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APPLICATIO� FOR CON8TRUCTILN PERMIT � <br /> ro ee corx�o�euac xnc�.�v�rt <br /> BUILDINO DEPARTMENT HEA71N(i SYSTEM: OAS O ELEC7RIC O <br /> 259•8810 <br /> Il DEMOLRION ❑ COM8INATION �BUILDMKi 1_1 MECHANICAL ❑PLUMBINfi ❑ SNiN <br /> dRER YUL�Op[t3 GiV iv 'Ip�E <br /> �v�r �,�ous�/� ,Aun/sa*✓ i*o� On�i.e evae.rr wn S'v�to/ � � d�?%�'uL <br /> nrux� w..nw�ee cm i. �c�c <br /> •'IGMiEtT0110E4N4N WLMMf&4 GIY M IIIdE <br /> DY�rrM/ A,�direrrs /ro2 �bavrr N�M 6vaeem uiR fbaoi ao� asr��i <br /> ocxewucwiwcmn uu�ooirtss cm ar mwc ei�rt�wne� <br /> `/e 3 <br /> r axm�cmn w��aor�ss cm zr nowe aarziceraar <br /> viuw�acwrwcron wiwonEss cm zr rrawE ar�rzuceraEr <br /> cussanene <br /> f I NEW I I AOOITION AUERATION qEPAIH IJ OEAqLITION I 1 WOODSTOVE/FRPLINSERT IJ BUILDINURELOCA710N <br /> t � caawrrtnsou ra. Q_�' <br /> Cd1iMCT%IKEOFWONII �O C � F�.� <br /> OESCNlENOM/JA6W�NEfOIT NVOI <br /> a�c-s��i <br /> rnoraseouseorwaurx� I HEREBY CERTIFY THAT I HI1VE RE�D 11ND E%AMINED THIS <br /> APPLIC�TION AND KNOW iHE SAME TO BE TRUE AND CARRECL ALL <br /> lEML0f4CNIPiqNOiPRCttNiY��MWNBEIOWOIlAR�1C11FqINCOPE51 PflOVISION50FUWSANDqiDINANCESl30YERNINOTHISTVPEOF <br /> WORK WILL BE COMPIETED WITH WHETHER SPECIFIEO HEREIN OR <br /> LOT �a'� � NOT.TME OR�NTINO OF A PERMIT DOES NOT PflESUME TO OIVE <br /> AUTHORITY TO VIOLATE OR C�NCEL THE PROVISIONS OF�NV <br /> OTHER STATE OR LOCAL UW REODUTINfl CONS7HUCTION OR 7HE <br /> PERFORlMNCE OF CONSTRUCTIIXJ.TH�T I AM AUTIqpQED BY THE <br /> OWNER OF P PERTV TO PERFORM THE WORK FOH WHICN <br /> APPLICA ON IS AD �ND I COMPLY WITH THE STATE <br /> CONT A1RS U 1827 W AND 2%200 WAC. <br /> X � <br /> >ro�c.�oo�ss /'iJ3G_ af-Jo.3s w,.n.K o.� <br /> 07-� [OGLC Nf'lMer< �nrwnxea�cnmw <br /> vw�le�o MEauwc�� <br /> N0. TYI'EOFR%TUREORrtEM FEE N0. TYPEOFEWIIPMENf FEE <br /> W�7ER ClOSET�TOILEn /VC—MINDL�UNITS--H.P. <br /> BATMTUB � FORCEDAIRSYSTEMS--B.LU. M E.A <br /> IAVATORV�WASHBhSIN) UNITME�TE75—B.LU. M <br /> SXOWER CLOTMES C qYERS <br /> KITCMEN SINK d OISP VENTIUTION FAN <br /> DISHWASHER MNGE HO00 <br /> LAUNDRV TMV WATER HEATER <br /> CLOTHES WASHER Wppp STOVE <br /> URINAL METAL FIREPUCE 8 CHIMNEV <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR OMIN HEAT PUMP <br /> BACNFLOW PREVENTEflS GRS PIPINO <br /> ROOF DMINS—MINLEADEN3 EXHRUST FAN <br /> SINK(SEAVICE—B�R.ETC.) <br /> SUB TbTA� f SUB TOTAL f <br /> PEIiM1T S PERMIT f <br /> TOTALFEE S TOTALFEE S <br /> FOH OFflCE USE ONLY: <br /> iNONiSEIlIiCK PEANYtB�CIt $�ESEIBACR PWlprtCNN1AlEN iEE IECEMT1q. <br /> — 7C7r� <br /> us[mr�e ioru�[� v�c�wrs�tc FEE9 V�LUA710N FEE <br /> BUILDINO O ' Sy <br /> M1rtqCdrtSNIM/ f iMFO[pRt�tiWl pvonueaun <br /> �/ PlUM81N0 <br /> 6iiE0ill00. ois1M[5 ��MI MEGNANIC�L <br /> 1 <br /> OLCURV1CYlpN iM1ESvrowtEN5PE0D MEqMl�niliqN M�ITIONl�LPIANGNEGN <br /> SVRMRIEfl <br /> PF�SOtlfOP6MNLLEPS <br /> S7�TE BUILDINO SURCIUR6E �S'O <br /> MtIJtEBY euxs�wnoveoer ry,�OFEIIERETT pueucvqnKs <br /> ��fir. JM rucco�� ,o.w <br /> a6 !6z <br />