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- APPLICATIG.�1 FOR CONSTRUCT �dN PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PaINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: U GAS O ELECTRIC � <br /> 259-8810 <br /> � i DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> OWNER MAILAOOFE55 CITY ZIP PHONE <br /> � � I ATI� I� S. CEI,fTR/� KE}�11 �I80�7 8�-03G`f3 <br /> TENANT MAIIAD�RE55 CITV ZIP PHONE <br /> ,�� x PAv ' �.� P_nE� io i i� Fv .��r- r_-�.� wn�! Fv���r—r—r <br /> Cy' H ARCHIT CTOR�ESIGNER MAILADDRE55 � CITY ZIP PHONE <br /> 9� y <br /> i <br /> GENEFALCONTPRCTOR MqILpODRE55 CITY 21P PMONE STATE4CENSEM <br /> P/��/ �I PAK I ZC�I S. CEI�ITI�L K��1T �t�'Z_ ��-Q.';Q`3 PnV�II�714�I P/� <br /> �y � MECHAICALCONiRAGTOR MAIL�DDRE55 CITV ZIP PHONE STAELiGENSE/ <br /> �N � <br /> �p N — <br /> �x � PLUMDING CONTflACTOP IdAIL AD�RE55 C17V ZIP PHONE STATE UGENSE p <br /> 'J d CLASS OF WORN <br /> "'�-0� C7 , ! NEW i 1 ADDITION . '�. ALTERATION ��, REPAIR _OEMOLITION ' ' WOODSTOVE/FAPL INSERT ' ' BUILDING RELGCATION <br /> Fi � <br /> 7� � /�/� CONTACTPEFSONANDPNO'N�"E}�NOj 1 I [��/� <br /> Z'H ��q! CONTRACTPRICEOFWORN �OOW. � �Il'C OSI u LU�II� �J.7Ll —O7,'� <br /> DESCRIBE WORN AND SOUARE FOOTAGE INVOLVEO . <br /> r H y tZEPL./�CE ' ELCC�TE �.I k-{ FI�UIZE <br /> gw PROFO�EDIISEUFBUiIDING i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> H <br /> n ,/� � � �' � �= L �' �L APPLICATIO�J AND I:PIOW THE SAME TO HE TRUE AND CORRECT.ALL <br /> �� � LEGAL�ESCRIPTIONO aaoPEn v�seowr+eE�owoa nnncNFoun cooie5l— PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPEGIf-IED HEREIN OR <br /> y y ior etocK oF NOT. THE GR�NTING OF A PERMIT DOES �VOT PRESUME TO GIVE <br /> y 0 y AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> . � S�E �TT�PI—I LD OTHER STATE OR LOCAL LAW REGULATING CO�STRUCTION OR THE <br /> - ___.__ ,1 ��. — PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> ! OWNER OF TriIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> L . . . APPLICATIGN IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTURS LAW 7827 RCW AND 296200 WAC. <br /> X r (.� � I ,Z.,� — <br /> aaaecr aooaess s'�"a"'°E +'E <br /> '_� ,oii5�v��R���l �u�� ; t-v -Tr �,.Yo:,s,�F:s�,�E�sE�o <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIX?URE OR ITEM FEE N0. 7YPE OF EOUIPMENT FEE <br /> t�' N'ATE9 CLOSET(TOILET) A�C—NHNDLG 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 /> '_' SHOWER CLOTHES DRYERS <br /> KITCHEN SINK 8 Dlg'. VENTILATION Fl.N <br /> — � <br /> '�1 DISHWASHER RANGE HGOD <br /> LAUNDRY TRAV NJATER IiEATER <br /> ' ' CIOTHES WASHER _ WOOD STOVE i <br /> � URINAL METAL FIR[PLACE 8 CHIMNEY <br /> �� DRINKING FOUN iAIN FIREPLACE INSERT <br /> �' _ FLOOF DRAIN HEAT PUMP _ <br /> _ BACKFLOW PREVENTEHS GAS('IPING _ <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> '� SIIJK(SFRVICE—BAR,ETC.) _ <br /> '—' —_ _T <br /> � — i <br /> '�; SUB TOTAL 5 SUB TOTP.L $ T <br /> PERMIT 5 PERMIT $ <br /> TOTAL FEE S TOTAL FEE S <br /> ` FOR OFFICE USE ONLY: <br /> fiiONTSETBnCK PEAqSETBACH SIDESEtBACK PLANCHECKNUMBEP FEF. FECEIPTNO. <br /> - -�C�S,-,�-_ _ 3� �2 /3�.=,� (�300/ <br /> USE20NE LOTAPEA VACANT$ITE �EES VALUATION FEE <br /> ��� / A1 J —�— . <br /> OUILDING ZD ��� <br /> 1VPEOFCONiS.ALlO4YABlE iYPEOFCON$i.ALiOAL IXCuvANCY IIoOtPN¢ln�Gurv115 i <br /> /� � �_ � .� PLUMBING � <br /> iv <br /> SREOFBLDG. NO.OFSTORIES BASEMENT MECHANICAL <br /> OCGUPANGLOA� FIRESPPNHL[R5� NEI�IDIMITATION ADDITIONALPLANCHECK i <br /> ��.�. � <br /> ' SPPINKLER ' <br /> REASONFOqSPFINKLEP!� — � <br /> STATE PIIILDING SUPCHAPGE / � <br /> INTAKEBV PLqNSAPPROVE�I3Y CITYOFEJERETT PUBLICWOflK$ <br /> LOCALSALES T' <br /> JM � 7/ TAX COUE IS 3105 rora� 2/ � � ' l� <br />