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, � �� � APPLICATIOI�'rOR CONSTRUCTIO,� PERMIT ���«" <br /> l �p� <br /> a� �--� <br /> 'f � TO BE COMPLETED IN INK—PLEASE PRINT � y� <br /> � IM Er+Nreen � .. <br /> " CITY OF } , <br /> eVeYe�l HEATING SYSTEM• ❑GAS U ELECTRIC ❑_ � ' <br /> BUILDING DEPARTMENT <br /> 259•8810 <br /> i l DEMOLITION I"1 COMBINATION ,C{I BUILDING I l MECHANICAL CI PLUMBINO I 1 SIGN <br /> � � ONME11 WRADDPE6S CITV SIP VNONE <br /> t ��N6 co Pv•6o,c 370� n,�Sot -�G S"�N�"i.���.,n 9'Pir.y 3Yz -aaz� <br /> R � � MMLMMIE55 CITY � PIIONE . <br /> TENN/I�T�� <br /> �r� ARCNIT'GT,�SIONEfl M�M1�PE55 CITY t P i PIqNE � ., <br /> C <br /> A� MARAWRESS � GITY ZIP PIIONE IICEN5E1 . <br /> yG dE11EMLCONfMGTOR /�iC�j.f�Ci.L� i <br /> M <br /> ■� � s-Ti�c /3��'z z �,+(Q...� .rw _R-.- 9sis G s�Z- s9�o � <br /> MECMANIC�LCONTNGT011 1ML�DMEbS CITY 21P P�E IICEN5E1 <br /> � RUIBNOGd/TMGT(Ni AUR/�DDPE63 GTY SIP „ P110NE LA:ENSE� ; <br /> � `� <br /> p ��� � �- . <br /> a NEW ❑ ADDITION ❑ ALTERATION f.] REPAIR ❑ DEMOLITION ❑ WOODSTQVE/F4'.^�.INSERT ❑ BUILDINO RELOCATION `t <br /> Ld1UL7VFASp1ANDP110NEM. �� <br /> p C..�.�,�,t�tin /�SrE..�QorGsk r 2Gi -3.f�13 <br /> �dRMLTP111LE OF W011R Z I O O O <br /> r pE9Cqgc WpIK/J!O BOWINE F00T�6E y[o <br /> � G'7 5� PL�TKotiw. ai++...-..s c.-�s-L.. �%�r-�'-�. ;,_�. <br /> pppY09E0USE0FBUlDNO I HEREBY CERTIFY THAT 1 HAVE READ AND E%AMINED THIS Y <br /> � , jYl�{�nI TS NN✓G6 �LM7'f�'/�M _ APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL (,. <br /> lFML0E6GPIPTqNOiFR01'ENTYI��NBELOWONATTACHFWRCOP�ES) PROVISIONSOFLAWSANDORDINANCES60VERNINOfHISTVPEOF <br /> ��y .. WORK WILL BE COMPLETED WITH WHETHEP SPECIFIEU HEREIN OR <br /> M ioT giocK or NOT.THE ORANTINO OF A PERMIT DOES NOT PHESUME TO�IVE <br /> � AUTHORITY T9 VIOLATE OR CANGGL THE PROVISIONS OF ANY +� <br /> � �� OtHER STATE OR LOCAL UW REOULATIN6 CONSTRUCTION OR THE � <br /> PEHFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIYED BY THE ���� <br /> � OWNER OF THIS PROPERN TO PERFORM THE WORK FOH WNICH <br /> " "'r" APPLICATION IS MADE AND I COMPLV WITN THE STATE ' <br /> CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> ' bqN�TUPEOiCONiP�CT011d1AUfNOH�1E0�6ENT D�iE ; <br /> - X�*-� ,� G��� /����9� <br /> � PPWECTMqlE69 n /�ppLM�WTSGITVB1151 SSIIGCN5E1q.MlOBU5MF54NM1E <br /> , o �„ CLSlNO I`-D ��—O� <br /> �� . ��5�� MECHANICAL <br /> -•.\- Np, TYpE OF flIfTUNE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> r WATEH CLOSET(TOILEn � A/C—NHNDLQ UNITS—H.P. � <br /> ���i BATHTUB <br /> � FOHCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> � UVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M � <br /> � CLOTHES DRYERS ' <br /> SHOWER � <br /> C� KITCHEN SINK 6 UISP 1 VENTMTION FAN <br /> DISHWASHER � RANOE HOOD <br /> � UUNONV TPAY ; WATEH HEATER � � <br /> CLOTHES WASHEH � WOOD STOVE / ' ' <br /> , r�. UFINAL ' METALPIREPLACE��CHIM.NEY � <br /> ` DRINKINOFOUNTAIN �'� � FIREPUCEINSERT � <br /> FLOOR ORAIN " HEA?PUMP ' <br /> � BACNFLOW PAEVENTERS ; GAS PIPINO I <br /> � �� � ROOF DHA S—RAINLEADERS � EXHAUST FAN ' • <br /> I �I I SINK SEHVICE—BAR,ETC.) � <br /> � � <br /> � � � <br /> � <br /> �; LI� ' ; �'� <br /> � SUBTOTAL f � PERM�TA� s �---�— ' <br /> PERMIT S � � � <br /> � TOTALFEE S TOTALFEE S '�. <br /> �' FOR OFFICE USE ONLY: <br /> - FPOIITSETBACN PE�NSE78�CK SIDESETB�CN �/Gn�Nti�/`,/ «E ��� � ��EIPTNO <br /> d� � <br /> J"/ <br /> USESONE 1OI11REA veceNrsrte FEES VALUATION FEE <br /> BUILDINO �1 �� � ��' '. �'� I <br /> (YVEOfLOMS.I�IlOW�BIE IYP[OfLOH5I�C111At oauwx[r wautti�'xc�"'�s i � <br /> I _ ', I I I _ w 1 ° 2 PLUMBM� �_ I <br /> V 'V i <br /> SIIEOFBIW� � i HU.OF5ia1�ES n�SEMENT MECHRNICAL I _ ' <br /> 80 � ' ' <br /> OLGUPNICYlW10 R11ESPfl11NlE11SRE0'� NEIOHiLIM1UilON AODITIONALPUNCHECN �yU � `��+ i <br /> I OTHER � <br /> � <br /> REASONFWISPOINNlEPS � � � <br /> STA7E OUILDING SURCNARGE <br /> INUHEBY Pl/�N PPPOVEOOY CITYOFEVEflETT PUBLICWORN$ —�� <br /> �H LOCAL SALES <br /> r� TAX COUE IS 3105 TOTAL '3E 0 � 9� � <br /> � . <br />