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APPILICATIC 1 FOR CONSTRUCT-INPERMIT <br />TO BE COMPLETED IN BLACK INK -PLEASE PRINT <br />EATING SYSTEM: d GAS ❑ ELECTRIC ❑ <br />BUILDING DEPARTMENT <br />259-8810 <br />❑ DEMOLITION Li COMBINATION El BUILDING MECHANICAL I-]PLUMBINGCI SIGN <br />........., wn ennnFSS ':ITY ZIP PNDNE <br />LENANt <br />G.. <br />MAILAODRE.iS <br />CRY <br />LP <br />I., <br />O <br />ARCHITECT OR DESIDNER <br />MARADDRESS <br />LRY <br />2N <br />PHONE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />LITY <br />IIP <br />P14ME <br />STATELCENSEA <br />MECHA41CALCpEFADFCR <br />MAIL ADDRESS <br />LITY <br />21A <br />PHONE <br />STATE LCENSEA <br />MMLemIMY, <br />--E1��-- <br />Ii0 %inGT4J <br />Imlr <br />3ro230D <br />lyw=TgLZIEIIG6 <br />RUMBWILpITRACTOR <br />MAKA DREBE <br />CITS' <br />ZIP <br />PHDHE <br />E51A.. LICENSE <br />CONTRAETPRICE OFWOR ZZcA <br />DESCPISE VAN,( AND SQUARE FOOTAGE INVOLVED^Fm0 <br />CONTACTPEASONANDPHONE NO. <br />K. . l <br />JC <br />IBMY <br />�1Q23�ft�11HS3gZbGb <br />Mgt �_.n.sm sNTAL.NIK rrtiRec.o L <br />_ <br />i <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PlgvoSFOUSE DF BULDINO <br />1)cozL4L C11JLe <br />PROVISIONS OF LAWS AND ORDINA14CES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />LEGAL DESCRIPiCIH CF PIIOPEHTY ISNDWNBELOVIORATALNIWOLOPIE51 <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />LOTBLOCK DF <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION 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 />CON RACTTLAW 18.27 RCW AND 296.200 WAC <br />PARCELT.AKID NUMBER <br />1 _/ _ ` �4 <br />-:? <br />--11—• <br />COHSTRUCTION LOAN UNDER, ADDRESS. TELEPHONE NUMBER <br />PRAT ADDRESS <br />% L <br />,Ii � <br />sA.e <br />PAR <br />UI�BVSN[SSIK(NY N] <br />PLUMBING <br />MECHANICAL <br />NO TYPE OF FIXTURE OR ITEM FEE <br />NO. TYPE OF EQUIPMENT FEE <br />WATER CLOSET(TOILET) <br />AIC—A/HNDLG UNITS—H.P-Z.'Vz-1-3 <br />BATHTUB <br />FORCED AIR SYSTEMS—B.T.0 E.A. <br />_ <br />LAVATORY (WASH BASIN) <br />UN-THEATERS—B.T.U. M <br />SHOWER <br />CLOTHES DRYERS <br />KITCHEN SINK 8 DISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />_ <br />FLOOR DRAIN <br />HEAT PUMP__ <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRAINS—RAINLEADERS <br />EXHAUST FAN <br />SINK (SERVICE —BAR, ETC.) <br />SUBTOTAL 5 <br />SUBTOTAL $ <br />PERMIT S <br />PERMIT $ <br />TOTAL FEE 3 <br />TOTALFEE 5 <br />r,. aErrwc wc..�.c.. <br />ER <br />FEE <br />RECEIPTHO <br />FRONTSETUCK <br />REAR SETBACK <br />SMSETELEI <br />PLAN CHECK NO <br />USE ZONE <br />LOTAREA <br />VACANT SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />❑ YES 0 NO <br />TYRUCBMi <br />NO.OF BiFMIES <br />PRNM A¢PIMrtLLI44UWit <br />--- <br />Elw <br />PLUMBING <br />SUE OF BLDO <br />FIRESPRINKLERSREOD <br />BASEMENT <br />MECHANICAL <br />❑ YES ❑ NO <br />OECUFANCYLDAD <br />FINEALARMREOD <br />NEOMLWMATCN <br />ADDITIONAL PLAN CHECK <br />OTHER <br />RFABON <br />STATE BUILDING SURCHARGE <br />INTAKE BV <br />NA2iS APPROYEDOY <br />CITY OF L:'EflETT <br />PUBLIC WORKS <br />LOCAL SALES <br />TAX CODE IS 3105 <br />TOTAL <br />DATE <br />