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^"�, �,,, <br /> APPLICArION FOR CONSTR4�:TION <br /> PERMIT <br /> Ille Evar9ree�� pyp�p�� <br /> ��� evere�t e <br /> C � H <br /> N BUILDING DEPARTMENT <br /> � H �n 259-8810 TO BE COMPLETED IN INK— PLEASE PRINT <br /> � OWNER MAILAODRE55 Ci1T C�P CMONL <br /> � y z _��y.y,�BE Ll u�cnc�i3ARBA�n ,252 8 F. �,P.yNo EveTett 98101 :25 9 -�90� <br /> �H � iENANT RIFILAD�AE55 CIiY ZIP PNONE <br /> V!H <br /> 1'3 � � MAllA00RE55 Ci1Y 2iP VIIONE <br /> AnCMrtECT OR OESiGHEP <br /> �' � e ��eeaE,c,c� Sex7oa - / 89 '� <br /> O H GENEF�LGONTPACIOR MAILPD�RE55 GiY ZIP PNONE 4CENSE• <br /> C�j �n �. <br /> O MCGHANIC0.CONiRAGTOR MAILA�ORE55 piY ZIP PI�ONE LIGENSE• <br /> � y� VLUMBINOGOM1�q�LTOR MAIL��ORESS GITY ZIP PNONE LIGENSE• <br /> t-i H <br /> y /!-A <br /> H �y �y <br /> GLASSOF WOFK <br /> �� y ❑ NEW ❑ ADDITION ❑ ALTEPATION lG REPAIR Il� DEMOLITION ❑ WOODSTOVFJFRPL INSERT ❑ BUILDING RELOCATION <br /> TENNNIMPNOVEMENTOPINi[RIOPREMODELOMIY � GOMPCTPERSONANDPIIONENO <br /> H� CONTRACTPRILEOf WONK 1C� C 1 4 J_— � _�U_ �A //.] ��.� �4�'-u-ii-�-1�+ M/�� t L� <br /> y0y �ESCPIBEWCPI(ANp50UAREF00TAGEINVOlVEO <br /> �s-rue,v �ortcHc-s/RoaFs f Sl�eu�tua� -/Duvtr .Z5 �1 - 5 9 07 � <br /> cao�osm use oa ew�oirve I HEREBY CERTIFV THAT I HAVE READ AN D E1:AMINED THIS APPLICATION AND I <br /> KNOW'HESAME�OBETFUEANDCORRECT.ALLPROVISIONSOFLAWSAND <br /> S� Jen' i 4 � ORDIN?NCES GOVeRNING iHIS TVPE OF WORK WILL BE COMPLEIED WI7H , <br /> LEG4DESGRIPLIONOFPPOPERTYISNOWN6ElOWORARALHfOURICOPIE51 yyHETHERSPECIFIEDHEREINORNOT.THEGRANTINGOFAPERMiTDOESNOT , <br /> 17ttirtu32 S' Z oF M,��I,P- �I CANL� hN� PRESUMETOGIVEAUTHORITYTOVIOLATEORCANCELTHEFROVISIONSOF <br /> ioi B�ocK� ANYOTH'cRSTATEORIOCALIAWREGULATINGCONSTRUCTIONORTMEPER- <br /> �,� FORh1A10E OF CONSTRUCiION.THAT I AM AUTHORIZED BV THE OWNER OF I <br /> THIS PROPEFTV TO PERFORM THE WORK FOR WHICH APPUCATION IS MADL <br /> `� L,. e�7f Um �1n �(LQS'f AND I COMPLY WIT4 THE STATE CONTRACTOPS LAW 1827 RCW AND '� <br /> 296.200 W4Q � <br /> Lvrq 9GNAIUREOFCONiPAC10ROPAUi110nq[DAGENi 04i[ <br /> .� �� �w/ �C L ii / M <br /> �Q�uyG � oY 1 �nrS' naaL � SnD. � X � � � C ' U I . <br /> � � <br /> PRQIEQADDR[55 APPU..<MSCIiY�U51N[SSLiCENSENOP� BUSiN[SSN E <br /> z � 2 t G N� ! <br /> ' ' PLUMBING MECHANICAL <br /> ' ' NO. TYPEOFFI%TUREOH�TEM FEE NO. TYPEOFEOUIPMENT FEE � <br /> � WATEACLOSET�TOILEn WC—A/HNDLGUNITS—H.P. _ <br /> '�' BATHTUB FORCED AIR SYSTEMS—6T.U. M EA = <br /> LAVATORYIH'ASHBA£14) UNITHEATERS—BT.0 M <br /> ' ' SHOWER CLOTHESDRYERS � <br /> � KITCHEN SINKB DISP. VENTILATION FAN � <br /> ' DISHWASHER _ RANGEHOOD � <br /> LAUNDRV TF.AV WATER HEATER <br /> ' CLOTHESWNSHER _ WOODSiOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEV _ <br /> �1 DRINKINGFOUNTAIN FIPEPLACEINSERT — <br /> � FLOOR DRAIN HEAT PUA7P <br /> 1 BACKFLOW PREVENTERS GAS PIPING <br /> � E%HAUSTFAN <br /> ROOF DRAINS—RAINLEAOERS — <br /> 1 SINK(SERVICE—BAR.ETC) _ — , <br /> ' _ — <br /> 1 <br /> ' SUBTOTAL S SUUTOTAL 5 _ <br /> PERMIT 5 PERMIT 5 _ <br /> TOTAL FEL 5 TOTAL FEE 5 <br /> FPONTSET&1CN � REAASEiOAGN � SIOESETBACN /O PUNCNEC NUMOEP FEE � PECEI NO <br /> ` 30� io" Z" �"G.s'o" Z� 35 0'' � S U" g I�L,L�g ° ((�- �.�I "7� <br /> USEZONE �j w^rnnenC i�pX�7O' �A�a�Tsre FEES VALUATION FEE <br /> �l�. L S�,Jb� ❑YES '�'NO <br /> BUILDING � ��'-- �l 1 LL� <br /> iYPEOFfANSi. OCCUPANGYGROOP NO.OFpWELLINGUN115 �� <br /> ALLOWABLB/PCIOF�� �r 3 � PLUMBING _ <br /> �� <br /> SREOF9L�0 I NOOfSTORIES ,BYSM[ OCCLOAD MECHANICAL <br /> Y `/�Rbov 2 �� �� <br /> MEiGNiLIM1iALI0N QTMER �/ <br /> �' J � <br /> FIRESPNINKLERSREOUIRED ❑YES .ND STAiE BUIl01NG5URCHARGE I� )^, <br /> STATE ENERGY SURCHARGE <br /> APPLICAtIONAGCBY P�AH��PP� PUBLICWORKS <br /> —C�Ill / �-�/ . <br /> ti JV�� y�C.i TOTPL , <br />