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APPLICATIC" 1 FOR CONSTRUCT� �N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT — I <br /> BUILDING DEPARTMENT HEATING SYSTEM: U GAS U ELECTRIC U ---I <br /> 259-8810 <br /> I I DEMOLITION I I COMBINATION I I BUILDING I i MECHANICAL I 1 PLUMBING fJ SIGN <br /> OWNER MAII�DORE55 CITV 21P PIq11E <br /> /J i r <br /> �,�7���J� � .�ni,n. � 'at. a� .�< . .�p GV�/ZE? <br /> TENQI7 IAe1LA00 E55 { CITY ZIP PNONE <br /> ������ <br /> �NCNITEGIOROESIGNF.R M�IL�DDRE55 CITV 21P PHONE <br /> GENCRAICONTRAGTOR MMIAD�PE55 CIiV ZiP P110NE ST�TELICENSE• • <br /> / / /�)�� <br /> / -�RLL l _A�JJFIJ ��u..�c l O l3oK i. 7L?� !?c.UiJ�,. l��.� 9�(�8 —C172_ Q <br /> ME WIGLLCONiRACTOR /M�ILA�DRE55 GTY_ qIaIP �/ `7/PNO�NJE / ///y��ST�(TEL�CENSEI (-� <br /> vLUMB1 0�RACiORv M�1R�DOSQ,� j��ll�� CITV��LE /OP�Y /(OP J�1 I 1/�5(�EILINN�'Z /Z N� <br /> '• COIliP�CT VRICE OF WORK <br /> '� .�� <br /> �IBE WONK AN�SOUAPE FOOTAOE INVOIVED �pryi�LT PEP50 D PHONE 1{0. <br /> A^'f �U_) ^' �_� � I C,�J�S�U �. <br /> ��J �Jt �"t. <br /> ' u'`� ' dT" 1 HEFEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSED 115E OF UILDINa APPLICATION AND KNOW THE SAME TO BE TRUE AND COHHECL ALL <br /> PROVISIONS OP LAWS AND ORDINANCES GOVERNING THIS TYPE OF ' <br /> IECI�LDESCRiPTIONOFPROPERTY�SNOWNBEIOWORATTALNTWOCOPIES� WORK WILL BE COMPLETED WIiH WHETHEH SPECIFIED HEREIN OR <br /> iot e�ocK oF NOT. THE GRANTING OF A PERMIT DOES NUT PRESUME TO GIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFOqMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE ''� <br /> OWNER OF iHIS PROPERTV TO PERFORM THE WORN FOR WHICH I <br /> APPLICAT�ON IS MADE AND I COMPLY WITH THE STATE <br /> P�RCEL T/U(I D.NUMBER CONiRAC70FS LAW 18.27 RCW AND 296200 WAC. <br /> CONSiRUCTION IOAN IENDER.�DURE55,TEIEPMq1E NOMBER `�' I � <br /> PR C7ADORE33 / � l--V�. "•• .--o-=—�,�,�� 3�9� <br /> � � scN,iunc art <br /> / {„�/J ��J J� �O `L,� / Ci�YDU5MF9514[NSLhO <br /> PLUMBINQ NECHANICAL <br /> N0. TYPE OF fll(TURE OR ITEM FEE N0. TVPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET� N�NHNDLG UNITS—H.P. � <br /> BATHTUB FOfiCED AIR SYSTEMS—B.7'.U. M E.A. ' ii <br /> LAVATORY(WASH BASIN) UNIT HEATERS—B.LU. M ; � <br /> SHOWER � CLOTHES ORVERS � � <br /> HITCHEN SINK 8 DISP � VENTILATION FAN � <br /> DISHWASHER RANGE HOOD � <br /> LAUNDRYTRAY ; WATER HEATEF <br /> CLOTHES WASHER � WOOD STOVE � <br /> URINAL METAL FIREPLACE(W000 BUANING) . .. <br /> DRINKING FOUNTAIN FIREPLACE INSERT ; <br /> FLOOR DRAIN � HEAT PUMP � � -,,� <br /> BACKFLOW PREVENTERS � GAS PIPING � <br /> HOOF DRAINS—RAINLEADERS � E%HAU57 FAN . <br /> SINK(SERVICE—BAR,ETC.) i.J�C ` ' , ,�l <br /> I <br /> � � % <br /> ,� <br /> � <br /> SUB TOTAL 5 � SUB TOTAL S <br /> PERMIT $ � PERMIT S � <br /> TOTAL FEE E TOTAL FEE 8 �. <br /> FOR OFFICE USE ONLY: <br /> FPONiSETBACN RE�RSETB�LK SIDESE78ACK F CMECKNUMBEH iEE � �� AEC TNO. <br /> G « �;" � c� <br /> USE 20NE LOT ARE� v�c�wr stte FEES VALUATION FEE '�, <br /> i: VES I �: NO BUILDING i �i <br /> }ypFp��pM51. NOOFSTOfiIES accurwcr xoauxtuixcuxrts .. <br /> 4PW> � <br /> PLIIMBING ' <br /> i i, <br /> SIZEOFBlDO. FlNESFRINNLERSREO'0 B�SEMENT MECHANICAL i ' <br /> f] YES :�`� NO <br /> OCCUPANUIOAD FINEALIRMREOA IIEIGNTIIAIITATION AOOITIONALPLANCHECK � <br /> OTHER ,. j� . /� � � Cn <br /> REASON —��� <br /> STA7E BUIL�I G SUFCHAflGE <br /> INTN(EBY PUNSAP N OBV CITYOFEVEflETT PUOLICWO{iKS <br /> LOCRLSALES <br /> DATE $'�� TAI(CODE IS 3105 TOTAL r�� �' � ��� <br />