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A,PPLI�:ATIC ^7 FOR CONSTRIlC'�"�ll� PEF'tMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DFPARTMENT HEATING SYSTEM [�GAS .J ELECTRIC iJ _ <br /> 259-8810 <br /> I DEMOLITION L COMBINkSION �+' BUlLDING ! MECHANICAL �i PLUMBING i ! SIGN <br /> OWNE9 ��,pI�A00RE55 CRY �/ ZIP PHONE <br /> �ac./ C�raSi oZs v �c��t��4 �✓�tr 7r" 9Y7i'i� <br /> TENANT MA!L4��RE55 GITY ZIP PHONE <br /> � <br /> ARCHITECTCFIDESIGNEfl 'dAILADDRE55 CITY ZIP pHONE <br /> C h<1 !� <br /> �GENE�R�ALGOMTRACTOF � h1A/IL�DORESS CITV 21P PHONF cTqTcI.ICENSEk r <br /> ✓e'LPon �i�r�T�vh �/D�rcS �7o�-or;.a- v,•w �� vv.�nf)' S�� 341 /373' l�aLoa�(� rS� -CIT <br /> MECHANICALCONiRAGTOR fdAILADDRE55 qTV ZIP PHONE STATELICENSEe <br /> PI.UldBINGCONTRACTOF IdAi�AD�flESS qTV ZIP PHONE STATELICENSEe <br /> CONTRACT PFIC:qF WORK <br /> 'J[��oszc�_ -- <br /> SCRIBE WOPK FN7 S�UARE FOOTAGE INVOLVL!1 pONTACT PERSON AND PHONE N0. <br /> P»+ot�'� /' �O'� <br /> ��Pu> �'v,C� �?�o�s�.,,;,�T—/��l�i�n 3af�t ve �;e � 'v� -r 7 — <br /> fP�'�e � i HEREBY CERTIFY 'lHAT I HAVE HEAD AND EXAMINED THIS <br /> P:i0PO5ED USE OF BUiL01NG APPLICATIOIJ AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> �al, PROVISIONS OF LAN.S AND ORDINANCES GOVFRNING THIS TYPE UF <br /> LcG�LDESCRIPTIGNOFPROPEPTV�SHOWNBELOWORATTACHTWOCOPIES) WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �aTa�/t�ZZ BLOCK��"'� oF ��6��'� ��'��� � NOT. THE GRANTING OF A PERMIT DOES NOT PRcSUME TO �IVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> ec�, �. OTHER STATE OR LOCAL LAW REGULATING CONSTFUCTION OR THE <br /> v4,L 3 �s P s i /� � � 5:.�,H <br /> /� i PEP.FORM1IANCE OF CONSTRUCTION.THAT I AM AUTHOFIZED BY THE <br /> CO�� OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> PAR�EIlAXI nuraoea APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> /%///p �' /1 _ CONTRACTORS LAN11027 RCW AND 296200 WAC. <br /> // ( X� !/ <br /> CONSTROCTIOilIOANLENDER.A�DRESS.TELErFONENUMBER <br /> /���. ,� 5�G 7�'-f <br /> PROJECT/�DDRESS si Hnrur+e on*c <br /> �5 aNL Lo�,b azP �„v�o���Ess�����,;; �:, <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FIXTURE OR ITEM FFE NO. TYPE OF EOUIPMENT FEE <br /> � WATER CLOSET(TOILET) A�C—A,. NDLG UNITS—hI.P. I <br /> �_ BA�f I-iTU6 ; FOFCED AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORI'(WASH BASIN) � UNIT NEATERS—B.T.U. M ; <br /> f SHON��R � 1 :;LOTHES DRYERS _ � <br /> KITCF V SINK 8 DISP ; VENTILATION FAN ; <br /> DISFIWn�4ER ! RANGE HOOD �- <br /> LAUIV�flY TRAY �'lATER HEATER <br /> CLOTfIES WASHER � VJOOD STOVE � <br /> URINAL ; METAL FIREPLACE;bVOOD BURNING) <br /> DRIM<INC FOUNTHm I FlFE°LACE INSERT . ; <br /> fLOOR DRAIN HEAT PUMP —r— <br /> bACKFLOW PF;EVENTERS ; GAS PIPING <br /> F•:OF DRAINS—RAINLEADERS [XHAUST FAN � <br /> SINK�SERVICE—BAR,FTC.) <br /> --�— <br /> -- — -- — <br /> —— � <br /> � � <br /> -- � -- <br /> FUE �OTAL 5 ; SUBTOTAL S <br /> PERMIT S PERMIT $ � <br /> TOTAL FEE S TOTAL FEE 5 <br /> FOR OFFICE USE ONLY: <br /> FFONTSETBACK REAFSETpAGN SIDEScTBACK PLANGHECKN h18CA FEE RECEIPTRO� <br /> �/� 3.�D <br /> use +e �oTnaen VACFNTSITE FEES VALUATION FEE <br /> " S� YES G NO BUiLDiNG • ,rj �� �/� 7 � p(� <br /> lYPEOFCONSi. NO.OFSTORIES ocN�:!¢v iAo�oNEwuGW:rtS — <br /> a�„^ ' � <br /> �_ � • 3 PLUMBING 3S � U D <br /> SIZEOFBLOG. FIRESPRINKLEFSRCO'D BASE�YF_S �! �fO �'�ECHANICAL /S i L�'� <br /> � ' � ACDITIONAL PLAN GHECK ' <br /> OCCUP4.NCY LOAO FIRE ALARM REa D HEIGNT UMITATION � <br /> I� /L �-- Zg - ; - <br /> � OTHEF _ <br /> REASOtJ — <br /> STATE BUILDING SURCHARGE ��rJ <br /> MTAKE�Y �—�-"_— PiANSAP�'R�DBV --"— � <br /> � CITY OF FV68�TT PUBLIC WORNS , <br /> I LOCA!_;iP.�ES <br /> pqT�v � S� TAii COG'r !S 3105 TOTAL <br /> � <br /> A <br />