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APPLICATIi�I �OR CONSTRIJCT-�ON PERMIT ���� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUI�DING DEPARTMENT I1EAT!NG SYSTEM: �GAS ❑ELECTRIC U <br /> 259-8610 <br /> I:1 DEMOLITION I I COMBINATION fXj BUILDING I I MECHANICAL I I PLUMBING I I SIGN <br /> OWNEII MAILAD011E55 G1Y ilP PIIONE <br /> �r9G� yhh-YhF � ��`/l�- E/;�n/Q,c-F- f1�6 � �vo�/� /u.tt 9.Piu , � 2y ?770 <br /> TENANT Mr111�0�1iE5S CIfY ZIP PIIONE <br /> �RCIIIIECTOflDESiGNER MAqpODBE55 CITY 21P PIIONE � <br /> GEtlERALCONi0�Ci00 MnI�AODRESS ptY ZIP puONE SIAIEIICENSEI <br /> ���/�� F /-�S , ��,;i��s� �,gc�� I-�r � � o L� <br /> MECNANICALCONiRACTOP MAILADURE55 CIIY 21P �IIONE SfA7EUCENSE� <br /> PIUMBW�CONIMCTOfI MAILAUURE55 CIIY ZIP FMONE STAIEUCENSG� <br /> CUSS OF WOflN . <br /> EW IJ ADDITION I_I AI.TERATION I I REPAIR I I DEMOLITION I I WOODSTOVE/FRPL INSERT I I BUILDING RELOCATION <br /> CONTqCT PEfI50N ANU PHONE NO. <br /> CONTFiACi PflICE OF WON( � <br /> -{ D .t N C�- 1�'f� U=� .3 1�'- :5 7 i-7 <br /> DESCf118E WOi1K AND SOUABE f00t�GE INVOLVEO � <br /> g,��,�� i� � ��Y 3 S��r sxt o� <br /> PqOPO5EDU5EOFBUIIDING p i HEREBY CERTIFY THAT I HAVE REAO AND EXAMINEO THIS <br /> S/N��P ��i.y��n,r.�., �S y,�� ����,p „ APPLICATION AND KNOW THE SAIdE TO BE TRUE AND CORRECt ALL <br /> LEG�l0E5CRIPiIONOF PflOPEf1I /IOWN OEIOW OIlAI7AC11 FOURCAPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE GF <br /> wr J� eiceK oF `_,/�V C=/1 /-I/� � �q�- �'�'�RK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESiIME TO GIVE <br /> Fd,QgSr f'��(',� AUTHORITY TQ VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTFUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHOqIZED BY THE <br /> OWNER OF THIS PROpERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> . CONTRACTlORS LAW 1827 RCW AND 296200 WAC. <br /> . X T', r�^�.P`�/;/i"'��_ ,�- 7- %7� <br /> PRQIECTAOORE55 saue� e on�¢ <br /> � " � � — � r��� �� V�. Llf 6J6WESSlKEN5EN0. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIxTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> � WATEFi CLOSET(TOILET) � A/C—MHNDLG UNITS—H.P. <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> LAVATORY�N'ASHBASIN) �— •- UNITHEATERS--B.LU. M � <br /> SHOWER CLOTHES DRYERS � <br /> KITCHEN SINK 8 DISP i VENTIlATION FAN ' <br /> DISHWASHER —T RANGE HOOD <br /> LAUNDRYTRAY � WATER HEATER � <br /> CLUTHES WASHER � WOOD STOVE ' <br /> i <br /> URINAL ' METAL FIREPLfiCE 8 CHIMNEY � <br /> DRINKING FOUNTAIN ; FiREPLACE lNSERT ; <br /> FLOOR DRAIN � HEAT PUMP —�— <br /> BACKFLOW PREVENTEf75 ; GAS PIPING � <br /> ROOF DFiAINS—RAINLEADERS —�— EXHAUST FAN --;— <br /> SINK(SERVICE—BAR,ETC.) � � <br /> _ _i ' ' <br /> � <br /> — —�— <br /> � , <br /> SUB TOTAL $ ; SUD TOTAL $ i_ <br /> PERMIT $ T� PERMIT $ � <br /> TOTAL FEE $ � TOTAL FEE $ � <br /> FOfl OFFICE USE ONLY: <br /> FOONfSE�BACK REAfISETBACK SIDESEIB�GK PLANGIIECKNU�jMDEfI FEE qEGEIPINO. e, <br /> �' � � s� � �L- �7 1 ;7.`J� <l <br /> USE20NE �oranea vnc��+Tsire FEES VALUATION FEE <br /> —I 3�'� Y '— <br /> OUILDING � r��S �S(' <br /> ttPE01GONI5.�llOWAOLE 7YPEOfCUNSI.ACIUpL occUnxcx NadoMuixcuuuf � <br /> 4P0U� PLUMBING <br /> -rJ �,,.1 /Z,g � —;— <br /> —,_— <br /> S ECFB NO.OFSTOIilES BTSEMEN� � <br /> i?D t�T MECHANICAL �_ <br /> s' 'Ar� Z- hSU ; <br /> OCGUPNlCYLOAU FIRESPIiNKLE05qE00 NEIGHiUMIiAtl01! ADDITIONAIPLANCHECK _ �_- <br /> N/.a rJ' � <br /> � srnir�k�ea �' , �, , �;� <br /> PEASONFOfI5Pf1INNLERS � � - <br /> STATE BUILDING SUFlCHARGE i� ���" <br />