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APPLICATIQ 1 FOR CONSTRUCY� JN PERMIT � <br /> TO BE COMPLENEO IN BLACK INK—PLEASE PRIIdT <br /> HEATIN3 SYSTEM: U G�S �ELECTRIC ❑ —� <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> pEypL�TIpN � � COMBINIITION BWLDING MECHANICAL XPLUMBING SIGN <br /> q M�1�ppp[55 LILY IiP �MOM[ <br /> ���� � l aaa�Y i�o� CRAHD �VE EVER�cT w� �a.oi i!e •��ii <br /> �u""�INE IIMPdt.�E�� �„� :�P � �E 2S&-�Fl3� _ <br /> t 5 0.IDDRE55 CIiV 2iP PRp1C <br /> 1 �lllC� �C.c`� — <br /> 0[NFP4fGNiP�LIDR M�RMDHESS GfY ZIV ��K•NC SUiELCENSE• <br /> MECN�VqµCOMiN�CtOR MA0.AOORE55 CIi�' ZiP FMOME SiAiElqCNSE• <br /> RIIMlMpCplTN/�C1Ofl WR�DCNCSS CItY IIP RU�1E Sil.tEI�LENS[� <br /> C/w` i • . /J <br /> ^1��5 OF MOI1N <br /> � NEW ADUITION ALTERATION XREPAIR DEMOLITION WOOUSTOVE'PRPLINSERT BUILDINGRELOCATION <br /> cor�r�ci vrasou u+o>rwnc ra <br /> LWiP�L PRCfOFKCNIt <br /> pE$CFBE NMK ANO SGUI.PE f(%11�6E MV0.VC0 <br /> u m b�. <br /> �ao�fce�• ' � — <br /> v/n]pbsc sEanmmmc,/� I NEREBV CERTIFV TNAT 1 MAVE REAO AND E%AMINED TMIS <br /> \��.lYO h�.I KL.C� ����C S� � APP�ICATION AND KNOW TME SAME TO BE TRUE AND GORRECT.ALL <br /> iEouo[Scaivnouovariov[n*v�s�rnvrvBE�owonet*ecr�roue�/`"rcsi PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> WORK WILL BE COMPLETFD WITN WHETHER SPEGFIEO NEREIN OR <br /> iot e�ocK . or N0T THE GRANTING OP P PERMIT DOcS NOT PRESI�ME TO Grv[ <br /> AUTHDRITV i0 VIOLATE OR CANCE� iHE PROVISIONS OF ANY <br /> OTMEfl STATE OR IOCAL LAW REGULATING CONSTRJCTION OR TH[ <br /> PERFORMANCE OF CONSTRUCiION.THAT I AM AUTHORIZED BV TME <br /> OWNEN OF THIS PPOPERiV i0 PERFORM THE WORK FOR WHICH <br /> _ APPLICATION IS MADE AND � COMPLV WITH TME SiATE <br /> CONTR OHS LAW iB 27 R N'AND 296200 WAC. <br /> x /o�I �L <br /> FMIELT WOR[55 urnnwt or i <br /> n� �a�ua �,� rr �,.P,��=,��,n�.� — <br /> ��5� MECHANIC�I <br /> rq. T1�PE OF Fl%TURE Oli ITEM FEE NO. TYPE OF EQIIIPMENT FEE <br /> _L WATER CLOSET�TOLLET) A'CrA HNDLG UNITS—HP _ <br /> BATNTUB POPCFGAIRSVSiEMS—OTU Id EA. <br /> UVA'ORVIWASHBASIN) UNITHEATEFS—B.TU. M <br /> SHOWEP CLOTHESDflVERS <br /> KITCMEN SINK A OIS� VENTILATION FAN <br /> DISHWASMER RANuE NOOD <br /> UUNDRV TflAY V.'ATER HEATER <br /> CLOTHES WASMFR WO�D STOVE <br /> URINAL METAL FlREPLACE 6 CNIMNEV <br /> DRINKING FOUNTqIN FIREPLACE INSERT _ <br /> FLOOR GRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS GAS P�PING <br /> ROOF DRAINS—RAINLEADERS E%HAUST FAN <br /> SINK(SERVICE-9RR.ETC.) <br /> SUBTOTAL S SUBTOTAL E <br /> PERMIT $ PERMIT b <br /> TOTALFEE S TOTALFEE E <br /> FOR OFFlCE USE ONLV: _ <br /> fNpliSEiB�CK �E�RSEiB�CK 5�l[SEIB�Ck �I�NGMEC✓.NUMBEP FEE NECE�P11q <br /> 38aso <br /> usExonc ior�n[� wc�msrtc FEES V�LUATION FEE <br /> BUIIOING <br /> iYRpLOMISI�IIVN�BII i1RIXLONSi�[iU4 ��^�'• ���«m•���s <br /> �"°" rwueiNc Ga <br /> 54[OFBl00 NO OFSiORlE4 B�SEMENI MEGNINICRL <br /> OCCurANcvt0+0 nRESPP�n�ERSPEOv MEicNTln/neipn A�D�ilON4lPIANCNECK <br /> � SPRiNN1EF <br /> PE�SON fOR 6M1�MRFPS <br /> STAIE BUIL�ING SURCP�RGE <br /> mi��car ruxs�wnovEoer CITYOFEYEREiT weucw0a�s <br /> LOC11L SALEf <br /> TAK CODE IS J7�5 *m►� _ <br />