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APPLICATIG��' FOR CONSTRUCT'``�N PERMIT � <br />� TO 8E COMPLETED!N BLACK INK—PLEASE PRINT <br /> , �1 <br /> --__ ---� <br /> i � -- <br /> HEATING SYSTEM� 'J GAS �� i.,i EIECTRIC U _--____ -_— <br /> BUILDIi�G DEPARTMENT � <br /> 259-88i0 <br /> � i DEMOl.IT10N COMBINATION y�1 BUILDING J(MECHANICAL v!�LUMBING i ! SIGN <br />� -- � CITY ZIP PHONE <br /> JWNER MP��I�DDRESS Rc r <br /> � ��3 V / /V Z4�J <br /> EN� � ��h �` Z1,Oi_�`� CITY ZIP PHONE <br /> MRIIODOHESS <br /> I .��� � <br /> GITY ZiP PHONE <br />� ARC�,C cj OR DESIGNER - MAh ADDRESS ��� _ C��Z <br /> , �z , <br /> L CTy Z�P E �� STFTeLIGENSEN <br /> GFNERALGONTRACTOR MRILAODH-_SS <br /> �+� i i�ot 38K.k.�6 v.� fi�c.aa�. �t eo3 c 35�.-�'f 3 SJ FrM�c..a,�{Toz�S�- <br /> '^�� 'T_ ZIP � <br /> QTV <br /> MECHANICALCONTRAGTOR MAt�w1DRE55 � QC�10 <br /> Q �W'L� Z�p PHONE SiATE LICENSE tl <br /> � UMBING COMRAGTOR MAiL ADORESS GITY <br /> -� S.vu• zj9-gii � <br /> �-�S -�.�t.- <br /> C.ON ACTPFICEOFWORK <br /> �S K GONTACT PERSON AND PHONE NO. � <br /> �ESCRiBE WORN/ND S�UARE FOOTAG iNVOLVEO <br /> �aqS T�l - <br /> . y �� <br /> i HEREBY CERTIFY THA7 i HAVE READ AND EXAMINED THIS <br /> PROPOSED USE OF BUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> �,� PROVISIONS OF LAWS ANQ OFDINANCES GOVERNING THIS TYPE OF <br /> �ecn�oesca�PTioNOFPaoPearvlsHowNee�owoanTrncNrwocoaies� WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> ^) `��� ��_u^r NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> �pT. 2 e��K oF r' AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> — PERFORMANCEOOF OONSTRUCTION.LTHAT�AM AUTHORIZOED BV THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WOFK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WiTH THE STATE <br /> PARCE� �, R i.o.�vuMeea CONT A TORS LAW 1827 RCW AND 296200 WAC. <br /> WNSTRUCTION LOAN LENDER.FDDRE55.TELEPHONE NUM�ER L Z,L <br /> 0 1E <br /> � � SIG TU _ <br /> PROJECT ADD �n �y , cirv aus � se No <br /> L <br /> PLUMBING MECMA A <br /> FEE NO. TYPE OF E�UIPMENT FEE <br /> NO. TYPE OF FIXTi1RE OR ITEM p,��-p/HNDLG UNITS-H.P. <br /> WATER CLOSET(TOILET) %�� <br /> BATHTUB ' FORCED AIR SYSTEMS-B.T.U. M E.A. <br /> I.AVATORV(WASH BASIN) I � UNIT HEATERS-B.T.U. M _ <br /> CLOTHES DRYERS . - - <br /> � SHOWER � . VENTILATION FA�1 �- <br /> � KITCHEN SWK&DISP ' -r� _ <br /> RANCiE HOOD , <br /> DISHWASHER � . WATER HEATER - <br /> LAUNDRY TRAY � WOOD STOVE <br /> CLOTHES WASHER � METAL FIREPLACE(WOOD BURNING) - <br /> URINAL FIREPLACE INSERT <br /> DRINKING FOUNTAIN - HEAT PUMP <br /> FIOOR DRAIN GAS PIPING <br /> BACKFLOW PREVENTERS ExHAUST FAN !/� - <br /> ROOF DRAINS-RAINLEADERS <br /> SINK(SERVICE-BAR.ETC.) -- . <br /> _- —i— <br /> � SUB TCTAL $ <br /> SUB TOTAL $ pERMIT $ <br /> PERMIT $ TOTAL FEE $ <br /> TOTALFEE $ <br /> FOR OFFICE USE ONLY: aeceiar r+o <br /> PLAN CHECK NUMOEF FEE / I� �.(' <br /> FRONT SETBACN REAR SETBHCK SIDE SEt6ACK !� V <br /> � � � L <br /> ZO � �/ S � � . FEES J VALUATION FEE <br /> �OT ARErI VACNNT SITE ` <br /> USEZONE ��� yl VES . ' NO +-� /- <br /> BUILDING /S 7Y' �� <br /> � NO.OF STORIES WGUPANcv NO Of[�wFIUNG ONItS � i <br /> TvnEOFGoxST. n cnoi_3 / PLUMBING <br /> .S� � 9C` <br /> SREO�F�BLp G.Sf FIRESPRINKLERSREO'D BASEMENT � MECHANICAL - <br /> 1'ti'�`1' T � 'i'��. VES � <br /> 5 HEIGHTW.1ITAliurv� A�DITIONALPLANCHECK <br /> OCCUPANCV LOAD FlRE ALA(iM FEO'0 <br /> A � Z� OTHER � _ <br /> REn50� STATE BUILDING SURCHARGE '�G <br /> /� / �� <br /> INTRKEBY PLANSAPR��`jE9BV CITYOFEVERfTT PUBUCWORKS — <br /> p" LOCAL SALES �3 3 � <br /> TAX CODE IS 3105 TOTRL <br /> oArE 3 ti <br />