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/Al��LICATIO'i ,�OR COI�YSTF�Il�TE' - .Id PI:RMl3 °�`'`°�` <br /> ...-n���,a,�,��, <br /> TO 8E COMPLETED IN INK—PLEASE PRINI" � <br /> cur or <br /> �verett HEATING S'fSTEM: ❑GAS U ELECTRIC U — _ —_— � <br /> BUILDING DEPARTMENT <br /> 259-8610 <br /> DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> OWNER MAIL�DDRESS CIiY ZiP PHONE � <br /> �cuE �imo.�F a�o� LDh13�0 ��-�rE,�- .zsa-9�s7 <br /> IENAtIT <br /> AIAILADDRE55 CITY Z? Pi1JNE <br /> �P:CHrtECTONDESiG^!ER MdiV,DCRE55 CITY ZiP P�'�ONf <br /> ��� G{�I�FpqLGONTRAQCR MAIL���RESS CILV ZIP �'HONE lIC[NSEe � ' <br /> r•�n iv�lCD�a �N� �'sTw��t�/ /zs z CA�7'tti 6�sth o�,C ri��R. 47>-+i�s7 �toL(3Gf L/o <br /> �pEC11AllICALGONTRRCiOR M.NLADDRE55 <br /> [�iy ZIP PHONE LICENSE� <br /> ,o�x <br /> C�N �iiy ZIP PMONE UCENSE n <br /> PLU�A�INGLONTRACTOP MAILAODRESS <br /> r� �3 <br /> y r. <br /> r� y� c�nssoFwoaH � — <br /> NEW �. ADDITION ALTERATION �EPAIR DEMOLITION WOOOSTOVEiFRPLINSERT �. BUILDINGRELOCATION <br /> � �� - /'� /1 WNTAGT PFRSON ANO PMONE 110. <br /> y r CONfRAGTPriICCOF4VORK � /�OD.OV _ . <br /> z� — <br /> Df ScnioE woRK Ar10 souaRE FWraGE INVGW[o <br /> � y d �e=2no,= Pa,cr�i.,-�, vi,rc.w s � <br /> 7�J O d �moeoseouse -ow�oiuc I HEREBY CERTIFY THAT I HAVE READ P.ND EXAMINED THIS <br /> � L�7 O �, y� APPLICATION AND KNOW THE SAME TO 8E TRUE AND CORRECT.ALL <br /> H C �f-r;r;r�caianor+oFa��oce��v�sHovmee�owonnrlr.r_��vcu��cn�i�.,i PRCVISIONSOFLAWSANDORDINANCESGOVSRNWGTHISTYPEOF <br /> 3� WORK WILL BE CO�dPLETED WITH WHETHER SPECIREG HEREIN OR <br /> � y z ���r__ o�aK oF NGT. THE GRANTING OF A PERMIT DOES NGT PRESUME TO GIVE <br /> H y AUTHORITY TC VIOLATE OR GANCEL THE PROVISIONS OF ANY <br /> Cy _ OTHER STATE OR LOCAL LAW REGULATIN6 CONSTRUCTION OR THE <br /> N <br /> p H PERFORMANCE OF CONSTRUCTION.THFT I AM AUTHORIZED BY THE <br /> n d� OWNER OF THIS PROPERTV TO PERFORM THE WOFK fOR "�HICH <br /> APPLICATION IS MADE ACD I GOMPLY WITH THE STATE <br /> � [�7 CONTRACTORS LAW 7827 RCW AND 295200 WAC. <br /> z HCA s�c!+aru��eorrvanncicrwHwrnouizeonctur onre <br /> r? O f/� <br /> �r c.o�� �r u o,✓ <br /> P�1nJCGiALJRE55 -- " -- �� <br /> ,?6oro �o� � sr ,:���.�_.,�.,s��;;���,.,��,�ss���«�s_��o �,�oE��s���5s�,�„� <br /> PLUMBING MECNANICAL <br /> N0. TYPE OF FI%TURE OR ITEM FEE NO. TVPE OF EOUIPMENT FE <br /> f'e �w _ WATER CLOSET(TOILET) ___ � __ ____ A�C—ArHNDLG UNITS—H.P. ' <br /> ac� BATHTUB _ FOFlCED AIR SYSTEMS—G.LU. M E.A �_ <br /> LAVATORY(WASH BASIN� UNiT HEATERS—B.T.LL M <br /> �e <br /> � SHOWER CLOTHES DRYERS <br /> I Q KITCHEN SINK 8 DISP VENTILATION FAN <br /> + DISHWASHEfl RANGE HOOD <br /> LAUI�DRY TRAY WATER HEATER <br /> '� 4 CLOTHES WASHER WOOD STOVE <br /> e i URINAL IdETAL FIREPLACE 8 IMNEY <br /> DRiNKIN FOU IN FIREPLACE INSE � <br /> —i-- <br /> FLGOR DRAI� HEAT PUMP <br /> ��@�� . BACKFLO PREVENTERS GASPIPING _ . <br /> ROOF MNS—�RAINLFADERS EXHAUST AN _ <br /> SIN (SC-RVICE--BAR,ETC.) ��- <br /> �41. � - -- -�T <br /> !'"' '+ � _ SUB TOTAL "7 <br /> SUBTOTAL S <br /> i �'�"' — � PERMIT 5 PERAIIT 5 <br /> � TOTALFEE 5 TOTALFEE 5 <br /> I � FOR OFFICE USE ONLY: <br /> fN:IIRSF.i�ACr. ��EAPSEipRGk SIOESCT�ACH VLANCNELKNUMOCR F[E PECEIPTNO. <br /> i�s�ZaN� iornaen V�CANTSITE FEES VALUATION FEE <br /> sui�otrvc j i-7 ' O d <br /> 1rrFOFcoNi50:toWAatE ��PEafGaNsiAtluat �'ceouo�Y xaoimv[w�"-,ii'�•'s — — — <br /> PLUMBWG <br /> �T <br /> � <br /> SIZEOPBLDG. NOOFSTORIES BaSEMENT �,¢LHANICAL � <br /> OCCUPANGYlOAD FIflE`%9NNlEflSRE00 MEIGHTLIMITATICN A�OITIONALPLANCHEGH _ <br /> OTHER <br /> — �—� <br /> iiFA50N FOR SPRINNLERS <br /> STATE 9UILDING SURCHARG[ � �;:�� <br /> R+LANEOY PLANSRPPHOV[DOY CIlYOFEVEREiT PUBLICWORKS <br /> LOCALSALES <br /> � TAX CODE IS 3105 TOTA� /�1/ � Sl� <br />