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constructioiD, <br />inc. <br />an equal opportunity employer 1 <br />general contractors <br />12861 7,, ci. <br />KELLY ROTH <br />Project Maneger <br />l A' <br />5529- 1861h place s w a box C36003a IyluTwoo(I, washington98046 <br />./ <br />ARONIIECT OR OESIONER yy.Aa RTlMIE� <br />MAIL AODRE9S <br />'rl <br />+.+I�ZLiA, <br />OENEMICONigACTOR <br />1� C i <br />MAIL ADDRESS <br />KATION FO:D <br />P MITTION Fe <br />LETED IN INK • PLEASE PRINT <br />,BUILDING ❑ MECHANICAL O PLUMBING ❑ SIGN <br />CITY ZIP <br />a <br />3 MECHANICAL CONTMCTOR MAIL ADORESS CITY <br />'i UP PHONE LICENSE <br />• <br />•I <br />PLUMBINOCONTRACTOn MAIL ADDRESS CIh <br />ZIP PHONE LICENSE a <br />'!J CLASS Of WORN <br />I+ ❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ 'WOODSTOVC/FRPL.INSE RT ❑ BUILDING RELOCATION <br />VALUATIOUN OF WVHK((CaOSST OFMATERIALS PLUS LABOR, - <br />1� �aL� <br />1 <br />DESCRIBE UWORE � <br />1 <br />'11 I C>0 L T� V Sl �ICIZZ aZ��J <br />' I USE Of BUILDING <br />Z13 4 <br />LOT BLOCK_ <br />PLuYB1Mn <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP. <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br />rCF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERE- <br />TIPOR NOT. THE GRANTING OF A PERMITDOES NOT PRESUME TO <br />GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS Or ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />OR THE PERFORMANCE OF C NSTRUCTION. <br />uIGNAT E F iMCi RAU ORIZEG AGENT DALE <br />x 2 — / 6 -) <br />ESS LICENSE NO <br />0 6 Z� <br />MECHANICAL - - <br />TYPE OF FIXTURE <br />FEE <br />WATER CLOSET TOILE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />BATHTUB <br />SANATORY WASH BASIN <br />AIR COND. UNITS—H. P. EA. <br />REFRIGERATION UNITS—H, P. EA <br />-- <br />SHOWER <br />BOILERS—H.P. EA. <br />KITCHEN SINK a DISP. <br />GAS FIRED AC. UNITS —TONNAGE EA <br />-- <br />DISHWASHER <br />FORCED AIR SYSTEMS—B.T.U. <br />WALL HEATERS—S.T.U. M <br />UNITHEATERS <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />WATER HEATER p ` iq <br />EVAPORATIVE COOLERS <br />URINAL <br />CLOTHES DRYERS <br />VENTILATION FAN <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />RANGE HOOD <br />AIR HANDLING UNIT— C F M. <br />_ <br />STOVE <br />ROOF DRAINS—RAINLE <br />_ <br />SINK SERVICE —BAR ETC.) <br />METAL FIREPLACE A CHIMNEY <br />WOODSTOVE/FIREPLACE INSERT <br />SUB TOTAL <br />s <br />SUB TOTAL sPERMIT <br />�_ TOTAL FEE t <br />PERMIT s <br />TOTAL FEE s <br />Ir115 FURTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br />'V A- <br />/1 <br />4l/I' <br />y I / 7FJ, 7 <br />CJ F dl / <br />PUN <br />FEE Cud <br />CHECK FEE <br />RECEIPT NOVACAIOC O <br />USEZONE <br />TOT <br />n <br />FEES <br />VALUATION <br />fEE <br />TYPE OF CONST. <br />OCCUPANCYGROUP <br />ELNN'�1 <br />NITS <br />©UILDING <br />=3 q <br />3 <br />SIZE OF Bl00 '/NOOF <br />/ V A <br />STORIESMAX <br />OCC <br />)(1 - <br />PLUMBING <br />IE SPRINKLERS REQUIRED ❑ YES 9YNO MECHANICAL <br />OTHER <br />=LICATIO;NACCBYPLANSLIIECNEO BY APPR FOR ISSUANCE BVPENALTY <br />TOTAL - - <br />�r� �c75 sae <br />