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_,l <br /> � `�' , APPLICATIO� FOR C�NSTRUCTION PERMIT � ' "' ''' I <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT ��/ I <br /> HEATING SYSTEM: ❑GAS J BIECTRIC J.__ � <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> �� '�'� DEMOLITION COMBINATION �BUILDING MECHANICAL PLUMBING SIGN <br /> ��]] OWIRq(,GAt!l'. - M�IIA�DRESS � dTV ZiP VNpIE I <br /> p ((p��?? -ri� QoE��rG co. �?e. �S�x 37�7 �/5 �?r=-7� ���. w� 9Rr2s' 3Yz.-s�7!' <br /> q y TEN�NT MutMDRE55 �CITY 21 PHONE <br /> `TR-E BoEiN/ C'o. <br /> Fj .�.� 1PCNRECT OR DESIONENh��"�����ADORE55 C�TY IIP P,qNE <br /> � A (Sva.tiG�..E�n/ �110LSicC C:. � C /�ioJ( �Jy3 /SS/1c�ti?�F L�/A.y"�"<�7 ?��— ! L)'i <br /> O� O OENERQ LONTRACTOR M�IL��ORE55 � CITV 21P VIIONE 6TRE LICENSF� <br /> ,�y�j �../2i6Hi SC,lt�t'.,: 1-�.t' �nn.<Scr.Q: �'-�' f�'t _�.7�`l .SEii-,lrL' , �^'n 9r��'aJ Gc•�r/wr_i�,h-�=/G� i''^� <br /> MELN�NiCK Cp11P�CTOR MML�DORESS LrtV 7iP PNONE ST�TE IIGEHSE� <br /> ��� <br /> � PWMBMGCp1TR�CTOR M�R�OOFE55 GTv SiP PNONE ST�TEIiCENSE� <br /> ��8 <br /> L�• C'a LL�SSUFWONN <br /> � � � �NEW � ADDITION . ALTERATION REPAIfi DEMOLITION . WOODSTOVE/FFPL INSERT �. BUILDINQ RELOCATION <br /> S� C(1NT1LT PERSON�ND PNpIE Np <br /> I c1,.n/��,n <br /> �y LONTR�CTPRICEO�WMIN �nN �L��fii��i(>!//�-S�I <br /> DESCRIBE YIORK RND 6W�RE FOOT�GE MVOLVEO <br /> q�� t�n.n-�`cti '�v7Y ;F 26 h -3s 63 <br /> � r PROPOSEDUSEO�BU�LDi'IG i HEREBV CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> y y UI-F�L(3 T�Ir-i LSti- y��' yU T APPLICATION AND KNOW?HE SAME TO BE THUE AND CORRECT.ALL <br /> 0 LEWLUESGAi�TIONOiVPOVERTYISHOYMBELOWOP�T��CHFDURCpPIE51 PROVi510NSOFLAWSANDOR�INANCESGOVERNINGT4ISTVPEOF <br /> WURK WILL BE COMPLETED WITH WHETMER SPECIFIED HEREIN OR <br /> �ot eiocK oF NOT. THE GRANTING OF A PFRMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITV TO VIOLATE OP CANCEL THE PROVISIONS OF ANV <br /> OTHER STAiE OR LOCAL LAW REGULATiNG CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTMORIZED BV THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296200 WAC <br /> ._j1- i <br /> X .a.fl �-�'G�^M-�� � 7 /'.' J. <br /> PROJECi�DDREI5•5, / n 9ce� mi u�+[ <br /> 3QO� V�/. �T.S/NQ /G/� I L �l � l CIiVBUSMlSSI�CEN5EM0 <br /> P�.UMBING MECI:ANICAL <br /> F� NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> � '� WATER CLOSET(TOILEiI A'C—A/HNDLG UNITS—H.P <br /> � � BATHTUB FORCED AIR SVSTEMS—B TU. M E.A. <br /> � � LAVATORV�WASHBASIN) UNITHEATERS—B.T.U. M <br /> SHOWER CLOTHES URVERS <br /> i �� KITCHEN SINK 6 DISP VENTILATION FAN <br /> � DISHWASHER RANGE HOOD <br /> LAUNDRVTRAY ; W�TERHEA7EF <br /> � CIOTHESWASHER —� WOODSTOVE <br /> URINAL METAL FIREPI.PCF.6 CHIMNEV <br /> _� �RINKING FOUNTAIN <br /> FIREPLACE INtiCFT <br /> FLOOR DRAIN HEAT PUMP <br /> BACHFLOW PREVENTERS GAS PIPING <br /> '�1_' ROOF DRAINS—RAINLEADERS E%HAUST FAN <br /> SINK ISERVICE—BAR.ETC.) <br /> �y <br /> — --T— <br /> SU6TOTAL 5 SUBTOTAL b <br /> I PERMI7 $ PERMIT E <br /> I �+1� TOTAI FEE b t _ Tl1TqL FEE S <br /> l � <br /> � FOR OFFICE USE ONLY: <br /> -- FRONfSETB�CN PE�RSEIBACN SIDESELB�CN PL�NCNECKNUMP'F �EE �ECBviNC <br /> ��. �j� �� �. /�a / . t (,. <br /> useia+E wt�nEe wc���rsrte FEES VALUATION FEE <br /> BIIILDING � <br /> 1VP[Oi LONiS�IIOWAB�[ IVVE a�LON51 ALIU OCCutiFn �w a D+il�rx:m•5 '-- — <br /> _ N v w' rluMeiNG _ _ <br /> SIZEOFBIUG NOOf5�OR1[5 BASEMENt MCCHANICAL <br /> � � Sti.�r 1 <br /> CUP�NCVIO�D fiqESPANfllER5RE0� HEIU�iLiMilAliOH AUDITIONAIPLANCHECK _��� i.� <br /> 2 ,I 11 SPRINNIER ' <br /> RE�SONlORS�PI':NlENS M V --- ---- --� <br /> SiA7E�UIL�ING SURCN4qGl' U i� <br /> INT�NEBY PL�NS/�fPFOVfUOY CITYOFEVEREIT PUBLICWOFNS <br /> 1 �.� i LOCAL SALES <br /> � TAX CODE IS 3105 ro*ai /�' - ' <br />