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APPLICATION FOR CONSTRUCTION PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PpINT ����y� <br /> BUILDING DEPARTMENT HEATING SYSTEId_]GAS ❑ELECTfiIC f] _ � <br /> 259-8810 <br /> i i DEMOLITION I I COMBINATION BUILDING i i MECNANICAL i I pLUMBING I I SIGN <br /> aW1�ER MAIL�DOpES$ <br /> T/yr CIIV 21P PIIOIIE <br /> �� QDE�nr6 c�. �?e. 6ux 3')u7 ���5 _n�- C <br /> �E�����, —. .��se�Tc.E w� . 9��LY 3Yz -�f78 <br /> / � MAIIADpRF55 b1Y , zIP <br /> 7RTt e li3 Ql✓Nl.��/ f'IqNF � <br /> MLMIp1CTOq0E51G!!Fp AI�ILADDRE55 CIIY <br /> lIP PIIONE <br /> �OVMf ErrG �ntCCn..f �Q� SP�v �r�sv� it-V�,r 5�'0,�?.✓E w/J . <br /> CENERALCONIMCiOfl IA�ILAODIIESS — —� <br /> C��Y Z�r ���n��E SUIEIICEN5E1 <br /> RIECII'NIG�LCpNf1UC7011 NAl1�0011E55 CIiY <br /> ZIP PIIONE STAIE LIC[IISE I <br /> PlUM01NdCONIf1AC1011 MqILAU011[5: ���� — '� <br /> ��� PIN�N[ St�ff LICENSG� <br /> CLA55OF Wp11N <br /> I I NEW �I ADDtTION I I ALTERATION I I REPAIR I I DEMOUiION � I WOppSTOVE/FRPL INSERT I I BUILDIN6 RELOCATION <br /> coNinci rensoN nrro mwr�i r+o — <br /> CONiRACTPRICEOFWOlIN L�'�UN/i� �jT�Jy�Qp2S� �-G6 'S.( �� <br /> UESCBIOE WORN ANU SWARE FOOUGE INVOLVEO <br /> C.Iflu,Ert. LkPR-.�/5reel — <br /> vnoroseo use ov euaowa <br /> Prt.o✓rve /Nc,6SMEG C/�-/hcr � � HEREBY CER7IFY THAT I HAVE READ AND EXAMINED THIS <br /> lEO�LDE5C111PIlONOFVROPE11tY�5NOWNBELOWO(I�IiALNUF/pURCOPFS D w�T PROVISIONSOF AWS NDORDI AN ESGOVERNING7HSTYPEOF <br /> tor g�p�g oF WORK WILL 8E COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRAN7INQ OF A PERMIT DUES NOT PqESUME TO QIVE <br /> AUTHOR�TV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STA7E OR LOCAL LAW REGULATINO CONSTRUCTION OR Tf1E <br /> PERFORMANCE OF CONSTRUCTION. THAT I qM AUTHORIZED BY THE <br /> OWNER OF TFIIS PROPERTY TO PERFOpM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COAIPLV WITII THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 2g6200 WAC. <br /> PfIpJECT�DDfiEI5.5. --- x ��// � � " •�" � 3/Z 9•.�� <br /> U yy• SifJUIUIE <br /> � �StNa RD. �d-�a ��� <br /> PLUMBINO c�v euswEss iccr�sc�u <br /> MECHANICAL <br /> N�• TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT <br /> WATER CLOSET(TOILET) FEE <br /> A/C—NHNDLG UNITS—H.P. <br /> BATHTUB , � <br /> FOHCED AIR SYSTEMS—B.T.U. M E.A. �— <br /> LAVATORY(WASH BASIN) --�-— UNIT HEATERS—B.T.U. M � <br /> SHOWER � CLOTHES DRYERS � <br /> KITCHEN SINK 6 DISP _ �__— VENTIIATION FAN -- , <br /> DISHWASHER , <br /> LAUNDRYTRAY RANGEHOOD <br /> CLOTHES WASHER ' WATER HEATER � <br /> URINAL ' _ W�DSTOVE � <br /> METAL FIREPUICE 6 CHIMNEY , <br /> DRINHING FOUNTAIN FIREPLACE INSER7 — � <br /> FLOOR DHAIN � HEA7 PUMP ---'f— <br /> BACKFLOW PREVENTERS ; GAS PIPING � <br /> ROOF DRAINS—qAINLEADEHS � E%HAUST FAN �'— <br /> SINK�SERVICE—BAR,ETC.) � — ;__ <br /> � <br /> � — � <br /> � <br /> ; <br /> _ _ � <br /> � , <br /> � � <br /> SUB TOTAL S ' � <br /> PERMIT E � _ FiUB TOTAL S � <br /> ' PERMIT �— <br /> TOTAL FEE E ' TOTAL FEE S --�— <br /> FOR OFFICE USE ONLY: � <br /> FqONlSE7BACN REAPSETBACN SIDESEID�CK PUNGNECKNUMOEH FEE <br /> 3S� �/ n�ccinrra. <br /> USEZONE IOTAREA V�CANISITE FEES <br /> VALUATION FEE <br /> IYMO/GONISAILOWABIE /YV[qCONSIACIUQ rcx�eµc. DUILOING —�— <br /> xn nr�miiwcuxiis � <br /> r.nan _— <br /> PLUMOING � <br /> i <br /> SIZEOFBLDO. NO.OFSIORIES BASEMENt � <br /> MECHANICAL � <br />, i <br />� occuru�cv�oeo vme srn�iKi¢as neoo u¢roi�r uuiunor� ADDITiONAL PLAN CHECK i <br /> � <br /> NEASON Fpq SPRIIIklENS SPHIIlKLER � <br /> � <br /> STATE OUtLDINa SURCHAf10E --T_ <br /> MINtEBY ' p�µg�pppOVEDBY CITYOFEVERE7T P(�BLICWORKS �— <br /> LOCAL SALES ' <br /> TAIf CODE IS 3105 TOTAL , <br /> _ : <br />