <br /> U � ��s�cn ..Uo �2' '_".rc��.�;sn<�,...�ty , SEPA CHECK LIST REQUIRED <br /> :;1�.iE �y��,r.�F. j� YES <br /> I rbCJ<fiht.\y�yy.f�lpoC �n� f�.ml't.\,��.cry�.:...t L �}x�. � ND ' <br /> .p' R.,•Zt c�t E�Sntf- L7�,�r,�u�i ��o .•I•, e �x� r (�li,t <br /> LLC�f:L� n �;01 i�rp, �i n( V Ir�Y>� �'r�t�f i I <br /> JOB ADDRE55 <br /> �'�L� � �� _ � . �, .'� , �MECHANICAL <br /> PLUMBING TVVt Oi CNEH6V [, '^, �FIfC. <br /> . NO. TYPE OF E�UIPMENT �- � FEE <br /> AIR COND. UNITS-II.P. EA. �� "-""-iS� �-'_ I—_ <br /> NO. TYPE OF FIXTUPE OR ITEM FEE RU f+iuERnTinN �rNnS u v Ln, --� --� <br /> _ _�__ <br /> IIAIH 711U5 S POIlkf15 IIP � A "' ' ' -'-'"--""-�-'— � <br /> CIOfHFS W�SH6H ' �r�ncen Alll S�SiEM�11.T.U. MEA. �- �- <br /> UIti11 YJnSNENS i -' - '-"'-- '--. . ..—...- -L"-- <br /> UNINr.INfi 4UU�JT111N5 i - - '-'-"� --"-" --- ' 1 <br /> i10011 UIIMNS � SPACF R WAII ��EA1[NS � fl T.U. �— <br /> Klli�IFN ti1NK•i Po OISV � VNI111FnTEP: H.7.0 "___`� T <br /> IIAIISINK$ � EVI�I'ONA11VlCOO1.EH5 __h_ � <br /> IIOUV UIipINS NpIN �CAU[115 CLUlnLSORVEPS .. --'"_-"' I T <br /> $/IOItiFN flATM$ VENTIlf1TION i pN <br /> !I(NVICt SIN✓,5 -- -'-"-'--" --- � <br /> tiUMVS - SEWA(iE VUMP __ RANGE NOOD_ _ —� � <br /> ___ <br /> NN IUNDUNO UNIT C.t M. �— <br /> URINALti __. ._' _ _.-'_" '__.. . . . ..' __ _" 1"' '_" <br /> WNEnCIOtiI'.TS � . . ..._ .. . _. . . _ . . � <br /> Wn7fI111f.AIENti - ELECI:NIC � WATER NEATER • . �... " �__ <br /> WAiH BASIN5 - � FAC. BUILT fIREPLAC! R CHIAINkv � _ I <br /> LAUNDflV TIIAVti CAS�SvSTEM� NO O► OV TLI 15 � _r <br /> 1 _ 3..— <br /> — ' _'.___ ." ._' .9ufllUfnL .Si . ... . I <br /> � '_" ___'_ _____ ____iE11Mlt SI "_""'""_.'�- <br /> — " _ � _ _ __..____" _ - '"-i(�Tnl fkF $ I <br /> SUO TOTAL __.� __... <br /> PGRMIT 5 �����: vfl�MiT IIEC(1Mt5 NV. 1 nNt� V�iil) �i WunY, nH CUN!;Tltu[ <br /> TOTAL FEE -� T�nN �Ufllpl11LE11 ii NO� Ct.`+MIN[1Il WiTr��N 1?0 C•��':. OP iF <br /> CUY:if1UCI�ON Ofl WOIIK L': !;V: -'^rt�f0 0ll P•I�NppNU) t0{: A <br /> WATF.R SfNVICE $Vf 91f1C SU{`PLY Sllf Vtf110p 01 1J0 OA�S AT /�Nv IIM! N ttn..:'nK c:Cl"d�AfNCFU <br /> + + lK HkAHYAHUSFItlACR 1 IIIRt.11v ClI1TIiY T1141 I IIqVL IILl�il11NI� F�INR�INIfI �111: .\V <br /> - HUC�Ii(�N f�Np KNI1W 1111. Sr\plF 10I�L 7f1UF. ANU C(��:�1! Cf. AlL'. <br /> Plif1VISIONi O� 1 �1V: �NU p11DIN�NCFti fUVl1lh�Nc'. 1���5 ivPll <br /> Of WOIIK Wlll BECOMPI�FUWIf�iN'��FT��ER :1V(GF�!O ��EREIN' <br /> U::l /UNL LU7 AHLA V/�CANI SITL T- U�i NOT. TI❑� (i11AN71NG �If n FEfib�il pOlS NpT PnFSVME �O <br /> (i1VE 11UTIiOflliV TO ViOlAfh OH C4NCLL T��E �'�UViSipNS OFI <br /> ❑vE5 ❑HO nNY OIHCfI STME O11 LOCnL 1 nW 11L(fU1.l�TWii CON5T11UCTION <br /> iiYVE O��CONST. UCCUPANCY GNUUP NQO/OW!�.�ING Ofi THL PCIIFORM�NCE O� CONSTf1UCl10N <br /> � UNITS � <br /> 512( OF O��C. NO. OF STORIES MA%.00C. LLAO J � � <br /> X JJ =�/�.��_��t��s�'���_._y_y�7 7 <br /> SIi1Nnl nt./NcuN1RnC1 IlnNnu 1� nLINr Pnr( <br /> IINlZONF IM!;lMLNI Ilfil ':I'IiiNRi,l15 <br /> FlOU�NLII L:.NCIIIl6NUM11L11 PL/�NCrILCKIIt <br /> ❑res ONo 14i �i¢eeirrtir� <br /> SPkCIALCONO�TiONS _ �I�'/ . , . <br /> h ') <br /> FEES VAlUAT10N iF.E <br /> ' _�_ _"—__'_ _ '_..'_.T__ <br /> —-'__"_r.'—_"� � <br /> .__' "'_"._ __.___ _' "'__L'_ <br /> _�""'- '- HUIIDING { � ' � ' . <br /> . � <br /> � ---- —. .. ':.--.. . - -- -- �--�. ._r-- <br /> � vlu�+n�N�i <br /> SEPA REVIEW COMPLETE ❑YES ❑ NO � <br /> conlact q p • � <br /> Plannin de (. MLCII�NICM i <br /> __ �._ <br /> on¢a ' <br /> i <br /> — ----T— <br /> w�������++•��v��u��nU�41lMILl1OY� �MMOVIf10�iKIY� PFNI1LtV SEC. ]OJbI � <br /> '_�_�_.��_.��_ _. _.. ...___ . -.. . . �._.._ <br /> � � L_" <br /> � TOTAL i 1 <br />