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APPLICaTtO� �"FOR CANSTFiUC;TI� N PERMIT ��°' <br /> TO BE COM"LETED IN BLACK INK-PLEASF PRIMT ��� <br /> y O H � HEATWG SYSTEM: J GAS J ELECTRIC �1 - - <br /> �j � � BUILDING DEPARTMENT �--- <br /> � � x 253-8810 <br /> T y y DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> y e.lAll PDORE55 CITY IP PHONE <br /> t � rn•n:En <br /> H �: r�-� i 'r iJ 1� 1 iyi�lK dy� I��t L �.a � 1'f 9�'.Zo's _ 3 ' 1- C k� '� <br /> F� O AIAILADORE55 CITV ZIP PMONE <br /> y � TENNIT <br /> h] H �TJ CITV ZIP PHON[ <br /> y H nnGertECTOii0E5iGNER AIAiLA0DRE55 <br /> `L ��Ty Z�p PHONE STATELICENSE� <br /> H <br /> � y � GE:r�AL CONTRALiOR MAII AD�RE55 <br /> � ~ �1`���T—, CITY ZIP PHONF. STA'ELICEflSEA <br /> H � O VEO�ANICNLCONTRFCTOF MAIIPD�FE55 <br /> �V n <br /> H C CITY 2iP PMO4E SiATE LICENS[• <br /> Z H ^� PLuv.�INGGONTRACTCR MAItNDDRE55 <br /> ''� yz - <br /> H H u;.ss oF vioAK <br /> �� NEW X ADDITION AI.TERATION REPAIP DEMOLITION WOODSTOVEiFRPL INSERT BUILDING RELOCATION <br /> ~ CON iACi PERSON ANO PHOKE NO. <br /> n d � <br /> � Yy <br /> r � CG�i(inCi PRiCE OF WOi1K 5 �n -- <br /> DESCRitlE WOPK AND SOUPRE OOTA EIINVOLVEO <br /> H o C�/� 1�� /c-. .,n.,c� P.al�Q,1.o �. �, S" <br /> r�noaos OUSEDF6 aowc i HEREBV CERTIFV THAT I HAVE READ ANO EXAIdINED TMS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> �rnr,�oeSCRivnoNOF ROPERTY�SHOVINBEIOWOFATTACNF00RCOP1E51 PROVISIONSOPLAWSANDORDINANCESGOVERNINGTHIS?VPEOF <br /> WORI(WILL BE COMPLETED WITH WHETHER SPECIRED HEREIN OR <br /> io� eip�H or NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIULATE OR CANCEL THE PROVISIONS OF ANY <br /> 1� �\���— OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR TH� <br /> PERFOFih1ANCE OF CONSTRUCTION. THA7 I AM AUTHORIZEU BV THE <br /> OWNER OF THIS PFOPERTV TO PERFORM THE WORK FOR WHICN <br /> APPLICATION IS MADE AND I C01.1PLY WITH THE STATE <br /> CONTRAGTORS LAW 18�7 RCW AND 296.200 WAC. <br /> x �i�,�J�) Z� � .�� 16 `(l, <br /> PI �P'E <br /> P�1��ECT(.�7{1��5 - <br /> I I �PLl1�ING C��L< �� ��`, �_ ���—vs.� :i•. r.o - <br /> MECHANICAL � <br /> 1 ' FEE NO. TYPE OFEOUIPMENT FEE <br /> � N0. TYPE OF FI%TUAE OR REM <br /> WATER CLOSET(TOILET) A�C-��HNDLG UNITS-H.P. _ _ <br /> '�1 BATHTUB FORCED AIR SYSTEPdS-6S.U. 1.1 E.A. <br /> LAVATORV(WASH BASIN) UNIT HEATERS-B.T.U. M <br /> I � SHOWER CLOTHESDRYERS -. <br /> � ' <br /> KITCHEN SINK 8 DISP VEN7ILATION FAN �_- <br /> ' _ DISHWASHEfl RANGE HOCD - <br /> ' _ LAUNDRVTRAV WATERHEATER <br /> CLOTHES WASHER WOOD STOVE i <br /> URINAL METAL FIREPIACE&CHIMNEY __ <br /> �� FIREPLACE INSE9Y _ <br /> ORINKWG FOUNTAW i- � <br /> iFLOOR DRAIN ,�" � HEAT PUMP/ _ <br /> � BACKFLOW PBEVENTERS GAS PIP G <br /> ROOF�RFINS-RAINLEADERS EXHAI�ST FAN - <br /> ��1 SINK(SERVICE-BAR,ETC.) --� <br /> I� <br /> �' / _ <br /> � SUBTOTAL "a <br /> ' / SUBTOTAL 5 — <br /> PERMIT S PERAIIT 5 <br /> � TOTALFEE S TOTALFEE S <br /> FOR OFFICE USE ONLY: neceirrrvo <br /> PLAt1CNECNNU1.13ER� FE[ <br /> l�ONiSFiCnCK �EMSETOACK SIGESELBRCiy �� � /C) /(��,��J <br /> z� . Zu � s C <br /> vncnNrSi�e FEES VALUATION FEE <br /> US[ZONL WTARF�A � � <br /> -1 �ZSXl69.J=13 L'� /JO oui�oiNc ��00_. �y�_o`_ <br /> ivPCf,iCONISALLOWABLE lYPEO�LOtl5tAL1U0.L oc�peuia r:Lmovm��'r;uva <br /> ;i� � ✓ _ N 4 � PLUMBING — <br /> 9LDG. NO Of STORIES BAS MENi MECHANICAL _ _. <br /> ADDITIONAL PLAN CHECK _, <br /> OCLUPRNCVLOAD FIRESPBNNLERSREO'0 HEIGIRpII,M�L1ilOR �_ <br /> �Ll SPRINRLER .. <br /> i— <br /> PEASON fOR SP�iAHL[RS <br /> /�1 <br /> STATE Bl11LDING SURCHARGE 'J � . <br /> „����,�_i�r-- -- � � �� v�a�, nrvnovr.00v CITYOFEUERETT Puuuctvor�hs <br /> — �� LOCRLSALES {.% ; � � <br /> TAX CODEIS 3105 TOTAL <br />