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APPLICATIC* FOR CONSTRUCTIVN PERMIT <br />TO BE COMPLETED IN BLACK INK -PLEASE PRINT <br />P�h HEATING SYSTEM J J ELECTRIC J <br />BUILDING DEPARTMENT -- <br />259-8810 PLUN31NG SIGN <br />1, DEMOLITION COMBINATION BUILDING MECHANICAL <br />OM1Eq 4Ail AOJPE55 <br />CITY ZIP PHONE <br />IENANi MAL E:lONE55 CM LP PINXiE <br />AR[H11ECi ON DE'aGNER 4AM1 ADDRESS <br />CITY DP PHdiE <br />ECNIRACT PRICED WMY. <br />COMACT PERSON AND PHONE Nn <br />DESCRIBE Y:nRRANn SWARL FCOVIDE IM Mn D <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />IIIaEEE4l/ddd---2A¢¢ ram- <br />ROPOSED USE CF BL'SDMG <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />LEOAL 11RIPTON OF F E RTY IsrwwN BELOW Un A4.ADH rvro COAIESI <br />NOT, THE GRANTING OP A PERMIT DOES NOT PRESUME TO GIVE <br />DLaK GE — <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />LoT <br />OTHER SATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION, THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAZY 18.27 RCW AND 296.200 WA',. <br />PlIc TAX 1n. NUAIDEB <br />NGWIM[ w1E <br />CgiSTRULiFRIL0.W LENDEn AOnNLSE-TELEPng1ENUSER <br />PROJECT ADDRESS <br />ury usWLwaEML.o <br />MECHANICAL <br />PLUMBING <br />TYPE OF FIXTURE OR REM <br />FEE <br />NO. <br />EOI <br />FEE <br />NO. <br />AC-A'HNOLG UNI <br />WATER CLOSET (TOILET) <br />FORCED AIR SYSTEMS--B.TA. Ed E.A. <br />BATHTUB <br />UNIT HER . M <br />Y (WASH BASIN) <br />LAVATORY <br />CLOTHES DRYERS <br />VENTILATION FAN <br />SHOWER <br />KITCHEN SINK d DISP <br />RANGE HOOP <br />DISHWASHER <br />WATER HEATER <br />LAUNDRY TRAY <br />WOOD STOVE <br />CLOTHES WASHER <br />METAL FIREPLACE (WOOD UURNING) <br />URINAL <br />FIREPLACE INSERT <br />DRINKING FOUNTAIN <br />HEAT PUMP <br />FLOOR DRAIN <br />GAS PIPING <br />BACKP-OW PREVENTERS <br />EXHAUST FAN <br />ROOF DRAINS-RAINLEADEHS <br />SINK (SERVICE -BAR. ETC.) <br />^— <br />SUBTOTAL $ <br />SUBTOTAL 3 <br />_�_. <br />PERMIT $ <br />PERMIT 8 <br />TOTAL FEE S <br />'— <br />TOTAL FEE $ <br />�`— <br />FOR OFFICE USE ONLY: <br />I UO1n bEt8ACK REAP: <br />;YES '.-i NO <br />I.PI WLGNSE ND asTORKs l;�;' In orwul <br />'IlF GP EMIIN - YES n NO <br />DATE I TAX CODE IS 3105 <br />BUILDING <br />PLUMBMG <br />MECHANICAL <br />ADDI'IGNAL PLAN CHECK <br />oniEn <br />STAI I aUILDWG SURCHARGE <br />.Bt IC WORKS <br />TOTAL I Z <br />