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r <br /> APQLICATIL�1 FOR CONSTRUCT�AN P�RMIT /�j � � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT +���'��T � <br /> y�C n�+ � BUILDING DEPARTMcNT HEATING SYSTEM: J GAS i.J�LECTRIC J_ _ � j <br /> Cn t� r� 259-8810 � ' <br /> �� H DEMOLITIOIV COMBINATION BUILDING MECHANICAL °LUMBING SIGN <br /> � f] (p OWNER IAAILAO�RE55 GiV ZIP PHON[ <br /> H�� „u��(2�•:sw�gnl �o��-.ox `�(4Z. Evcc2i-rr_g�{zr�1 7s�u1 Zs2- 130��.___ <br /> tyC O TENA'NTf r's/AEiC c..o�r uni�nooaesc GTY ZiP aHONe . <br /> H .7 V AGf�N� I <br /> p �' p ARCHREGi OR DESIG�Eq� IdAIL ADUqE55 CITv ZIP PHO�IE <br /> �yH v� _—� CUECL�'7'7 �1�d20( 'ZOG�LSZ—(3�—_ � <br /> l�.ossw�v�w Y3ox`ll�i� <br /> � 'jy'� GEIlERRLCONTFACTOR MaILAO[1RE55 CILV ZiP PHONE 51niELICErvSE[ �I <br /> � �— C' oss��� Po�ox7i �Z C-.�c�ac_�-r 9�z.o� zx / z�z- �3o� <br /> d <br /> � �"� � Ml�MPNIULCONiRACTOF MPILA�ORF.SS CIiV ZIP PHONE SiPTELICENS[� il I <br /> ��(] �A/V' / <br /> � PLUMBINGCON��R MRILAOD(iE55 CITY 21P PMONE $iPTELICENS[M � <br /> aH� --N � — <br /> CA55OF WORK <br /> r y y . �IEW A!JOITION � ALTERATION jQ REPAIR '� DEMOLITION � WOODSTOVE��RPL INSERT � Bl11LDING RELOCATION <br /> C01lTACT PERSON RND PHONE NO. <br /> g d y �-�x,o R o ss vHq K <br /> ��'+ CONiFAGTPFICEOF\VORK � <br /> ' �s�� DESCWBE WORN PNO SOVARE FOOTAGE INVOLVEO . <br /> Ho C�i� �t 4c.o_�l�a p,c��uQ w�— ou�c�n '�� 5 , , <br /> vnoaoseouseoFe�i_ort�c i HEREBV CERTIFY THAT I HAVF: IiEAD AND EXAti�WED THIS . <br /> Rei���:�� ��'��Fx � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> �ecn�oescaivnoneFvnovearv�sHowvsewwor+nnneF�FouRcoPiesl PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> WORK WILL BE COMPLETED WITH WHETHEFi SPECIFIED HEREIN OR <br /> �pr b�ocrc oc NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANGEL THE PROVISIONS OF ANY � <br /> LOT Z3 ow� G Y �7 L�+ �����- OTHER STATE Ofi LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> �, PERfORMA1JCE OF CONSTRUCTION.THAT I AM AUTHORIZED 8Y THE , <br /> '(��(!L�{ ,,,.�4.a�nourLs i19D��� N Uev nWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COM1IPLY WITH THE 5'fATE <br /> + �o n-n �I CONTRACTORS LAW 1827 RCW AND 296200 WAC. � <br /> QCCp W,T I��{C�`/�2 I�N VO� L q <br /> _����"-co� 5fnc o..,.iz x-I/""�ll`� ' w �-==-�yt'�-������--. <br /> •A1L'a[ E <br /> PRpI[CT ADDPESS _ � <br /> ," ��� O ' � �.� � orveuswessuc�rvsrr.c <br /> � MECHAWICAL <br /> I �r PLUMBING � - -.--� <br /> �� �� NO. TYF'E OF FIX7URE OR ITEM FEE NO. TVP:OF EOUIPMENT FEE <br /> i A,'C—A�HNDLG UNITS—H.P. <br /> WATER CIGSET(TOILET) <br /> BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> �� LAVATORY(lNASH BASIN) UNIT HEATERS—B.T.U. M <br /> 1 !i� SHOWER CLOTHESDRYERS <br /> I . KITCHEN SINK 8 DISP VENTILATION FAN <br /> � �ISHWASHEFI RANGE HOOD <br /> � WATER HEATER <br /> � LAUNDRYTRAY <br /> �� CLOTHES WASHER WOO�STOVE <br /> URINAL IdETAL FIREPLACE S CHIMNEY <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN � HEAT PUMP <br /> 'I !1_� BACKFLOW PREVENTERS i GAS PIPING <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) <br /> � ,�� — <br /> � --�— <br /> SUBTOTAL � SUBTOTAL b <br /> PERMIT 5 <br /> !'+l TORALI FEE 5 TOTAL FEE S <br /> FOR OFFICE USE ONLY: <br /> FqONT5ET9ACK HEARSETORCK SIOESERIRCN PLnNCUELItNIIM�EP FE[ RECEiPiNO <br /> 3�JOv <br /> usezor+e �oTaaea VAGRNTSITE FEES VALUATION FEE <br /> BUILDING �$- '�U <br /> iYPEOiCONiS.ALlOWABLE TYPFOF[ONSLAL1UAl ot[uveacr rv00iDw[wuc'.xns i <br /> ,H',3 FLUMBING _� <br /> r. <br /> SIZFOF�LM'i. NO.OiSTORiES BASEMENT M.ECHANICAL <br /> i <br /> 08CUPANGYLOAp FiRESPflNKLER5flE00 HEIGHTIIMrt�TION A�DITIONALPLANCHECN �7 i,�S <br /> i <br /> SPRINKLER <br /> RCASON FOfl$PRINNLEPS <br /> --i— <br /> STATE BUILDING SURCHARGE y �s O <br /> iNiAe[BV PLANSAPPROVEDBV CITYOFEVEflETT =uoucwoAKs <br /> LOCAL SALES <br /> /—� TAX COOE IS 3105 T�TA� �' � s� <br /> — I �l �f}.� cr- �/���Lf •�U <br />