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� �f <br /> � . ..jT�MW � <br /> = APPLICATION�OR CONSTRUCTIO'� PERMIT � <br /> TO BE Cf).Nt-LETED IN BLACK INK—F�LEASE�Rli+i <br /> i <br /> ' �EATING SYSTEM: AS O SLECTRIC ❑ —� <br /> �� �' BUILDING DEPARTMENT / <br /> �'� � p 259-BB10 / <br /> f;� � � I> DEMOLITION I 1 COMBINATION BUILDING -�fuIECHANICAL �PLUMBING � i SICaN � <br /> . ���� OWNER MM A RE55 CITY 21P VHONE .. <br /> , - ryY7-d I z Sz-9�� <br /> � `, �p�ry{ �A� NI�ODRE55 CITV ZIP PNONE . <br /> � � a <br /> .i ARCHITECTORDESIGNER MAIL�DOFE55 CITV ZIP PHONE <br /> ��� '' QENEMLCONTiUCTOR M�hADDRE55 �� 'IT/ ZiP PHONE STATEUCENSEt ., <br /> A a. <br /> �� �4 MECHI�NICN.CON TOP MAILADDRE� /y� � �P PHONE STATEIICENSE��� , <br /> � /� ��''ff �„-��iF{S� �nm.0,�7� <br /> • J /j''� �.�--��r <br /> �M R ABIN6CONT ACTON AILADDNE55 � CITY ZIP PNONF/ StATEUCENSC� � <br /> H i <br /> ., M cussocwonn . <br /> ��M . f l NEW I '�. ADDITION . � A TERATION . �' REPAIR DF.MOLITION '. 1Y00DSTOVE/FRPL INSERT '�. i BUILDING RELOCATION <br /> I p <br /> � _ �� _— CONTRCTPERSONABDPHONENO. ; <br /> r�p CONTN�GT PpICE OF WOIiK �AJ <br /> y¢ p�S�RIBE RK SIXI�NE FOOTAG INVOL /J /�y� / � <br /> ! O p � ll`4KPr7� � . <br /> PflOPOSEDUSEOFBUIL I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS . - <br /> � APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEMLDESCRIPTIONOFPROPEflTV�SMOWNBELOWORATTACHFOl1RCOP1E5� PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> , .� WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> ioi e�ocK oc NOT. THE GRANTING OF A PERMIT DOES NOT PRcSUME TO GIVE <br /> � �� J� � AUTIIORITV TO VIOLATE OR CANCEL THE PROVISIONS OP ANY : <br /> J OTHER STATE OR LOCAL LAN/REGULATING CONSTRUCTION OR THE <br /> - PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED dY �HE <br /> OWNER CF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE , <br /> � CONTRACTORS LAW 1827 RGW AND 296200 WAC. . <br /> X �'—�' /�—�/� � � — <br /> pGn�IpR'-""'S ' Oe�E ` � <br /> _ P CTA[1 RE55 � �.:J <br /> .$' �' <br /> crtr e�sm[ss�kEr+sE uo <br /> �� t VLUMBING MECHANICAL <br /> � y g$ ►q, TYPE OF FlI(TURE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> � � - �i WATER CIOSET(TOILET) A�C—/VHNDLG UNITS—H.P. J <br /> . �t FOiiCED AIR SVSTEMS . .U. E.A. ' <br /> , ��� BATHTUB � <br /> , i LAVATORY(WASH BASIN) UNIT HEATERS--B.T.U. � <br /> SHOWER CLOTHESORVERS <br /> ` KITCHEN SINK 8 DISP VENTILATION FAN <br /> DISHWASHER RANGF HOOD <br /> 'i � LAUNDRY TRAY WATER HEATER <br /> � � CLOTHES WASHER WOOD STOVE <br /> . � URINAL METAL FIREPLACE 8 CHIMNEY --� <br /> FIREPLACEINSERT � <br /> � � � DRINKING FOUNTAIN —r— � <br /> �I � � FLOOR DRAIN HEAT PUMP �_ <br /> BACKFLOW PFEVENTERS GAS PIPING � <br /> . ). ROO'DRAINS—RAINLEADERS EXHAUST FAN ' <br /> � ' SINK(SERVICE—BAR,ETG) — '�� — <br /> 1 1 �� <br /> --�—. <br /> I . <br /> �� SUB TOTAL 5 SUP TOIAL 5 �'��'- <br /> � �• , PERMIT S PEflMIT 5 /.^'�� _ <br /> � � TOTALFEE $ TOTALFEE $ ' <br /> FOR OFFlCE USE ONLY: � <br /> . FRONT SETB�CK RERR SETBACH SIOE SETOALN PLAN CN�NII'� FEE RECEIPt N0. I <br /> O / <br /> use zone �or"..en VACANT SIi[ FEES VALUATION FEE I <br /> . BUILDING � <br /> tYPEOitONiS.ALIOWABIf IYPEOfLONSi.RJIWI acu>eNCr NOUVn'[uiucunns � <br /> cAav � PLUMOING <br /> i <br /> SIIEOFBLOG. MO.OFSTOflIES BASEMENL MECHANICAL � - <br /> OCCUPANCYLOAD FlRESPRNrcLEFSREO'D HEIGNTIIMItAT10N A�DITIONALPLANCHECK <br /> SPRINKLER I <br /> REASON FOR SPRINNLERS I <br /> STATE BUILOING SURCHARGE <br /> INt�NEBY PUNSAPPROVEDBY CITYOFEVEREIT PU9LICW�RKS <br /> LOCAL SRLES � <br /> TAX CODE IS 3105 TaT�� <br />