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� i . <br />c r <br />i; `��' <br />� <br />, �,; .., <. <,::,�;::,=.v,y�,., ... , . ,.. <br />. .. . � � M .. 1�.�: t:� Y ' . . <br />APPLICAT�N FOR CONSTRUC i�ON PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT � <br />HEATING SYSTEM: Yj CiAS 0 ELECTRIC O <br />BUILDING DEPARTMENT ' <br />t . <br />259-8810 F <br />i I DEMOLITION ❑ OOMBINATION ❑ BUIIDING �I YECHANICAL CI PLUMBING [ I SION !� <br />owr�n . wu��ooness cm zw r� <br />SVffiiS1T @'4SilG ]1Q181tP1Y 14th a POPiAEt BVffi�iT 1w 98201 258-9222 <br />rewurt wu.�ooneas cin zv r�a� . <br />MC„(fECTOppFSpMEp y�L/�pppESS LRY ZIP PNONE <br />OENEWLCONTW1CTp1 WLMOXESB GITY ZIP PNONE ST�TELIGENBE� <br />ormwu.r g�� 7469 ��] iY�i]Plil� in 01i7f� 75l—SV.7 _ <br />wEc�wxcKcartwwron� wd�ooness . cm ziv wa� sr�re�aeNse� <br />^'m'� *"^ 1471 127th PL I�E BSIdBO[IB, ta 9B�S 61r-7�71 rrnmrss�6�r; <br />p��yyrqCONTqACTpq y/�IL�pp�E$5 CITY ZIP PHONE STATELICENSE� <br />IXASB OF WOIIIf <br />L I NEW ❑ ADDITION <br />�I ALTERATION I I REPAIR I.I DEMOLITION I I WOODSTOVE/FRPL INSERT I I BUILDING RELOCATION <br />CONTACT PE1160N 1VID PIIONE NO. � <br />caNm�crrn�cEOFwauc i5Z5"l.W <br />pEBCqpE yppl( µp 90W1RE FOOTAOE INVOIVEC <br />rnaoeeo ueE oF eurnra <br />I�fAT 191fff.V <br />LEML OESCPIPfION OF P1i0PER7Y (SHOMM BEL01 <br />l0T BLOCK OF <br />KITCHEN SINK 8 DISP <br />DISHWASHEH <br />BACKFLOW <br />FOR OFFICE USE ONLY: <br />IIiDNTSETB/�CN flEM8ETB�CN <br />LOTMEA <br />I YPE Of CONiS. �LlOWABIE � IYPE Of CON57. <br />SRE OF BLDG. <br />NEASON FOfISPRINNLEFS <br />INTANE <br />FIRE SPRNKLEflS REO'0 <br />:�i,� 1.� <br />�$ <br />61DE SETBACN <br />VAGINT SITE <br />OCCuwxcY xoOfOWfuixcuxi�5 <br />4RWY <br />BASEMENT <br />1 HEREBV CERTIFY THAT I HAVE READ AND EXAMINED THIS � <br />APPLICATION ANO KNOW THE SAME TO BE TRUE AND CARRECT. ALL <br />PROVISIONS OF UWS AND ORDINANCES C'iOVERNIN(3 THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE � <br />AUTHORITY TO VIOIATE OR CANCEL THE PROVISIONS OF ANV <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE � <br />OWNER OF THIS PROPERTY TO PERFOHM THE WORK FOR WHICH < <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE ' <br />CONTRACTORS LAW 7827 RCW AND 296200 WAC. <br />�,�l,�e�..�-¢�.c-- ����i � /7 9i � <br />einun� � w�c . <br />AIR <br />3(00 �� <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />ADDITIONAL PLAN CHECK <br />SPRINKLER <br />STATE BUILDING SURCHARGE <br />PUBLIC WORKS <br />LOCALSALES <br />TAX CODEIS 3105 TOTAL <br />FEE <br />