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.�.� <br /> APPLICAT14rd FOR CONSTRUC7 .ON PERMIT ..�.a- ` <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT � . <br /> I HEATING SYSTEM: O GAS ❑ELECTRIC ❑ � <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> p\VNER MMLAoonEss Cltt 21r PIION[ , <br /> CJ f-�uS�ti� /��'�- - � <br /> ��t� _�p PHONE <br /> TENANT AUI. ODRE55 <br /> � � ro <br /> !� �yi� �RCN1IECTOfl0E51GNER MAILAD�f1E55 CIiV ZiP PIIONE <br /> � ^ GITY 2P ���ON[ STR7EUGENSE� <br /> �'J C1 GENERRICONiRr1CTOR FINLAODRE55 <br /> i � <br /> � CItY 21P P��ONE STAI[LICENSE/ <br /> � � {� M[CMRNIC�LCOMRAGTOR M�ILADDNESS <br /> g <br /> � ��TY Z�p PIIONE SiATE IICENSE/ <br /> � N � PLUMBI NifiPCTOR MAiLADDRESS <br /> p CUSS 0�K <br /> �q � NEW ! '� ADDITION �. '. ALTERATION REPAIR DEMOLITION WOODSTOVE/FRPL INSERT BUILDING REI OCATION <br /> � CONTACiPEPSON�NOPHONENO. <br /> �' ~ CONTRACTPPICEOFWOHK <br /> 4� M DESCPIBE 1VOBK�ND SOUARE FOOIAGE INYIX9E� <br /> � <br /> � 0~n PROPOSEOUSEOFBUiL01NG i HEREBY CERTIFY 7HAT : HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> � � lEG4L�E5G�'^TIONOFPROPENTYISHOWNBELOWOfl�TiACHFOUOCOPiE51 PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> WORK WILL BE GOMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> � � ioi eiocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEI THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> qpPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRA LAW 18.27 RCW A 296200 WAC. <br /> � /� .�^`Z'! f�12 � ?I�1 I 't l6 I -� ��o a� <br /> sicx�muc � <br /> PRQIEGT�DDRE55 <br /> —��'�r� /Oi� �nvoosmcss�xrvse�o <br /> PLUMBINA MECHANICAL <br /> N0. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) A'C—A�HNDLG UNITS—H.P. <br /> �` �� BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> • I t. UNITHEATERS—B.T.U. M i <br /> 1 � LAVATORY(WASH BASIN) <br /> � SHOWER CLOTHES DRVERS <br /> �� 1 VENTILATIONFAN <br /> i KITCHEN SINK 8 DISP '—T' <br /> DISHWASHER RANGEHOOD <br /> LAUNDRY TqAY WATER HEATER <br /> CLOTHES WASHER WOODSTOVE <br /> ��� METAL FIREPLACE 8 CHIMNEY <br /> URINAL <br /> � I ��1 � DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP <br /> � BACKFLOW PREVENTERS GAS PIPING <br /> �� ROOF DRAINS—FiAINLEADERS E%HAUST FAN ' <br /> �I �1�� SINK(SERVICE—BAR,ETC.) �'-- <br /> � i <br /> t '�1_1 • <br /> -Z SUBTOTAL 3 SUBTOTAL $ <br /> � PERMIT 5 PERMIT S <br /> •_,� ' TOTAL FEE $ TOTAL FEE 5 <br /> ` FOR OFFICE USE ONLY: <br /> FRONTSETB�CN PEARSETBACN SIDESETBACN PUNCNECeNUMBEP� FEE RECEIPTNO. <br /> 7U <br /> J <br /> USEZONE �ornaEn YAC�NTSITE FEES VALUATION FEE <br /> BUILOING <br /> tYFEOiLON6��llOW�9l[ iVPEOfLOH51.ACIUAI aCd>ucv xOdVnLLueGN.�s � <br /> 4R0°v � pLUMBING <br /> SREOFBLOfi. NOAFSTOPIES 9a5EMENT MECHANICAL <br /> OCCUP/JICYLORO flRESPRNKL[FSREOD NEIGNTUMITRTION AUDIiIONALPLANCMECK <br /> � . SPRINHLER � <br /> PEHSON FOR SPRINI(LENS � <br /> STATE BUILDING SURCHARCaE <br /> INTAKE BV PU1NS RPPROVED BV CITY OF EYEflETT PUBUC WORKS <br /> LOCALSALES � <br /> TAX CODE IS 3105 TOTAL ' <br />