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APPLICATI�"i �OR COWSTRi9CTa'1P1 Pl'eRMtT � <br /> TO BE fOMPLE'fED IN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEM: U GAS ❑ELEGTRIC ❑ � <br /> BUILDING DEPARTMENT <br /> 259�0810 <br /> 17 DEMOLITION ❑ COMBIIJATIGN I:1 BUILDING ❑MECHANICAL ❑PLUMBING ❑ SIGN <br /> OWNEP IM�/ILAO�f1E55 [iiY 21P P 1PN,D,NE G\ <br /> � M SL �CTS fSA�O I�/Oj~ ST S� CLCII��yv�ol�g J � I'�a��e <br /> iENI.NI NALA^O�CS$ CIIY IIY V11QYE <br /> AflCNILECIOPOCS�GNEO MAItADORE55 LIIY ZIP PNJNE <br /> GPIEFALWNiFAC10f1 M�ILAODRESS Cliv ZIP PHONE SiAiE4CEN5E• <br /> MECIIAN�LALGON11UCiOfl HAILADOPE55 CItY (IP FNW:E STALElKENSEt <br /> 1'WA�BINGCON1flAC10R NAttA00PE55 LITV $IP PIIONE SiUELIG[NSE• <br /> CJNIII�GLPfliCCOFYIOFK ��� _ <br /> �ESLaI�[WORNRIDSOU�flEf iAGEINVOlVfO Cq+LALifkR$ONAIIDGIqNEuO <br /> 'y 'n • �d <br /> /,, / / / (1� <br /> . __�,�,£_ ,n <br /> I HEREBV CERTIFY THAT I HAVE HEAD AND EXAMINED THIS <br /> r�r.cvo;co ose oF omm��rve APPLICATION AIJD KNOW THE SAME TO BE TRUE AND CORFEGT.ALL <br /> PROVISIONS OF LAWS ANU OR�INA."IC[S GOVERNING THIS TVPE OF <br /> icca�ocsw�vnwrovanonea*visHov�roeiowoeennceiwocoPies� WORK WILL 0E COMPLE7E�WITH WHETHER SPECIFIEO HEREIN OF <br /> NOT.THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ior eiocK oF AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHEP STATE OR LOCAL LAW(iEGULATING COiJSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FO�WHICH <br /> APPLICATION IS MADE AMD I COMPLV WITH THE STAT� <br /> rnecn ue i n xuMocn CONTRACTORS LAW 1827 RCW AI:D 296^�7 WAC. <br /> '! ' . '�� . - : . , ' <br /> LG�li1t1ULTONIOANLCNpE11.ADG11E55JElEPNqIENOMOfli � ns —4 � !/ /� <br /> �7%-�%`'"7 <br /> PflOJEC�A DflE S ^� \ 2 s�cr.w o� <br /> ,�o b r - �S ll �a�..:�s�,kt,��,�o <br /> PLUMBING MECHANICAL <br /> N0. TYPE OF FI%TUPE Ofl ITEM FEE N0. TVPE OF EOUIPMENT FF.E <br /> VlATER CLOSEI(TOILET) A1C—A�HNOLG 11NITS—H.P. <br /> [3ATHTUO FORCEDAIRSVSTEMS—B.LU. M E.A. <br /> L�VATORV�WASHBASIN) UIIITNEATERS—B.TU. M <br /> SHOWER CLOTHESDRVERS <br /> KITGHLN SINK A DISP VENTILATION FAN � <br /> --T <br /> OISHWASHEfl AANGE HOOD <br /> LAl1NURY TRAV WATEf7 HEATER <br /> CLOTHES WASHEFi WOOD STOVE <br /> URINAL 1dETAL FIR[PLACE(WOOD BUPNING) <br /> DPIIJKING FOUNTAIN FIREPLACE INSERT � <br /> —T <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS PIPING � <br /> T <br /> ROOF ORAINS—RAINLEADERS EXHAUST FAN <br /> SINN(SERVICE—BAR,ETCJ <br /> SUBTOTAL 5 SUBTOTAL S <br /> PERMIT $ P[RMIT $ <br /> TOTALFEE 4 TOT�LFEE $ <br /> FOR OFFICE USE ONLY: <br /> rt10NI5F10ALN PE�PSHOACN SI�ESEiBALK YIApCHECN11WA0E11 i[E PKEIPiNO <br /> Ll/L,-f l <br /> useeorv[ imnnu vncnrvTs�re FEES JALUATION FEE <br /> C] VES Cl NO pUI.DING / �� /� �rx� <br /> ivhOfCUNS[ _/ NOOfStOPiE9 m//a�w¢� x�ptMiuiWun�� <br /> � -�y Z l(�? I PWlABIq(i <br /> SI[[60`lpG FIPESVBINY.lE11511E0D DASEMENi � ��E�HANI(]AL <br /> �;� N� ❑ ves 'f No <br /> ,'CW`pnqr/y iaw FlFE/R�AaRMPEO� 1�[iGirtl�NiiAtiGN FUOI110NAlPLr1NLHECK _ <br /> / '(J�� V�/1 _ OTHER <br /> IiCAiON <br /> STATEUW�DINGSURCHMGE f � � J <br /> intn.inv ri,.eserv�ovsoer CIiYOFEVEflETT PUouGw0eK5 <br /> VM. LOCAL SALES <br /> �,���_ . � _ �y .(l Tl�X CODE IS 3105 �orn� _ - � � <br />