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APPLI�CATIC � FOR CONSTRUCT aN PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> r HEATING SYSTEM: �QGAS IJ EL[CTRIC IJ _ <br /> gIJILDING DEPARTMENT <br /> 259-8810 <br /> ! DEMOLITION I i COMBINATION � BUILDING T I. I I MECHANICAL I I PLUMBING I I SIGN <br /> O'NqER MNIADOfi[SS CIIV ].IP PItONE <br /> JhN GI�ouP 2151 WETNo1c�A�lE.5.5cr� EVL�ETt, bu�• `1aZo1 388-8�tcao <br /> IENANT MML�CDRE55 C17V ZIP PHONE <br /> p� 12ao WFhTCa.KEJ�VE.N. �E'J4'T'11-E.Wh.Ct81G1 285•33'1°5 <br /> �RCHIIECTORDESIGNEII M1UiL�DDPE55 cuv zm r�wuc <br /> _ D�uFf�T�►�K� �oo�Td►��Rl�-�.�'i.SfJ�TT1�,1.�• `181d� 292•92a3 <br /> GENEA�N111�C� 61�IL�[5���Q �1�.���/������ �'A�LIC� <br /> 3 <<...., <br /> MEp1ANICAlCON7R�CTOR AI�ILAUDPE55 CIlY ZIP P110N[ STATELICENSE� <br /> PWMBINGCONiR�CTOR MNL�UDRE55 CIIY ZIP PNONE STpTELICEN5E1 <br /> C TRAGAf PRICE OF WORR � <br /> I�'4 � <br /> DESCRIBE WOIiK AND SOUAl1E FOOI�GE INVOLVED CONTACt i ERSON A4D PIInVE NO <br /> (v►�'ao �.F��r c�F�cE/TEu�r �H- �IL;.�o�,J��'f�K1�F+1�K► 2`[2-g28`S <br /> t tt�+Y�"��T /`i � �^'V„� ���� I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br /> rno SED USE DF BUILDING r ��r ��y APpIICATION AND i(NOW THE SAME TO BE TRUE AND CORRECT.ALl , <br /> ��71DU � �2 O`�I�G �V�.�.1 • PROVISIONS OF L�WS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGRLD�ESGRIP➢ONqFP1i0PERTv�5110WNBElOWOqfiNYlAC117WCOCOPIES� r WORK WILL EE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �oT �--�—�� BLOCK�25 oF r �T�r �v���`� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> — AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> VowHE 3 O� p(,yC?�j� �1CjC� �� OTHER S7ATE OR LOCAL LAW REGULATING CONSTRUCTION OR TNE <br /> ' PERFORMANCE OF CONSTRUCTION.THl1T 1 AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR YlHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> AARCEL TA%I D.NUMPF.��V u�u� ��� CONTRACTORS LA B27 PCW AND 296.200 WAC. <br /> /ii���l <br /> Cdd57R�WANLEN�ER.ADDRESS.TELE�P110^ENUMBEfI <br /> 1 Y/tllle�T 1 A enQG <br /> /c Tr[„rr�Gr•�� n �D 7/ �:.� <br /> PROJ,�CT DREOSS �� � � sKnuu.�e nn�e <br /> •( �. <br /> � CIIYAUSME55UC[NSL 1ro <br /> PLUMB�NG MECHANICAL <br /> NO. TVPE OF f:!!:�URE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � A/C—A/HNDLG UNITS—H.P. � <br /> BATHTUB ; FORCED AIR SVSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M � <br /> SHOWER ' CLOiHES DRYERS - � <br /> KITCHEN SINK 8 DISP ; VENTILATION FAN � <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY ; WATER HEATER ' <br /> CLOTHES WASHER V�OOD STOVF i <br /> —�-- <br /> URINA� ' METAL FIREPLACE(WOOD BURNING) ' <br /> URINKING FOUNTAIN I FIREPLACE INSERT � � <br /> FIOOR DFAIN � HEAT PUMP � <br /> BACKFLOW PREVENTERS ; GAS PIPING ; <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) ; 1 . <br /> _ , <br /> -- � — __ — <br /> — � -- — � <br /> — � � <br /> � � <br /> --�— <br /> � � <br /> SUB TOTAL $ ; SUB TOTAL $ ; _ <br /> PERMIT $ � PERMIT $ � <br /> TOTAL FEE $ ' TOTAL FEE $ —~ <br /> FOR OFFICE USE ONLY: -�' ,2,j )�� — � �L/�..�?�i�,t�- <br /> Fi�or+rsemncK nennsEioncre smeseioncK rinr�cqe/crcrau�n� , ReG�� .�� neccir�i�.�� <br /> �r�, �; y <br /> USE20NE torn�en wcnNrsne FEES VALUATION FEE <br /> I� YCS f 1 NO pU�LOMG s�� .� ��f ' 7J� <br /> iYPEOfCONSC NOAFSTORIES aCUr�rmr xoIXfrMwMeunns <br /> .�� ' Ft� TI. �,2 �i PLUMBING � <br /> —�-- <br /> SIZEOFBIOG. FIPEFPRINNLERSPEO'U B�SEMENT MECHANICAL � <br /> GD�� 'T.I. YIEP DG YES Il NO � – <br /> occurnrvcr tono FlnE ninnM neon i+Eicrn uMrtnuGN �ODITIONAL PLAN CHEGK i <br /> G��-r.� . Y� ' <br /> or�ien � <br /> — , <br /> �[�s��l�'�iG DM�INJ�NI� �S- <br /> � STATE OUILDING SURCHARGE i <br /> iNinK�ov rinNsnrrnovEoer CITYOFEVEflETT PUULICWORKS ' <br /> LOCAL SALES � � <br /> i,,,,�, TAX CODE IS 3105 toin� J�� � � <br />