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• S /�I 2� �� <br /> ' ARPLIGATIQ"' FOR COI�lSTRUCT!"��N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEM: J GAS �_ELECTRIC J � <br /> BUiLDING DEPARTMENT <br /> 259-8810 <br /> i i DEMOLITION COMBINATION j!BUILDING i ' MECHANICAL I PLUMBING i i SIGN <br /> OWN[R M11FIL�ODR[SS CITY 21P �oG PHONE <br /> lGf� � �rt/ S- /7,?4�7✓C,��tia > iTuF r=1� wi+ �Bzo-= ,s3-'�Sa-� <br /> TENANT ldAILADDRE55 C17Y ZIP PHONE <br /> "E_)' <br /> ARCHIIECTOR�E5IGNER MAILAD�RE55 1( GITV Z'P Pf10NE <br /> 1 G l /�I�G ��U�'1h�_ � %n"iPo/� G77(„_�_ <br /> GENEBALCONTRACTOR MAILAOOPE55 / CITY ZIP PHONE STATE�ICENSEx <br /> `E1- � -I �O :✓1 �� / � _— <br /> MECMFNIC�LGONTR�CiOR tANLPODRE55 CITV ZIP PHONii STATELIGENSEk <br /> PLUM�INGCONTPAdTOR IdAILADDRESS CITV ZIP PHON'�'_ STqTELICENSEa <br /> f.ONTHPCT/P,RICE OF'NORK <br /> S yG�00 0 � <br /> DESCfiI6E WORK AYD SOU/Rc FDpTAG`.INVULVED f,ONTALT PEPSOt!AND PHONE NO. <br /> 1 UV <br /> �.r �', - Cr�ti,s;-�c.; e-��� m,a�-mcc.��+..1 � S��4s&� <br /> ���� �t� -J- .�Q/a-✓L (�.ft�HG� I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> aaoaoseo use oF euaoiNc AFPLICATION AMD KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> � PROVISIONS OF LAWS AND ORDINANCES GOVERNING TH!S TYPE OF <br /> S I-.IZ. <br /> iOTALDE�Noy�jqOp,t(�rv,s�FOF �r ;� i[5� — WORK WILL 6E COMPLETED WITH WHETHER SPEGFlED HEREIN OR <br /> /'/l1,T �� NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OH CANi.EL THE PROVISIONS Or" ANY <br /> �n[,��g f?r'�t � ) P(< � �GK -uao ^ 1�-�<� _ OTHER STHTE OR LOCAL lAN REGULATING CONSTRUCTION OF THE <br /> AAy� n PERFORMPNCE OF CONSTRUCTION.THAT I AM AUTHORIZEU BY THE <br /> /L L,�. 't-YLP.-��.'- d-� �-�� ��- �j� -y OWNER OF THIS PROPERTY TO P[RFORM TI1E WORK FOR WHICH <br /> �---� APPLICATION IS MADE AND I COti1PLY WITH THE STATE <br /> Pnace�Tnx i.c.Nur,+oea GON7RACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> Q7�� -OOo -O�/- oaa / <br /> CONSiRUGT10NL0ANLENDEfi.A�CRE55.TELEPHONENUMOE❑ �7g- Go4Y /' �/ � �� <br /> (/,t t� i1�r %.n.�.i ic�F Sil��a� Rta r.1cIS C c;.,t [v,.,.� X U/�"r- ���-- S`.7i '=�G <br /> P OJ[CT ADD S� 8—� / � s,crv.mnc ����C'�.'ZS � pA1E <br /> 22� �� crtvousixessur.�usv.o <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> y WATER CLOSET(TOILET) , ! � — AIC-A/HNDLG UNITS-H.P. <br /> ( BATHTUB � ; '� FORCED AIR SYSTEMS-B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) %/� �j UNIT HEATERS-B.T.U. PA <br /> / SHOWER ' / ' CLOTHES DRYERS - <br /> � KITCHEN SINK&DISP � ; -$ VENTILATION FAN � _ <br /> OISHWASHER RANGE HOOD '_ <br /> LAUNDFY TRAY - WATER HEATER � <br /> CLOTHES WASHER � � WOODSTOVE ' <br /> URINAL METAL FIREPLACE(WOOD BURNING) 3�J' � <br /> DRINKING FOUNTAIN i FIREPLACE INSERT �_ <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFI.OW PREVENTERS GAS PIPING <br /> ROOF DRAINS-RAINLEADERS EXHAUST FAN <br /> SINK(SERVICE-BAR,ETG) <br /> — , <br /> ��_ <br /> SUB TOTAL 3 � � _ SUB TOTAL $ <br /> PERMIT 5 _ PERMIT 5 � <br /> TOTALFEE S ' TOTALFEE S � ' <br /> FOR OFFICE USE ONLY: <br /> FRONiSEtBAC/ REAFi5ETf1ACK SIOESETBACN PLFNCHECRtlUMBER FEE / REC@IPTNO. <br /> � � s � , � y- ros� a�� �� a53� <br /> use_oNe ioTneen vncnvi e FEES VALUATION FEE <br /> !� �-� �. YES ! NO BUILDING _�.l`7 ��JL� <br /> 1Y�0�N5� 110.UFSTOFIES o¢u��u+Gx r.p0�o'::['.�nr;un'�5 � <br /> 3 °O0° FLUMBING ' <br /> /) �I <br /> 52EOFBL�G FIRESPRINNLEPSREOD BAS'iMENT ,/ h�ECHANICAL (�_ <br /> « 7i`C�y�'�U O -'. YFS '." ry� - - <br /> A�DIiIONAL PLAN CHECK T <br /> OCCUPANCV:OAO PIRE�LAR1dRE0� NE�GHTLIMITATION � <br /> -����-�'-��-`,�Aq � OTHER �� � <br /> REASON L �O <br /> STA7E BUILDING SURChIARGE <br /> I'JiAdEBV PLANSAPPFOVE�BY CITYOFEVERE7T PUBLICWORK$ �O ' <br /> J I�- LOCAL SALES _ <br /> o�TE �,� 9y TAX COOE IS 3105 TOTAL � L) <br />