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�� APPLICATIV�I FOR CONSTRUCI �O!� PERMIT <br /> � TQ BE COMPLETED IN BLACK INK—PLEASE PRINT ��T <br /> BUILDING DEPARTMENT HEATING SYSTEM: U GAS ❑ELECTRIC O � <br /> 259•8810 �� <br /> ❑ DEMOLITION ❑ COMBINATION Y BUILDING ❑MECHANICAL __I PLUMBING ; SI(3N <br /> OWI�ER MARI�UDRES6 -ft CRY 21P PIIONE <br /> 7� �oEi�r� ��, �?o. �Sox 37�7, M�5 ��-�� �,��, w�. 9 r2� 3Ya•-sP�P <br /> TENANT M�R ESS Crtv LI/ PMONE <br /> Tl'F£ BoE7NG, Co . <br /> ARCMRECTOR�E6qNER M�R/�DURESS �� CITY ZIF P110NE <br /> T/* /+�/ST�,✓ G✓. //�/t" �/� - M'V .W_ �vSr�L;C",bvR . 9A'Zoy �9c � 9/7L <br /> OENEMlCp^1iW�CTOR �ILADDRE55 CIN 21V P1qNE BTnTEIICEN9E� <br /> r��F /T�C)STI�1 C<) R"TML <br /> MECM/J/q�LCONTMGTG9 MIIRADDREFS CITV 2iP PMONF 6t�TELKEN5E1 <br /> P VIABMOCONTRAf,TOP MA6ADDRE6fi CITV Z�P FMONE 6TATELIGENSEI <br /> CL�SSOF W011N " <br /> �1 NEW ❑ ADDITION C 1 ALTERATION LI REPAIR L '� DEMOLITION :-, WC�DSTOVE/FRPL INSERT ; I BUILDING RtLOCATION <br /> � -7 COMt�GT FERSON/YD iMONE NO. <br /> CONTR�CT PRICE OF WdiK /D� i O(� L.L�d N 2 Eh7 2 � <br /> DE6LRREwORKAND60U�REF00U0E OLVED �6 6-3s 63 <br /> r� .iC^ c- c ' - CyN�, <br /> rqoroseouseoveuaon+e I HEREBY CERTifV THAT I HAVE READ AND E%AMINED THIS <br /> ��w6� ,� �E��-Pf f.�p/Ls- ,�VGT/Si�ni F- APPLICATION ANU KNOW THE SAME TO BE TRUE AND CORREC2 ALL <br /> LEO/�IDESCFIPTqNOFPROPERTY;SMOWHBELOWORATT�LMFWqCOPIEB) PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTVPEOF <br /> WOFK WILL BE COMPI.ETED WITH WHETHER SPECIFIED HEREIN OH <br /> �or BLOCK or NOT. THE GRANTINi� OF A PEHMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITV TO �" 1�.ATE Ofl CAuCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR�JCAL LAW REOI �.ATINO CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION THA1 I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERT/Tp PERFORM THE WORK FOR WH'CH <br /> APPLICATION IS MADE F,NU I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.2�RCW A4D 296.200 WAC. <br /> / � e <br /> X �_,.�..u,( �' ��;.�,�,,�.-�. • y�v 9,, <br /> PNOIE�T�(1pRFI5•a, /� ��nu�nmE �/ n•r• � <br /> �3 �IV. C.i�.f/A/Q /C/�� CT'!�IlMF51lKEMFMO • � <br /> PLUMBINO MECNANICAL _ <br /> NO. TYPE OF FI%TURE OR ITEM FEE N0. TVPE OF EOUIPMENT FF.E <br /> WATER CLOSET(TOILET) A/C-l411NDLG UNITS-H.P. _ <br /> BATHTUB FORCEDAIRSVSTEMS-B.T.U. M E.A. <br /> LAVATORV(WASH BASIN) � UNIT HEATERS-B.T.U. M <br /> SHOWER � CLOTH.ESDFVCRS ! <br /> KITCHEN SINK 8 DISP ; VENTILATION I AN_ <br /> DISHWASHER � RANGE HOOD <br /> IAUNDRVTHAV ; WATERHEATER <br /> CLOTHES WASHER � WOOD STOVE _ <br /> UHINAL METhL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN � FIREPLACE INSERT _ <br /> FLOOfi DRAIN HEAT PUMP _ <br /> BACKFI.OW PREVENTERS GAS PIPING ___ <br /> ROOF DRAINS-RAINLEADERS EXHAUST FAN _ __ , <br /> SINK(SC-RVICE-BAR,ETC.) _ � <br /> I <br /> SUB TOTAL f SUB TOTAL S <br /> PERMIT S � PERMIT S � <br /> TOTAL FEE S TOTAL FEE S <br /> FOR OFFICE USE ONLY: <br /> FRONT 6ETBAGN RE�R SETB�CN SIDE 6ETBACN PIMI CNEGN NUMBER FEE RECEI�'T NO <br /> .s�S �l <br /> use zone LOT�RE� V�GANT SITE FEES VALUATION FEE <br /> BUILDING <br /> 7oa �y G3 9 'Sd <br /> TYPEOfLONiSAIOWAlIE TYVFO�Cp15T�L1U�l OCnMKr IqdOMWMGukrtt - <br /> �"0°" � PLUMBtNG <br /> 6REOFBLD6 NOAF6�ORIES BASEMENT MECHRNICRL <br /> OCGUP�NCY IO�D FIRE 6PRNKLERS REO'0 NEIONT IINIT�TION �LL PUN CHECK 7/ ) � �p <br /> i <br /> SHRINKLER <br /> 11EI150NFORSPRMKLERS � (�� <br /> ST/IE BUILDMG SUP�NFHGE � <br /> INT�NEBY l/MS�PPROVEOBY CITYOFEVERE7T PUDIIC\VORKS ~_ <br /> r1 LOCAL SRLES ^ <br /> ,fr� TRX COOE IS 3105 T�T�� y .3 S`f ; �b' <br />