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��� � <br /> r APPLICATIOt�FOR CONSTRUCTI�"N PERMIT � <br /> TO BE COMPLETED IN BLACK INK�LEASE PRINT <br /> HEATING SYSTEM: ❑GAS ❑ELECTRIC 0 <br /> BUILDING DEPARTMENT <br /> ' 259-8810 �� <br /> � DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN � <br /> ' OMMER M�iL��DRE55 GiTY ZIP PHONE <br /> GL�En�E P��'sztK �t?i Nt`wrtT EUt[i2c�.i�- �3�E-`�4-3C'� <br /> TENMIi M�R MDRE55 ��TY Z�P <br /> r �: r � �!c �rf- Z�-�' i !E Tr EVEe�Tt- �5�=3222 <br /> ' �PCHITEGTORDESN'iNER M�R�DDRE55 LITY IiP P�� <br /> IJ k <br /> GE4EFALCONiR�CTOR M�IL�DORE55 CiTV ZiP PHONE STtiELICENSE• <br /> C�^N3T ?14- �.7K-K�'R`.� 1 SE/l- "�10� �3-7[ZI Mc:BRlCR09_�Z!- . <br /> ��� MECMIJ/�GLL C011�CT 3��i�ooness LiTV 2iP PNONE ST�TE IICENSE .. <br /> � PLUMBMGCONTMGTOR M�RAD�RE55 Lliv ZiP PNONC STREIILENSE� <br /> M 1 <br /> �� i GUSS OF WORK � <br /> �, NEW ' � ADDITION ALTERATION V REPA�R DEMOLITION WOODSTOVBFRPL INSERT BUILDING RELOCATION <br /> CONI�CT PERSON�NO PNONE NO . <br /> �� ca�rn�crra�ceawon� OOe� _ 74]3-7�Z1 <br /> pE$Cqlg[yq{iN NA SOUARE FOOT�GE INVOLYEO <br /> �� , 2 i 02 fi E D H6C 1U oRt6i M. NO �H�l- �ES . <br /> ,� PROPOSEDUSEOFBUILDMG /^;� � i HEREBY CERTIFY THAT I HAVE REAO AND E%IIMINED THIS <br /> � G G w 'N CC. APPLICATION AND KNOW TME SAME TO BE TRUE AND CORRECL ALL <br /> �e �Epu pESCpipTqN Oi PROPEHtY IS��OWM 9ELOW OR ATt�CM FWR GOPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> y WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> Qp � io.��fi z� e�oc� �,5�1 0� - E NOT. THE GRANTING OF A PERMIT OOES NOT PRESUME TO GIVE <br /> �� AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV , <br /> U OTHER STATE OR LOCAL LAW REGUUTING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE �� <br /> � � OWNER OF TH�S PROPERTV TO PERFORM THE WORK FOR WHICH p <br /> �1�1 � NPPLICATION IS MADE AND I COMPLY WITH THE STATE '� . <br /> M CONTRACTORS UW 1827 RCW A D 296200 WAC. <br /> . � <br /> O� f <br /> X -'% Jr� Z a �'lol <br /> ' s .inc uac <br /> ' PiqJECT��E55 � <br /> j ` p'�'PUSMF59l�'.:L45f MJ ' <br /> j �� MECMAMC�L +. <br /> 1 N0. T/PE OF FlXTURE OR ITEM FEE N0. TYPE OF EOUIPMEHT FEE <br /> �' WATERCLOSET(TGiLET) NC-NHNDLGUNITS-H,P. <br /> � BATHTUB FORCED AIR SYSTEMS-B.LU. M E.A. Y <br /> '�,,-I�C�,' UVATORY(WAShBA51N) UNITMEATERS-�B.tU. M '� <br /> � � � SMOWER CLOTHESORYERS i <br /> � KITCHEN SINK 6 D1SP VENTILATION FAN i <br /> DISMWASHER RANGE HOO� �. <br /> <: �% LAUNORVTRAV WATER MEATER <br /> � CL07HES WASHER WOOD STOVE � <br /> �'�n ' URINAL METAL FIREPLACE 6 CHIMNEV '. <br /> ���� DRINKING FOUNTAIN FIREPLACE INSERT � � <br /> ' HEATPUMP <br /> �� i j g11pKROW PREVENTERS GAS PIPING � { � <br /> ROOF DRAINS-RAINIE�DERS EXHAUST FAN <br /> � �� SINK(SERVICE-BAR.ETC.1 — <br /> �J'. <br /> + - ,; <br /> � , <br /> C�: � � SUBTOTAL f SUBTOTAL E � <br /> PERMIT 5 PERMIT 5 <br /> � - TOTALFEE S TOTALFEE E � <br /> � FOR OFFlCE USE ONLY: <br /> � , FqONTSETB�GN RE�HSETBACN SIDESETB�CK PUNGNE�M^E�� FE�� `� AECEIPTNO <br /> lY <br /> � JSEZdIE IOT�REA WCANTSIiE FEES VAWATION FEE ' <br /> BUILOING <br /> � iYVEOiCONt$.�IIOWABIE iMO�CON57ACiU�I �M� iaav.ttt�i^WUN�IS <br /> PLUMBIN� <br /> • g�hppg�p�_ NO.OiSTORIES BASEMENT MECHANICAL <br /> OCGUPANCYLOAD FINESPPNKlER5RE00 HEIGMiIIMIIATIp: ADDITIONALPLANCNECK <br /> SPRINKLER <br /> � RE�SONfORSPRMKlEHS �, <br /> , � STATE BUILDING SURCHARGE <br /> � MT11KE9Y PLANS�PPROVEDBY CITYOFEVEflETT PUBUCWORKS <br /> = LOCAL SIILES <br /> TAX CODE IS 3105 roT�� ' <br />