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a��■ <br /> ��^� APPLICATIOI'''FOR CONSTRUCTIt"f�l PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT � <br /> LHEATING SYSTEM: U GAS fJ ELECTRIC 01�1?_ L�r c•—r__--- 1 <br /> 3UILDING DEPARTMENT <br /> 'S9-8810 <br /> DEMOLITION COMBINATION BUILDING �1GI�CHANICAL �-'PLUMBING SIGN <br /> �WHEp M�il�D�AE55 f.l1V IIP PNONE <br /> ao..,�. 3003 ��S,No R.i E��,.�++ �eoZ3 <br /> --�- ---- ----- - --- -- ------- - --- -- - - - <br /> ENANT M�II�WRE55 CIIY T�P PNIXIE <br /> 'S p11/6�� <br /> ACHrtECTORbES�GNER M�LL�DORE55 CIIY SiP PMONE <br /> 'fL� a..�s�t.. ¢o �oo f�.► �6M^�� R..�.�o�1 9 y o s r zZ�-g rov _ <br /> �ENER�lCON1N�CTOR MML�ODRESS GfY ZIP PMONE STAIEUGENSE� <br /> ri.._A.+.si��. pc. 0ex 23s7 Ev�.�.�{I, `14203 �.�b-cave zt'i-oi-A�U-s7- �c Z��N3 � <br /> �e�E���coNTc��l�llcr�l'11"7 Oa.ivo;} fMJ ��Sa.aHl�� ti {�10` -7G')-1�0o N1ACT�•UoW1+k2447'9_ <br /> UMBING LONTR�CIDR M�il�DDRE55 GI7Y 21V PMONE ST�LE IICENSE� <br /> �y ewu� /Ks�s��.ow�i�--- --- — --- <br /> ���s a won� <br /> VNEW ADDITION ALTERATION REPAIR DEMOLITION WOODSTOV6FRPLINSERT . � BUILDIN6RELOCATION <br /> 7 CUNT�GT PcERS�O�N�NDVIIONE N/O� <br /> pITRACT PRIGE O�W0111t � I �� / TA S�� �7CG� O�+C � <br /> �ESCRIBE WOHN AND SOU�NE FOOi�OE INVOLVEU <br /> 2 G G - 5 '1-� ef <br /> �aovosenusea•�unox�c I HEREBV CERTIFY THAT I HAVE READ AND EXIIMINED THIS <br /> �A f�V�1,t�c�L'�-u V i K APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> EG�L DESCN�FTION Oi PROPERTY ISHOWN B OW ON ATT�LH FWR COPICS� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS NPE OF <br /> WORK WILL BE COMPLETED WITH WIiETHER SPECIFIED HEREIN OR <br /> ot eiocK or NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO 61VE <br /> AUTHORITV TO VIOIATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER SiATE OR LOCAL LAW REODUTINO CONSTRUCTION OH THE <br /> PERfORMANCE OF CONSTRUCTION.THAt I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STAiE <br /> CONTRACTORS LAW 1827 RCW AND 29fi200 WAC. <br /> 22 <br /> x�•�/1.�.-��J�-'la'a"�'` v-�-5 L <br /> 'ROJECT�ODRESS I ( F/]� sn'�xennil o�rE <br /> 31/l1 \�1 �� �O ' �� • / ( a LI�Yfl115Wf55111fMSf Nfl <br /> K�d MECMANICAL <br /> qp, T17E Of FlIfTU11E OII ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> WATER CLOSET ITOILET) Z NC—NHNDId UNITS=H.P. _?1 p � <br /> BATHTUB FORCED AIR SVSTEMS—B.T.U._M E.A. <br /> --+— <br /> IAVATOHV(WASH BASIN) � UNIT HEATEFiS—B.T.U. M <br /> SHOWER CLOTHESDRVERS ' <br /> KItCHEN SINK 6 DISP VENTIUTION FAN 2 5 <br /> DISHWASMER —T- RAN6E HOOD _ <br /> LAUNDHVTRAV ; WATER HEA7ER <br /> CLOTHES WASHER � WOOD STOVE <br /> URINAL ' METAL FIREPUCE 8 CHIMNEV <br /> DRINKING FOUNTAIN � FIFEPLACE INSERT � <br /> T <br /> FLOOR�RAIN HEAT PUMP <br /> BACKFI.OW PREVENTERS ' ; - GAS PIPIN6 I <br /> ROOF ORAIN�RAINLEADERS � EXMAUST�AN <br /> SIHN�SERVICE—BAR.ETC.) ' <br /> — T <br /> T <br /> — � <br />� SUB TOTAL S SUB TOTAL S , U '�" <br /> PERMI? S ��� PERMIT f '�� <br /> TOTALFEE S S� TOTALFEE { ' <br /> FOR OFFICE USE ONLY: <br /> �RpI15E7B�Clt REARSE18�Gk SIUESEfB�f,R PI�NGNtCRNUMBER FEE RFCBPLNO <br /> X <br /> �se mr�e �or�ne� C�NT S17E FEEB VALUATION FEE <br /> BUIlDINO ' <br /> ___�— <br /> 'YPFpCONi5Au0W�81! !YP[qCON51ACi11Rl atuaew raptMlwruhns <br /> �"0°a PLUMBINQ O d <br /> � � <br /> 5q[ag�pp IqOFSTORIES BASEMENT MECHANICAL � <br /> OC <br /> ]CCUP�NC�IO�U �iRESPRNNlER5RE00 MEqMTIIMIUTION p�01TI0iULPLANCHECN � <br /> SPRINN�ER ' <br /> RE�SONfORSPPINnlENS -- —T— <br /> STATE'NILOING SUHCHARGF_ <br /> Nu�ee. —" a� �Ponoveoe. CITY OF EYEREIT PUBU�WOHKS ; <br /> � LOCAL 8ALES <br /> TAX CODE 18 J105 TOt LL �7��, ;o�, <br /> �..�� <br />