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APPLlCATIGnI FOR COIVS7'�r►l1CT .C�N PERMIT � <br /> TO BE COMF..ETED IN BLACK INK—PLEISE PRINT ��r <br /> EH ATING SYSTEPA: �J GAS J ELEC�'NIC J _._----------- _� <br /> BUILDING DEPARTMENT <br /> 259-8810 BUILDING MECHANICAL PLUM@ING SIGI4 <br /> DEMOLITION COMBINATION — — <br /> c,:.,�q / / v•:_nooaess <br /> crtr zi� rna,e <br /> �I Y/A!/.I* 1�1..� — �IP PHONE <br /> 1[N�NT 1AAIL ADDRE55 ��T� <br /> n�'.O�REGIORDESIGNER IdAiLAODr'�E55 <br /> CITv ZIP PMONE <br /> CItV ZiP P�IONE STATEUCENS'ca <br /> pq;:qq�GONTRAf,TOR MAILAODRE55 � <br /> C�]�� .� <br /> 9H �AECHANICALCONTR4CTOP MAILAD�RESS <br /> GrtY ZIP PHONE SiATE LICE�lSE a <br /> �'.0 w <br /> H ���, Z�p prypqE STATE L�CENS[P <br /> 9HV1 �LU��i GCONiRAG10R AIAi�ADDAESS <br /> H 9 3 � id�C.o <br /> H z�-i .:inssoF aK <br /> � y'7 NENI ADDITION ALTERATION REPAIR OEMOLITION WOODSTOV6FRPL INSERT BUILDING R�LOCATION <br /> � H� — CONTAGT PEFSOH FND PNON[fl0 <br /> y �C CGNTRACTPRiC[OF5ti0PN <br /> � O� [l[SCRiBiWOHKPNO50UAREFOOTAGEiNVCIVED --- <br /> y d h/�,,, � � <br /> O H tm.oacs2�useoFeuaoinc I H"eFEBY CERTIFV THAT I HAVE READ AND EXAMINEO THIS <br /> ',b �ty A?PLICA710N AND KNOW THE SAPAE TO BE TRUE ANU CORRECT.ALL <br /> � PROVISIONS OF LAN'S AND OfiDINANCES GOV[RNI�G THIS TYPE OF <br /> �V � SEGAL�ESCFIPTIONOFPROP[RTY(SHOWN�ELOWOR��TTACNFOUFCOPIES) <br /> C3 WORK 1NILL BE COIdPLETED WITH V.F+ETHER SPECIPED HEREIN <br /> 9 H C7 sor e�ocK oF NOT. THE GRANTING OF A PERI,AIT DOES �UT PRESU1dE TO GIVE <br /> r z AUTHORITV TO VIOLATE OR CANCEL THE PROVISIJNS OF ANV <br /> H y OTHER STATE OR LOCAL LA`N REGULATING CONSTRU�TION CR THE <br /> ON H PEFFORIdANCE OF CONSTRUCTIO^l.THAT I AM AUTHORIZED BY THE � <br /> n b� OWNEF OF THIS PFlOPERTY TO PEFiPORM THE W�RK POR WHICH <br /> � �r APPLICATION IS MADE AND I COP.IPLY WITH THE STATE <br /> CONTRACTORS LAW 18 27 FCW AND 296200 WAC. <br /> � 3 O tn <br /> �-� � y <br /> I�Id�i � z; s � � � ZL x�� � �� �L <br /> �-,.,E <br /> 1=:�oJLGiAU0RE55 - <br /> 12 Z.� �-Z2�' 12_3c� Lcrca_ ,—,,:;::;..:.-- -- <br /> PLUMBING MECHANICAL <br /> NO. <br /> TVPE OF FIXTU9E OFl ITEM FEE NO. TYPE OF EOUIPM17ENT FEE <br /> � WATER CIOSET(TOILET; ___ ___ A'�—�OHNDLG UNITS—H.P. <br /> w � __. ——— . _ — . <br /> I u a BATHTUB _ _ __ __ _ _ __ FORGED AIR S�S7EMS—�:LU. M E.A. <br /> +w UNIT HEATERS-8.7.U. M _ <br /> LAVATOflYIW�SH BASINj — <br /> SHOWtR CLOTHESDRYERS — <br /> '`"' � KITCHFN SINH 8 DISP VeNTILATION FAN . __— <br /> � _� DISHWASHER _ __ RANGE HOOD <br /> LAUNDRY TRAV W�TER HEPTER _ <br /> CLOTHES WASHER WOOD STOVE <br /> -� "� META�FIFiEPLACE 8 CHIMNEY <br /> y� � URINAL _ � <br /> "w•�..� FIREPLACEINSEPT <br /> DRINKING FOUNTAIN — —T <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVEMTERS GAS PIPING . <br /> � � -- EXHAUSTFAN <br /> -'�'�� FOOF DRAINS—RAINLEADEFS � <br /> SINK(SERVICE—BAR,ETC.) <br /> i <br /> � ` _ — —_ , _ <br /> e ..� . —_ _�— <br /> �"a' SUBTOTAL S � PERMOT�L � <br /> T <br /> �� PERMIT S �, <br /> TOTAL FEE 5 � _ _ _ TO`:'+L FEE S _�__ <br /> FOR OFFICE USE ONLY: _ �,«i,,,�„�, ' <br /> fR�HL5ET8dGK <br /> REARSciOAIX SIOLSET�A[;H PlAt1CNECKflt1'l,lR�' FLE <br /> � ; <br /> vncnnrsi�e � FEES VALU��?ION FEE <br /> uSc:ON@ �OTAPEA � — - <br /> �3�ILGING <br /> '�;(i0�G01RS.ALLOWA�IE lYPEOFLOtISiACiOAL aL[qWpc+ NOOlowtw�.�� " rWMBING <br /> 9TFii�BLDG. NO.GFSTONIES 9>SEME4T MECHANICAL _ <br /> A�DITIONAL PLAN ChIECK <br /> OGGu"M�YlOA� �IRESPRNNLERSREO'D HEiGNTLIMITATION — <br /> SPRINHLER i <br /> _ — —_ _-- --T— <br /> IIEAtiOv FOR SPBINKLERS � <br /> STAfE BUILOING SURGHARGC- _ <br /> i�iv,KEov i :rsni'�noveoev CITI JFEVERETT pueucwoaks � <br /> I LOCAL SRLES �— ; <br /> I TAX COOE IS 3105 Tora� <br /> _L_- <br />