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APPUCATIf`Y FOR CONSTRUC'�"`7N PERMIT ��� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: _I GAS U ELECTRIC ❑ _ <br /> 259-8810 <br /> I _: D MOLITION COMEINA710N i BUILDING I`rNfECHANICAL L�UMBING L' SIGN <br /> 01�7 � �t �7 M�A/iy ADDPE55 �/� ) ��� c�\V r ZIP`I PHONE < / <br /> �y� �i �.'�� /l/Jt-✓U fi„L� G7/� �/�-1Y'J� ll�/.� � �-�I �f 1.l �GILU �l�J �( J�_`.r <br /> ENANT MAI�ppORE55 QTY ZIP PHONE <br /> A�iCHITECTOP.DE5IGNEF MAiLALDRE55 CITY ZIP PNONE i <br /> GENEFALCOYlFACTJR MAILAOORE55 LITY ZIP PHONE $iATELIGENSEI I <br /> Ou�N�2 -- <br /> MECHANIGAL GONTRAGTOi1 MAIL ADDFE55 LITY ZIP PHONE STATE LICENSE� <br /> PW AIBING ONTRRCTOR MAIL FDORE$$ CIiV ZIP PHJkE StATE LICENSE/ <br /> k — <br /> CONTFACT PRIGE O�YlORN <br /> OESCNIBE WORK ANO SOUARE P00T4GE INVpLVED LONTFCT PERSON AND PHONE N0. <br /> I HEREBY CERTIFY THAT I HAVE FEAD AND EXAMINED THIS <br /> PROPOSED USE OF 9UIl01NG APPLICATION AND KNOW THE SAME TO BE TRUE AND CORFECt ALL <br /> PROVISIONS OF�AWS AND ORDINANCES GOVEHNING THIS TYPE OF <br /> LEGlLLDESCRIPTIONOFPROPERTY�SHOWNBELUWORATTAf.NTWOCOPIES� WORK WILL EE COMPLETED WITH WHETHER SPEGFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PR[SUME TO GIVE <br /> �oi BLOCN oF pUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER $TATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> " PERFORMANCE OF CO�!STflUCTION.THAT I AM AUTHORIZED BY THE <br /> � VOVV\t�.-' . OWNER OF THIS PROPERTY TJ PERFORM THE WORK FOR WHICH <br /> c;�"�' � � 2 �' APPLIC���A,,,TION IS MADE AND I COMPLY WITH THE STATE <br /> PARCE�TA%10.NUM9ER CONTR„y�T �RS LAW 1)))ggg.D RCW AND 29G.20�WAC. <br /> CONSTRUCTIONLOANLEN�EIi.ADDRE55JELEPHONENUMBER � � //��� _ `. ' (J� <br /> C / <br /> / <br /> PROJECT ADDRESS s��� uru� �/// � os e <br /> Cil v H15'�NF%l�CLhSI 1i0 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> / WATER CLOSET ITOILET) � A/C—A/HNDLG UNITS—H.P. <br /> BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M I <br /> SHOWER CLOTHESDRVERS <br /> KITCHEN SINK 8 DISP VENTILATION FAN <br /> DISHWASHER FANGE HOOD <br /> LAUNDFYTRAY ; WATER HEATER _ <br /> CLOTHES WASHER WOOD STOVE <br /> URINAI ' METAL FIREPLACE(WOOD BURNING) � <br /> DP.iiJitlNG FOUNTAIN FIREPLACE INSERT � <br /> ---T— <br /> FLOOR DRAIN HEAT PUMP � <br /> BACKFLOW PREVENTERS GAS PIPIYG <br /> Fi'�OF DRAINS—RAINLEADERS � ExHAUST FAN <br /> ;,iNK(SEFVICE—BAR,ETC.) ; <br /> � <br /> — � <br /> 5118 TOTA� 5 ; SUB TOTAL 5 ' <br /> PERMIT 5 PERMIT 5 <br /> TOTAL FEE S TCTAL FEE 5 <br /> FOR OFFICE USE ONLY: <br /> FRON75ETBACK REARSETBACK SI�ES[iBACN PLA4GIiCLHNUt1BEF FEE R[CEi^iN0 <br /> 6' <br /> USEZONE LOTRREA VACANTSITE FEES VALUATION FEE <br /> ❑ YES `. � ��G BUILDING <br /> tVECOFCONST NOAFSTOflIES aCuwNtv uoorowElu�:auY.rs � <br /> caao pLUM01NG <br /> SIZEOFBLDG. FIRESPNM!(LERSdEO'D i�SEMENT MECHANICAL <br /> � YES - NO - <br /> OCi;UoqNCVLOAD FIqERIARMPEOD HEIGNTLIMITRI:JN ADDITIONALPLAN�HECK i <br /> OTNER <br /> REASOY -- ����� <br /> . STAi[OUILDMG SURCHARGE <br /> iNIDv,EAV PLANSAPPROVED�V i C!T �� � dERETT PUBLIC" lRH$ <br /> LO(:A!SALES <br /> c�,E � TAX i:00E IS 3105 rorn� <br /> ' _� - <br /> � I <br />