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APPLICATICI.J FOR CONSTRUCn )N PERMIT � <br /> T�BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT NEATING SVS7EM: U GAS J ELECTRIC ❑_ � <br /> 259-8810 / <br /> D'cNOLITION COM8INATON 'YBUILDINO �MECHANICML . .PLUMBING SIGN <br /> bNHEfl WII.NIME55 Cltt ZIF PXONE <br /> BwI�.�;iew /JaR'W++'w 29�� B��sr. �r,,�.aw,rr 9�s�i 2S4_ g6SC <br /> LENA`�` IMILALOf1E55 l:1tV ZIV PMONE <br /> SA/M1��L <br /> NMX�IECtq10E511'✓1ER MAIIMDXESS CIT' ilG pMONE <br /> GENEMLCMiqM;iOq 1MILqO�PE% Liiv 2�> VMONE SiqiELILENSE� <br /> S/whw.rN�., �Vu2E4R,ww yqou $..�.£ �,✓�a.an.if pgtl/ <br /> YECNMIC.LLC iPPCiOfl AWILApMe55 CIIV ZIP >XQVE $TRTFJCENSEI <br /> SAM/L <br /> RIINBINGCCNTRACiOF YAILRpp11E5$ CITV ZIP pµ,'JNE SiRTELICENSEX <br /> S.an.t _ <br /> cussorwoa. <br /> NEW ADDITION ✓ALTEPATION REPAIR CEMOLITION WOODSTOVE/FRPL INSERT � ' 9UILOING RELOCATION <br /> �1 CANi.�CT PERSON.WO PIqNE NO <br /> CMiMCiPPiLEOFwCflK u / ODU . 0[J <br /> OESCfl9EwC(ix WVOSCVFIiEFWi4GE�NVCLVEO <br /> 260 4 fT. 2 Ns+r of�.�.�iv.Md�•d � <br /> v�aoseouseoreoimiuc � HEFEBY CERTIFV THAT I HAVE READ AND E%AMINEO THIS <br /> �pti f t�./ pas��:., APPLICATION ANO KNOW THE SAME TO 8E TRUE ANO CORRECT.ALL <br /> �ew�ceunivnoxarreovearviseowxaswwonenecwrouncories� PROVISIONSOFulWSANDORDINANCESGOVERNINGTHISTVPEOF <br /> WORK WILI BE COMPLETED WITH WHETHEP SPEGFIED HEREIN OR <br /> ior e�ocx or _ NOT.THE GRANTING Of F PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORIT\'i0 VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTMER STP:i c OF LOCni LAW REGULATING CONSTRUCTION OR THE <br /> PERFOFMANCE OP CONSTRUCTION.TNAT I AM AUTHOR2ED BY THE <br /> OWNER OF THIS PROPERTY TO PERF^^M THE WOflK FOF WHICH <br /> APPLICATION IS MADE AND I COMPLV� WITH THE STATE <br /> CONTRACTOqS LAW 1829 RC W AND 296200 WAC. � <br /> n �� ��V •�. <br /> �QOC� �n�( S� _ z (R w+'r(a...�(G��, s= >a. - 93 <br /> FFaIECT.NOflE55 �T NE tE <br /> VLUMBNM. MECXANIGIL � <br /> NO. TYPE OF FIXTUXE Oli REM FEE NO. TVPE OF EWIVMEM FEE <br /> WATER CLOSET(TOILEi) A/C—NhINDLG UNITS—H.P. <br /> BATNTUB FORCEDAIfiSVSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASHBASIN) UNITHEATERS—B.TU. M <br /> SHOW ER CLOTHES DRYERS ' <br /> KITCHEN SINK 8 DISP VENTILAiION FAN <br /> DISHWASHER RANGE HO00 <br /> LAUNDRY TRAV WATER HEATER <br /> CLOTHES WASYER WOOD STOVE <br /> URINAL METNL FIREPLACE 8 CHIMNEV <br /> DRINKING FOUNTAIN FIREPLACE INSERT ' <br /> FLOpR OFAIN HEAT PUMP <br /> BACKFLOW PqEVENTERS GAS PIPING <br /> ROOF DFAINS-RAINLEAOEBS EXHAUST FAN <br /> SINK(SERVICE--BFR.ETC.) <br /> SUBTOTFL $ SUBTOTqL $ <br /> PERMIT $ PERMIT $ ' <br /> TOTALFEE $ TOTAIFEE $ <br /> FOR OFPICE USE ONLY: <br /> FPONiSEiBRCK PE4RSElBPCK $IDESETBRLN GLqNCXECFNpM�BEfl FEE 9ELEIGiNO. <br /> V� <br /> �seioxe iornAen vncuursrtE fEE3 VAWIITION fEE <br /> BUILDING � 'i L� <br /> IIVfOfiON!$PIlOW.1BLf 1Vi10lCON>iRCIUAt WW.M XO4�VMLLiv4UXi5 <br /> IXcxa> PLUMBING <br /> SIZEC�BLCG NO OFSiORIES BASEMENi MECHRNICAL <br /> OCCUvuuv�OeD Fl�sSveNx�En5nEa0 eEiGNiuMrtniiON ND01'bNAtPL1NCHELN <br /> � SPRINNLEH <br /> PEASCNFOPSVFWNlEflS <br /> STATE BUILDING bURCMAPGE '�j(J <br /> i�uuesev nurvsnvvnoeeoe� CITYOFEVEBE7T pueuc�..�aKs � ' <br /> LOC11L SIILES <br /> � iiUl COOE IS 3185 *or�� r / .� <br />