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4PPLICATIMI FOR CONSTRUCT`ON PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTME�IT HEATING SYSTEM: U GAS O ELECTRIC ❑ <br /> 259-8810 <br /> L l DEMOLITION ❑ COMBINATION I I BUILDING I� MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNER MAIL�UDRE55 CITV ZIP PHONE <br /> L Awso rJ ►-t F� 233q I 1'lA AJ e e SeA'ZTl.� W(� �8'4 OZ <br /> TENANT M�ILADDRESS CITV 21P PHONE <br /> ��.esQ ow�us a�ai c�ene'�►' �e t�tlQne-T' <br /> ApCHITECTORDESIGNER MAILAODRESS CITV ZIP PHONE <br /> A2MIL�► P_(�iSO Zb� 5E 2�_ N lZ �'$�40 �2��OS <br /> GENERALCONTRACTOR MAILADDflE55 CITY Z PHON@ STATELIGENSEI <br /> nwu�ti . <br /> MECHANICALCONTRACTOR M�ILAODRESS CITY ZIP PXONE STATELICENSE� <br /> PLUMBINGCONTRACTOR MAILADDRESS CITV ZIP PXONE STATELICENSEt <br /> �W IJe� <br /> CLASS OF WORN <br /> I I NEW I�I ADDITION f 1 ALTEPATION I.I REPAIR I J DEMOLITION I .I WOODSTOVE/FRPL INSERT f I BUILDING RELOCATION <br /> CONTACT PERSON AND PHONE NO. ^� �2 <br /> CONTRACTPRICEOFWOPK �� J�Z��7-7 <br /> DESCRIBE WORN AND SOUARE FOOTAGE INVOLVE <br /> s Ubi�i � iJK o <br /> PROPOSEDUSEOFBUILO c i HEREBY CER1'IFY THAT I HAVE READ AND EXAMINED THIS <br /> AA.�� ST�I O APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEG�LDESCRIPTIONOFPROPEflTY�SHOWNBELOWOR�TfACHPOUHCOPIES) PROVISIONSOFLAWSANDORDINANCESGOVFRNINGTHISTYPEOF <br /> R. bhr.S 3 WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or� e�ocK ,�Q Ie oF NOT. THE GRANTING OF A PF.RMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> �O l lO �N G C1F �l, OTHER STATE OR LOCAL LAW REGULATING CONSTPUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> PflQ/I�ECTADDFF55 �N�ruA��t� �AIE 6�}--q2 <br /> ZG.Z. CIiV BUSME554LENSE NO. <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FIXTURE OR REM -. FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � A/C—A/HNDLG 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 DISP � VENTILATION FAN ; <br /> �ISHWASHER � RANGE HOOD � _ <br /> LAUNDFiYTRAY ; WATERHEATER ' <br /> CLOTHES WASHER � WOODSTOVE � <br /> URINAL ' METAL FIREPLACE 8 CHIMNEY � <br /> DRINKING FOUNTAIN � FIREPLACE INSERT � <br /> FLOOR DRAIN � HEAT PUMP � <br /> BACKFLOW PREVENTERS ; GAS PIPING ; <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) ; � <br /> � � <br /> � � <br /> � � <br /> i <br /> SUB TOTAL $ ; SUB TOTAL $ ' <br /> PERMIT $ 2 � PERMIT $ � <br /> 'fOTALFEE $ ; TOTALFEE $ ' <br /> FOR OFFICE USE ONLY: <br /> FRONTSETBRCK REARSETBACK SIDESETBACK PLANCI+ECKNUM ER F RECEIPTNO. <br /> .�/o /s <br /> USE20 E LOTAREA VALANTSITE FEES VALUATION FEE <br /> ~ I BUILDING OOU �— <br /> TYPEOFLONIS.ALI ABLE iVPEOFCONST.RCTUAL ecc Cv Noaoxtuixeuxn5 i <br /> -T/� � 2 ��� PLUMBING i <br /> .y.. <br /> SREOFBLDG. C.OFSTORIES OASEMENT MECHANICAL �� <br /> uP� .1. Y�Gi � � <br /> ADDITIONAL PLAN CHECK � _ <br /> OCCUPANCY LOAO FIRE SPRN l5\REO'D HEIGHT rLIMITATION -'1' <br /> . � IN �I. \ JO/ SPRINHLER <br /> i <br /> REASON FOR SPP NNLERS <br /> C \a..r. LL ��, <br /> !(�l� �H� STATE DUILDING SURCHARGE U- <br /> i <br /> MTANEBY PUNSAPPROVEDBY CI�Y�-0FEIIERETT PUBLICWORKS —T— - <br /> � LOCAL SALES , ,� <br /> 10 �Yy JM TAX CODE IS 3105 Tora� ;c U <br />