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�P�l.IGATIG� FOR CONSTRUC'�.�N P�RMi1T ,��" � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRWT � <br /> HEATING SYSTEM: CI GAS ❑ELECTRIC U <br /> BUILDIN�DEPARTMENT � <br /> 259-8890 <br /> D�MOLITION COMBINATION BUILDING ECHANICAL PLUMBING SIGN I <br /> OWNEP ^ MPILAD E55 ,Z�.' �( •'� U1Y 21P PHONE � ' <br /> ,4�c�ici�� Il' r �'ac��tc.�i 1-v��2a_�-� 4�)_��/ .;; 9 -/?O� <br /> � � �y GTY 2i� PNON[ <br /> � iEN/Ji�� NAILJ.DORESS <br /> H <br /> C M ARCHRECTORDESIGNEN MRILRDIN1E55 ��ry Z�P �E <br /> b H N <br /> y �c� <br /> ��qy�,pNTpAtTpp NARMDq[S9 CITY ZIP PH01� STATEUCENSE� <br /> � H 71 <br /> � M ry MECXRNICPL Cdi11iRCTCJR 1V10.�UDRE55 CIIY IIP �MOME STATF LICENSE/ <br /> y � <br /> R z pUJYgRJpCONTRACT�H lV1M1/�DPE55 GRY ZIP i'110NE STATEL�ENSC• � <br /> � tt�� --I�' "•' .�I� <br /> 3 <br /> � C1A550F WOFK � <br /> � '� � � 1 NEW '� ADDITION � �. ALTERATION REPAIR � DEMOLITION �. WOODSTOVE/PPPL INSERT � � BUILDING HELOCATION , . � iu <br /> � H � $ � WNTRLT PENSON AND PHONE NO. y: ,r <br /> '' �v Y � <br /> M H CONTPACTPRiCEOFWORK 17��'^-+^� � {����� '�-�• <br /> SN DESCRRE WORK AND SOURHE FOOTRGE INVOLVED � <br /> O O N � Y L1!/II �•�'�� � <br /> xl°ar u� a <br /> ROPOS[DUSEO- URDIN / I HEREBY CERTIFY THA7 I HAVE flEAD AND E%AMINED THIS "!i � <br /> � y � � / �.. . O..1 APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL __ ;i.�� <br /> 0 �����"�� PROVISIONS OF LAWS AtJD ORDINANCES GOVERNIIJG THIS TYPE OF �d:',C � f. �. <br /> LEGA�pESGRiPtiONOFPROPENTVI� eE�owonnT*ncHFoueconiesi y�ORK WILL BE COMPLETED WITH WHETHEFi SPECIFIED HEREIN OF : ;I � ;i� � � <br /> �oT e�ocrc oF NOT. THE GRANTING OF A PERId1T DOES N0T PRESUME TO GNE � ��..I t�!; � <br /> AUTHORITY TO VIOLATE OR CANGEL THE PFiOVISIONS OF ANY . �N <br /> OTHER STAT�E OR LOCAL LAW REGULATING CONSTFUCTION OF THE � <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED 6Y THE , �,, 9= <br /> OWNER OF THIS PROPERTY TO PERFORM THE WOFK FOR WHICH .-.�� � � <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE .',�. � � , <br /> CONTRACTORS LAW 1827 RCW AND 296200 WAC. � �"� <br /> fY�' <br /> x oa:r ��� <br /> i � :�,rnouness � � <br /> 4 �i _ <br /> ;:;�cr �'� CC� y-�, � ,.. . ,. ' <br /> ����, PLUM0ING MECHANICAL � , <br /> ��p, TYPE OF FIXTURE OF ITEM FEE NO. TYPE OF EQUIPMENT FEE .,�-� ; <br /> WATERCLOSET�TOILET) A'C—A'IINDLGUNITS—H.P. ; � -�_�y, �, <br /> 1 BAiHTUB FORCED AIR SVSTEMS—B.T.U. M E.A. � � �n <br /> �AVATORY(WASH BASIN) UNIT HEATEFS—B.T.U. M � <br /> �'o CLOTHES DRYEFS ' ���µ <br /> I �' � SHOWER � VENTILATIONFAN <br /> KITCHEN SINK 8 DISP ' . � �i <br /> � DISHWASHER RANGE HODD _ <br /> LAUIJDRY TR�V ' WATER HEATEF - <br /> � ; il <br /> ��� CLOTHES WASHER � WOOD STOVE �_�.�,�.�. .rl <br /> �� �� URINAL ' METALFIPEPLACEBCHIMNEV � y-` � 4 <br /> � ; FIREPLACEINSE(iT � ' <br /> D(iINKING FOUNTAW :�> — <br /> FLOOR DRAIN � HEAT PUMP � � . - <br /> � ' GASPIPING ��� � � ':� <br /> BAGKFLOW PFEVENTERS <br /> �1 ' ROOF DRAINS—RAWLEADERS � EXHAUST FAN ' � _���' �' <br /> SINK(SERVICE—BAR,ETC.1 i � ���� � � - <br /> � � ��f�� }, .•ryl <br /> !1 ' • — 'il.�.f��in:ll <br /> � '�'��'-�._. <br /> I I � SUB TOTAL S SUB TOTAL S '���7;:i-� <br /> �I �� PERMIT $ PERMIT S ! ' 1I1. '-'� <br /> I �1 �- TOTAL FEE S TOTAL FEE S 3Q ,"�_ ,- <br /> \ FOR OFFICE USE ONLY: 1�V�'� <br /> FRONiS[L9�CH AEANSEI[i4CN SIOESETBPCK PL/AyN,CHEC/K�NpUMBCR FEE R«EiPt���� �i_�, • - <br /> /�/ '� _.SO ip� <br /> us�ZpNE LOT�RE� vncu+Tsire FEES VALUATION FEE �. } `� <br /> DUILDING ���� - <br /> lYPEOfCONi6.�iLOWI�BIE TYPEOfGOHSiA;tUAI �r Nouownin:cuw�s <br /> PLUh1BING <br /> S¢EOFBI.DO. NO.OFSTORIES BASEMENi MECHANICAL G � � <br /> i <br /> ' OCCUPANCYLOAD FIPESPPNKLERSREOD HEIGNTIIMIiF110N <br /> ADDITIONAL PLAN CHECK � <br /> SPHINKLEF ' <br /> --T— <br /> R[ASpN FOR 5%11NNLERS <br /> STATE BWLDING SURCHAFGE <br /> iIJtAKEBY PUHShPPROVE00Y CITYOFEVEREi7 PUBLICWORK$ <br /> LOCALSALES � <br /> TAX CODE IS 3105 T�Tp� 7d '� <br /> — <br />