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� <br />APPLICATION FOR CONSTRUC7.+ N PERMIT <br />TO BE COMPLETED IN BLACK iNK—PLEASE PRINT ��r��r�s <br />BUILDING DEPARTMENT � HEATING SYSi'EM: U GAS ❑ ELECTRIC ❑ <br />259-8H?0 <br />I_I DEMOLITION IJ COMBINATIQN i I BUILDING �-111f�CHANICAL <br />ONTIER I MRIL/AODRESS CITY 2IP PH( <br />� � A s�, �/� %S/0/ (o <br />_ ✓il �l'tr 1 ✓�.f Frn.C.v � ��7 wr {rrn (/, <br />i 1 PLUMBIkG <br />NE <br />Z 3 3�y <br />. .... ^•^•'^""^��� l:1lY 21P PHONE <br />ARCMITECT OR DESIGNER MAIL A�OqE55 ��ry Z�P PH��E <br />�GENEHALCONTPACTOR MAILADDflESS CITY ZIP PHONE STATELICENSEf <br />/�s� /ro� �✓��h,� �1v S' �< zov S� fi� �io/ G 23 3m� <br />MECHANICA�CONTRACTOH M�ILADDRE55 CITV 21P PHONE STATELICENSER <br />MUMBINGCONiRACTOq MAILADDRE55 CITV ZIP PHONE STATELICENSE/ <br />GLA55 WORK <br />' i NEW I J ADDITION I I ALTEFATION <br />CONTRACT PRICE OF YpRK <br />DESCRIBE WOpK AND SOUARE FOOTAGE INVOLVED <br />PflOPOSEDUSEOFBUILDING � ` <br />/il., f�_ � — —�-� �.e <br />LEIiAL DESCRIPT OF P OPEPTY (51� WN BELOW OR AT <br />� <br />LOT gLOCK OF <br />TYPE OF flXTURE <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />FLOOR <br />SINK <br />FOUNTAIN <br />AIN <br />JPREVENTERS <br />FOR OFFICE USE ONLY: <br />FRONTSET&1CK qEARSETBACK <br />OCCUPANCY <br />INTAKE BV <br />5UB TOTAL <br />PERMIT <br />TOTAL FEE <br />I I SIGN <br />I! REPAIR i'� DEMOLITION I i WOODSTOVE/FRPL INSERT I I BUILDING RELOCATION <br />CONTACT PERSON AND PHONE NO. <br />I HEREBY CERTIFY THAT I HAVE RFAD AND EXAMINELI THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />FOUP GOPIES) PROVISIONS OF LqWS AND ORDINANCES CaOVEFNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE CaRANTING UF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCpL LAW REGULATING CONSTRUCTION OP THE <br />PERFORMANCE OF CONSTRUCTION. ?HAT I AM AUTHORI2ED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLV WITH THE STATE <br />CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br />$ <br />SIDE SETBACK <br />� <br />FORCEDAIRSYSTEMS—B.T.U. M <br />UNIT HEATERS--B.T.U. M <br />CLOTHES DRYERS <br />RANGEHOOD <br />WATER HEATER <br />WOODSTOVE <br />METAL F�REPLACE 8 CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUST FAN <br />BUILDING <br />ALIOWABLF TYPEOFCON57 ACiOAL OccuPnNtv xo OroWFum4Uxu5 <br />Lfl011P ALUMBING <br />�� NO.OFSTORIES BASEMENT <br />MECHANICAI <br />'-OAD FIRE SPRNKLEPS REO'D HEIGHT LIMITATION ADDITIONAL PLAN CHECK <br />SPRINNLER <br />SPqINKlERS <br />STATE BUILOING SURCHARGE <br />PLANSAPPFOVEDBY CIT1' OF EYEHEIT PUBLIC WORKS <br />LOCAL SALES <br />TAX CODE IS 3105 TOTAL <br />SUBTOTAI $ <br />PERMIT $ <br />TOTAL FEE $ <br />9 <br />� <br />0 <br />C <br />