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_. <br /> APPLICATION FOR CO�ISTRUCT.�JN PERMIT <br /> TQ BE COMPLETED IN BLACK INK—PLEASE PRINT � <br /> �.�.. <br /> BUILDING DEPARTMENT HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> 259-8810 <br /> �C DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> OVMER MAR�DDFE55 ��ry Z�P PHONE <br /> �Y�7'tA�UT��u SWiAr�S �'Ju.6r � ►�_�ts-►' �J U1[-_�vl 2E8-�b�4S <br /> TENANT M�IL�DDRE55 G{y iZ�p � PHpNE <br /> ARCMIiECT OR DESIGNEB MRIL q��FE55 LIiV zip phONE <br /> GENERALGONTHACTOP MnILp00Ac55 dTY ZIP PMpNE ST�TELICENSE• <br /> T� fl�"f1512�SA11.1F'cP <br /> MECHANICAI CONTPRCTOR MM�AODRE55 GITY 21P PHONE STRTE LICENSE• <br /> PLUMBING GONiRALTDP MRIL ADDRESS CITY ZIP PHONE ST�TE UCENSfi t <br /> CUSSOF WOfilt <br /> ��, �. NEW . ADDITION � ALTERATION REPAIR X DEMOLIT�ON WOODSTOVFIFRPL INSERT BUILDING RELOCATION <br /> fANTAGT PERSpN RND PNONE Np <br /> CONTMCT PR10E OF WORN _ D <br /> DESCFIBE WORN AND SOUARE FOOT�GE INVOLV[0 <br /> PROPOSEDUSEOFBWLDMG I HEREBV CEfiTIFV THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEG�L DESCRIPTIpryOF PPOPEqTV�SNONTI BELOW ORATTACN FpUR COPIESI PROVISIONS OF LAWS AND ORUINANCES GOVERNING T41S TVPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or� etccK �_ ov NOT. THE GRANTING OF A PEiiM1T DOES NOT PRESUME TO GIVE <br /> � , / AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> N OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> �11 n '�— PERFURMANCE OF CONSTRUC i ION.THAT I AM AUTHORIZED BV THE <br /> I�/ OWNER OF THIS PFOPERN TO PEFiFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CO!JTRACTORS LAW 18.27 qCW AND 296200 WAC. i <br /> vqaecTnooaEss �• �"'� +�' \ L1�IfIL��7 3��/1,_ <br /> s cn..ruuc o��� <br /> 15 � r�22-re4- <br /> CIiY BUSMF551�CE NSt NO <br /> PLUMSINO MECMANICAL <br /> NO• �TYPE OF FlIITUREE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � A/C--A�HNDLG UNITS—H.P. <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M <br /> SNOWER CLOTHES DRVERS , <br /> KITCHEN SINK 6 DISP VENTILATION FAI� <br /> DISHWASHER RANGE HOOD � <br /> LAUNDRYTRAY ; WATER HEATER � <br /> CLQiHES WASHER WOODSTOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN � FIREPLACE INSERT <br /> FLOOR DRAIN � HEAT PUMP <br /> _ BACKFLOW PREVENTERS ; GAS PIPING <br /> RGOF ORAINS—RAINLEADERS EXHAUST FAN � <br /> SINh;(SERVICE—BAR,ETC:.) <br /> _ ; <br /> _ SIIB TOTAL $ ; SUB TOTAL $ � <br /> PE:RMIT $ PERMIT $ ; <br /> T07AL FEE $ TOTAL FEE $ <br /> FOR OFFlCE USE ONLY: <br /> FPONTSETBACK RERRSETBpCK SIDESETBAGN PIANCHECNNUMBER FEE RECEIPTNO. <br /> �J <br /> use zor+e �ot nnen VpCANT SITE FEES VALUATION FEE <br /> BUILDING ' <br /> i <br /> TVPEOFCONiS.AIIOWABI[ iYPE0/CONSiAGTUAL atuvwcr xnIXbMwxcuNrts <br /> caour � PLUMBING i <br /> � <br /> SIZEOFBLOG. NO.OFSTORIES BASEMEN7 MECHANICAL � <br /> OCCUPANCYLOAU FIRESPRNNLERSR_O'D HEIG4TLIMIIATION ADDITIONALFLANCHECK � <br /> SPRINKLER � <br /> i <br /> REASON FOF SPHINKLERS — <br /> STATE BUILDING SURCHARGE � <br /> INTAKEBY PLANSACPPOVEDEiY CITYOFEVEflETT PUBLICWORKS � <br /> LOCAL SALES —�— <br />, TAX CODE IS 3105 TOTAL I <br />