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4��7y <br /> APPLICATIQ 1 FOR CONSTRUCT )N PERMIT �' <br /> TO BE COMPLETED IN BLACK INK—PLEASE P:.INT <br /> HEATING SYSTEM: �GAS O ELECTRIC U � <br /> BUILDING DEPARTMENT <br /> 259-8810 '�LL� <br /> ! I DEMOLITION I I COMBINATION L-I BUILUING i+!MECHANICAL ��rLUMBING i i SIGN <br /> OWMEIi MAM1MD�E55 CIiY IIP O��ONE <br /> �NED,n� E l�Es da3o (�,c ivrArc F6vc�7r 9-0�0� .�sa-s3vs <br /> i[uu�r u�awoxEss cnr zm riw�rt <br /> •'MIIICCICflOfSMaNEq Y�RAD�AE55 CIiV ZIP FMON[ <br /> fENERQCONIPALiOq MMI�W�ESS GLV 3iV PIpNF SUIELICENSC• <br /> Y6N41iC�LCp11R�Cipfl N�M1AOOPE55 n OtY ZIP PMONG S1AtELSCNSE� '�t-`� <br /> �T �� .vE Tl /C i97ai-�✓*f. /'/✓F./ ) LYNNW � 9P03L `/9uTA3/.! T f'XJ NRO'I�TY <br /> 1'WMOiNGCpltfl�CiOR M�PAOOP[55 CItY ZIP P��I Sl�i[LYENSE• <br /> CIXIIP�CT Pf1iCE OL WqIN <br /> �-,r�O <br /> pCSCP9EKOPA�N[IY�WLEFWqGEiNVIXtlEO CONUCLPEIISONANOPNyI� � � <br /> 1 NS�a GA .✓A C� H � �B� - . <br /> _�iQ � TA/✓ - <br /> I HEREBV CeRTIFY TMAT I HAVE REAO AND E%AMINED TMIS <br /> vrrorweo u5[a BunmHG APPLiCATION AN�NNOW THE SAME TO BE TflUE AND CONRECT AlL <br /> PROVISIGNS OF LA1Y3 AND ORDINANCES GOVERNiNG THIS TVPE OF <br /> ¢atDEsceiruw+avrrov[nivfsraw*+ec�oWon�rua�nvocooiES� WORK WILL BE COMPLETED WITH WHETMER SPECIFIEO HEREIN OR <br /> NOT.1ME GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> io* eiocK � qUTHORITV TO VIOLATE OH CANCEL THE PROVISIONS OF ANY <br /> OTHER SiATE OR LOCAL LAW flCGULATING CONSTRUCTION OR THE <br /> - — PEFlFORMANCE OF CONSTRUCTION THAT I AM AUTHORIZED 0�TME <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORk FOfl WMICH <br /> AFPLICATION IS MADE AN� I COAIPLV WITN THE STATE <br /> venca*�.i o��vue[u CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> L.�ss- o.s- o�d - oao� <br /> cwsin�crwrvionvi[rvo[n.woncss.*E�[rr�orvewuuecn <br /> x�� �.G�ti .�/a/s3 <br /> PR0.1ECf AODRE55 - ���� <br /> � _ _ __ <br /> PLUMBING MECNANICAI� k <br /> NO. TVPE OF FIXTIIPE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET�TOILETI AD-N�HNDLG UNITS-H.P <br /> BATMTUD / FORCEDAIRSYSTEMS-BT.U. A1 E.A. <br /> LAVATORY�WASHBASIN) UNITIIEATERS-BTU. M <br /> SHOWER CLOTHESURVERS <br /> NITCNEN SINK A DISP VENTILATION FAN <br /> OISNWASHER RdNGE HOOD <br /> LAUNDRV TRAV WATLR HEATER <br /> CLOTHESWASHER WOODSTOVE <br /> URINAL METAL FIREPLACE�\YOOD BURNINGI <br /> DRINNING FOUNTAIN FIREPLACE INSEflT <br /> FLOO��DRAIN HEAT PU61P <br /> B4CKFLOWPREVENTERS _'� GASPIPING _, _ __ <br /> ROOF DRAINS-RAINLEADERS L%HAUST FAN <br /> SINK(SEflVICE-BAfl,ETQ) i— <br /> SUBTOTAL S SUDTOTAL 5 Kp'U <br /> PER611T S �— PERMIT S �(l0 <br /> TOTAL FEE S TOTAL FEE S 'O�� <br /> FOR OFFICE USE ONLY: <br /> fRONi5E1B�CX NEAOSCiBI.CN 90ESEiB.��N �I�NCNECNNUMOEB �CE �LCEIPINO <br /> usEzur�E la*en[e veceHlSnE FEES VALURTION FEE <br /> Ci VES :-i NO BUIIOMG <br /> nnacaMsl rro.oFsian�Es anmu¢� woac�ui�rcu,�s <br /> ��''� PWMOMG <br /> ti4[OfBl00 ii11E5VPNAlEP9PE0D B�SfYENT MECH?NiCAL <br /> C7 VES �,fl NO — — <br /> OCcvvl.NLv101.O PnE,WRMNEan n[IGNilM�lnlpN /�O�I*�ONALPUNCHEGN <br /> on�en <br /> n[/.soN --� <br /> STRTE 0!➢101K�SMCNARGE <br /> iNf�MEBY RANSAPPPOVEOBY CITYOFEVEflETT �pBIICWOBN$ <br /> LOCIIL SIILES <br /> o��E TA7f COOE IS 3105 tou� <br />