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APPLICA7IG �7 FQ�R CONSTRUCT, �N PERMIT ���� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> � <br /> BUILDING DEPARTMENi HEATING SYSTEM: f�GAS ❑ELECTRIC ❑ � <br /> 259-88'0 <br /> DEMOLITION ! ; COMBINATION ✓BUILDING rINECHANICAL �LUMBING SIGN <br /> OWNER MFILA�DRE55 GITV�q�/ 21P PMONE <br /> W <br /> SIE�/E �.DEn��se GoeT: ��D f.�wiT 3r�. r I'1 .�1/ T a 4$L�s �S��y•L <br /> � MAILADDPE55 CITY ZP� PHONE <br /> �/�w�t S�)�iNJDN 3F/D G/-lr.6SI CT C , To�.l .YiI ' I �LS�O <br /> ROES'GNER MRILADDRE55 CITY 21P PHONE <br /> PNEReICONTRACTOR MAILADDRESS CITV ZIP PHONE STATECCENSE• • <br /> �Aav 94�ce /4ta Gon7 Ta�wi. L..� ,�tw�1,c��o �Yz7r 35� oc35 �klc ar - i�3,ry <br /> MFC!1F L�LCONTRRCTOR Mr11LADDRE55 CI1Y ZIP PHONE STRTEUCENSER <br /> �YERG¢e�.d ST.�Tc. S/��•T ,NeT,a L 3�/// -Nn�.s L�i l'f zo � 2SL'3iK/ 6+/-EQ- S Ssecay <br /> PLUMBINGCONTRACTOR M�'_ADLPESS GTV ZIP PI.ONE STATF.UCENSEt <br /> �-SQ��t SQIS�.�+D 6d'06 -/33Pu DoiY� Sf Sn: D� �t'F�r29U Sdd'-4o/ I 7'LYLU /IOLL <br /> CLASSO WORH <br /> ��NEW �. ADOITION , '� ALTERATION I i REPAIR � DEMOLI"iON . �� WOODSTOVE/FRPL INSERT . I OUI:DING RELOCATION <br /> '•/"�'�+F /"J GONTACT PERSON AND PHONE NO. <br /> CONTRACTPII�EOFWORK ''�'1D. OAQ �Y`�G)4 � G /��C �RLCC � S�' �6_i9 <br /> DESCRIBE NOHN AN�SOUARE FOOTAGE INVOLVE� <br /> �'vS1'u�, Cn�+ST. / ($' . FT, <br /> PROPOSEDUSEOFBUIL�ING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> �/roG i+ FAti,�S rT� �N�,► I�PPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGA�DESCRIPTIONOF PROPERTV�SHOWN BEIOW ORATTACH FJURCOPIES� PROVISIO�:S OF LAWS AND ORDINA�CES GOVERNING THIS TYPE OF <br /> 7p�°'T WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �o�,�_ niocK �/Y �F Mw /t �F F�G J NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORI'V TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> S����h�a �C y Cu...v�.. �_W A OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> � /I --� �/ PERFORA"ANCE OF CONSTRUCTION.THAT I AM AUTHORIZED B'(THE <br /> IIPC�YC�.i. .U-LUuJ$lL'�` 9L•C/li1OZ�UQ� _ OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR 'NHICH <br /> APPLICATION IS MADE AND I COMPIV WITH THE STATE <br /> COPJTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> �l737 <br /> � GLfNw��� AiIE Gvi e �.�a�.�.�..t...ae S L7•5'2 <br /> PRCJECT ADDRE55 s�cNntue[ oetc <br /> GItV P�'Si4E55 L�CEM1SE NO <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FU(TURE OR ITE�1 FEE NO. TYPE OF EOUIPMENT FEE <br /> ' $ WATER:LOSET(TOILEI) � � A/C-NHNDLG UNITS--H.P. I <br /> / BATfiTJB ; FORCED AIR SYSTEMS-B.T.U. M E.A <br /> LAVATORY(WASH BASINI aU � UNIT HEATERS-B.T.U. M ; <br /> / SHOWER �� � CLO�fHES DRYEfiS <br /> / KITCHEN SINK 8 DISP �; VENTILATION FAN ' <br /> / DISHWASHER � � RANGE liC'iOD � <br /> LAUNDRY TRAY v ; WATER 11EATER <br /> � CLOTHES WASHER �� � WOOD STOVE <br /> � URINAL � � METAL FIREPLACE 8 CHIMNEY � <br /> ORINKING FOUNTAIN � FIREPLACE INSERT ' <br /> FLOOP DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS ; GAS PIPING <br /> ROOF DRAINS-RAINLEAGERS EXHAUST FAN � <br /> _ SINK(SERVICE-BAR,ETC.) <br /> �� <br /> _ ' � <br /> � , <br /> � <br /> . 5UB TOTAL S , SUB TOTAL 5 � - <br /> PERhIIT S PERMIT 5 � <br /> TOTAL Ff:E 5 ' TOTAL FEE $ � <br /> FOR OFFICE USE ONLY: � , <br /> FRONT SETBACK REAP SETBACK S�DE SETBACK PLAN CHECK NONBER FEE / RECEIPT N . <br /> ZIC � ZO � i� �Alc/!R1 S� � �/D��U ) � <br /> y � <br /> USEZ�OjNE LOTAREA VACANTSI7E FEES VALUATION FEE <br /> �\— ( �3 � Y`GS BUILDING C,S C.:YJ� !02/;� <br /> iVPEOitON4'.ALL01'(ABLE 1YPEOfMNS[�G1UAL atu�v¢r NoOrowRUNGUVrtS <br /> _ J _ °aa'.S° �� PLl'MBING /} -r.4` <br /> ���� <br /> S�Z/�F�j j SF �' NO.OFSTORIES BASEMENT <br /> MCCHANICAL �/i� — <br /> S sf c�,c 2 l,� — L� <br /> OCCUPANCY LOAD FIRE SPRNKLEPS REO'0 HEIGHT LIMITATION AJDITIONAL PLAN CHECK i � <br /> Z SPIlINKLER i <br /> REASO FORSPflINKLERS -- � — <br /> S!A?E DUILOING SURCHAR;E L��� <br /> INTANEBY PLANSAPPROVEDEV CITYQF.VERE7� � PURLICWORKS 2r� !L/� <br /> � ,� LOGO�L SALES , T— <br /> A �� 7 /S y TAX CODE IS 3105 TOTAL 7�, ,�Z <br />