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�1� APPLICATI� J FOR CONSTRUC7 JN PERMIT � <br /> TO BE COMPLETEO IN BLACK INK—PLEASE:�RINT <br /> BUILDINGDEPARTMENT HEATINGSYSTEM: �:GAS ❑ELEC7RIC ❑ � <br /> 259-8810 <br /> DEMOLITION . � COMBINATION BUILDING iMIfCHANICAL PLUMBING � SIGN <br /> �i.Aee�a�un�y wAxlF25S iol9���ae F��cf7T P���E �-S�-osi6 <br /> ierunr u�neuoa[ss arc nn r�rorrt <br /> �ncNrtEc�a+ocs�cucn wn�oon[ss cm zio rr�orvt <br /> LCNEPµ[ONLP��IOR EUM1�LGRE55 CILY SO' VNpNE S1AlELCEN$E� <br /> YFCN14i[�LCWIP�LIIXI Y�IL�OD�E55 CII� ZIP PIqNE $i�iELICEN$[� <br /> '1 j{UMPS Nva7�,�c J`f�u NEis'a�' u1�D.NJII/£� ��''U7L �/B6-C� 7�j�,,,,��„�,�ur,�rF <br /> PIOMBMGLONiR.�LiOB MAllAO0P65 CIiY SiP PNJNE `i.1iElICENSE• <br /> cussawain <br /> NEW . ADDITION �ERATION � REPAIfl �EMOLITION WOODSTOVEFRPLINSEflT BUILOINGRELOCATION <br /> cwrt�c*rcn mvHeHerm <br /> cwin�crvnccawa�x ��I .� ��c� -66b3 <br /> ocscnie[wwM�wo sou�ne roo*r.ec nrvavco <br /> ��SrAir er+�. <br /> nno>cseouseormmona i HEREBV CERiIfY THAT I HAVE RE0.D AND EXFMINED THIS <br /> � 2 L APPLICATION AND KNOW THE SAME TO BE TRUE AND COflRECT.ALL <br /> �w•i esceir�qrvareorenrv�srrovmoeiowonn.ucHrauneowesi PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTVPEOF <br /> WORN WIIL BE COMPLEiEO WITH WHETIIER SPECIFIEO HEREIN OR <br /> ioi �a� oF NOT.7HE GRANTING OF A PERMIT DOES NOT PflESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANGEL THE PROVISION$Of ANV <br /> OTHEH STATE OR LOCAI.LAW REGUUiING CONSTRl1CTION OH TME <br /> PERFOqMANCE OF CONSiFUCTION.iMAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PflOPERTV TO PERFORM THE WORN FOR WMICH <br /> -- APPLICATION IS MAD: AND I COMPLY \VITM THE STATE <br /> CONTRACTORS LAW iB27 PCW AND 2d6200 WAC <br /> � �_� <br /> vnni[cr�oon[ss �`•r•�wt��Cf L �_ °��r <br /> a' 10 i� 'R�D n�� F�_�=4_�„� ..�us.�ti <br /> PLUMBING MECHRNICqL� � <br /> Np. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIVMENT FEE <br /> WATER CLOSET�TOILET) AC—A�HNDLG UNITS—HP. <br /> BATMTUB FORCE�AIRSYSTEMS—�.T.U. M E.A. <br /> LAVATORY�WFSHBASIN) 11NITHEATERS—BTU. M <br /> SMOWER CLOTHESORVERS <br /> �:ITCHEN SINN b DISP VENiILAT10N FAN <br /> DISHWASHER FANGE HOOD _ <br /> LAUNDRVTRAV WATER HEATER _ <br /> CLOTHES WASHER W00�STOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEV _ <br /> �RINNING FOUNTAIN FIHEPLACE INSERT <br /> FLOOH�RAIN HEAT PUMP _ <br /> BACKFLOWPREVENTERS � GASPIPING <br /> FOOF DPAINS—RAIGLEAOERS E%NAUST FAN <br /> SINK�SERVILE—BAR.ETCJ — <br /> SUB TOTAL 5 SUB TOTAL S O ' <br /> PERMIT 4 PERMR S / � <br /> TOTALFEE S TOtALFEE 5 T�—�_ <br /> FOR OFFICE USE ONLY: <br /> raw�ru*o�c. nF�nscra�ca s�ocsc*e�cK n.wc�cc�u��n7 ttc ncccm�r�o <br /> O <br /> usEtpv[ io*nnee ••�cr.ursrtc FEES VALUR710N FEE <br /> BWLOiNG <br /> i.awcoursuiavwt irr[acoxn�^.iuu rc:..nK, mnwn��.c...� -- <br /> '"" awMertac <br /> SiIEOi&W NJCiSiOR¢5 B�.SEUENT MELIIAN�LAL y) ' � <br /> OLGIID.�NLVIWO IIP(SVNNNtF115PE99 NCpM1OMli/lip! AO�IIiONALPLANCHEGd <br /> SPRINI(LEfl <br /> 11C�SCN(0115PPWx1EN5 <br /> STAiE BUtLDiNG SURLHARGE <br /> w-.xwr cuns.rcrover er I CI7Y OF EVEflETI PVBLIC WORNS <br /> LOCAL SALES <br /> � TAX COUE IS 3105 *oT�� <br />