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�. _. . _ _ - �. <br /> APPLICA'Tlf*N �QFi CpN��'Rlj�'!��'JN PERMlT <br /> TO BE COh1PLETED IN BLACK INK—PLEASE oRINT ���. <br /> BUILDING DEPARTMENT <br /> HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ --� <br /> 259-88iC <br /> I1%EOLiTIOtd ❑ COMBINATION ❑ BUILDING ❑ h1ECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNER MA�LADDRESS CITY 21P pqp��E a�. � <br /> � ��Q.�y � fr.��. �✓o��-� wP�? 33z-'z a��<<d�. � ���-��-� 98z�� �so� <br /> TEHANT MAILADDRE55 CITV ZIP <br /> PHONE <br /> ARCMRECTOROESIGNER MAILAD�6E55 CITV ZIP PHONE <br /> GENERALCOyiRACTOF MAILAO�NE55 CITY ZiP PYONE STATEUOENSE• <br /> M r fCGI E l/ ESC Ca u 0.,4 ri a l/.� L r 3s�o l ol-d�r� -f/� ;ls R c�nc� ce•1-/o,�;,7{-„ q �z.Z3 <br /> MEGNANICALCONTflACTOF lAqILADDRESS CITV ZIP PMONE STATELI�ENSE• <br /> PLUM�INGCONTRACTGR AIAILAD�FESS GTY 21P PHUNE STP"fELICENSE� <br /> '�/ �/ oo G� cti c� <br /> CONTRRCT RICEOFWOflH <br /> P �.. Ne/sc,� ,�_ s � -s s_o b' <br /> DESCRIBE WORK AtlD SOU RE FOOTAGE ItNOLyEO . ,� _ CONTFGi PERSOtJ ANO PMONE N0. <br /> b� �-t r, .oe /....�s 3000 ' <br /> — I HEREBY CERTIFY THAT I HAVE REAU AND EXAIAINED THIS <br /> PROPOSED lISE OF pUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GGVERNING THIS TYPE OF <br /> LEG�LDESG(iIPT10NOFPPOPERTYI�HOWN9ELOWOPATTACMTWOCOPIES� WORK WILL BE COMPLETED WITH WHETHER SPECIfIED HEREIN OR <br /> ��T BLOGK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGUL�TING CONSTRUC'fION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> PARCELTA%IO.NIIMOER APPLICA710N IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 10.27 RCW AND 296.200 WAC. <br /> GONSTRULTION LOAN EF,n.0 P[SS,TELEPMONE NI1MBEfl ` ���/��`_=�� <br /> ' D -� L, /{�e � h <br /> PROJECT A DR s:cunruac <br /> � oNE <br /> ❑IV�OSMESS I�CENSE NO —� <br /> PLUMBING 1.7ECHANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILET) _ i A/CrA/HNOLG UNITS—H.P. i <br /> BATFITUB FORCED AIR SYSTEMS—B.T.U. M F..A. —~ <br /> LAVATORY(N'ASH BASIN) ' UNIT HEATERS—B.T.U. M ; <br /> SHOWER CLOTHEF�aYERS <br /> KITCHEN SINK 8 DISP VENTILATION FAN <br /> DISHWASHER RANGE HOOD , <br /> LAUNDRY TRAY WATER HEATER <br /> CLGTHES WASHER � WOODSTOVE ; <br /> URINAL � METAL FIREPLACE(WOOD BURNING) � <br /> DRINKING FOUNTAW � _ ; FIREPLACE INSERT <br /> FLOOR DRAIN HEAi PUMP � <br /> BACKFLOW Pf�EVEVTERS ' GAS PIPING <br /> ROOF DRAINS—RAINLEADERS —�— EXHAUST=AN <br /> SINK(SERVICtE—BAR,ETC.) <br /> � ; <br /> _ <br /> � <br /> � <br /> —�-- <br /> _ SUB TOTAL $ ' SUB TOTAL $ ' <br /> PERMIT 5 PERMIT S <br /> TOTAL FEE 5 TOTAL FEE $ <br /> FOR OFFICE USE ONl.1`: <br /> FRONTS@iBAC1( REAflSETBAGK SIDESETBACK PI.ANCHECNNUMBER FEE RECEIPiNJ. <br /> usEzoNe iornnea VACAYTSRE FEES VALUA710N FEE <br /> ❑ YES fl NO � T— <br /> BUILDING <br /> 7YPEOFCONSi. k0.OF5TOF1E5 otcurr,x��. M00lowLLuxGuvnS <br /> caa> pLUMBING <br /> i <br /> SIZEOFBIDG. FIRESPRINNLERSREOD BM1SEMENT � <br /> ❑ YES ❑ NO MECHANICAL � <br /> i <br /> OLCUPPNG�LOAO FIREALARMPEO'D I HEIGHTLIMITATION AODITIONALPLANCHECK � <br /> OTHER � <br /> {iEA50N <br /> STATE BUILDING SURCHARGE ; <br /> INTAKE Dv PlANSAPPROVEDl1'! CITY OF EVERE7'f PUBLIC WORNS <br /> LOCAL SALES <br /> on.e TAX CODE IS 3105 TOTAL <br />