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��� � APPLICATI(� F'�R CONSTRUC'�"`�JN PERMIT �� <br /> TO BE COMPLETED IN BLACK INK-PLEASE PRINT <br /> � � BUILDING DEPARTMENT HEATING SYSTEM: G GAS �EIECTRIC ❑ � <br /> �.� 259-8810 <br /> p y!!!p��� ,., DEMOLITION COMBINATION J�' BUILDING MECHANICAL �PLUMBING SIGN <br /> Q y y .. OWNER MAILADf]RESS CIiY , 21P PHONE �, <br /> T <br /> H�� Ct.�/�'i_��. �'/h7f�,ei.(JE 11�/i(L f.E'. 5�'l � �i.uF_ `l f2U/ J'�T1-9iC S- <br /> TENANT � MAILAODFE55 CI1V ZIP PHONE <br /> K n <br /> ��O ARCMITECTOR�ESIGNER MAIIADDRESS CITV ZiP PHONE <br /> I� <br /> y <br /> y� GENERALGONiPPCTOR MAILApDPESS CITY ZIP PMONE STATEUCENSE� <br /> O,,qj, d cCt�,E/JF_ rT ��iicD.�'� T,u C TloO(n Ev.�G;P.�F_-tJ �u?�9dZo3 .�37i�/ FvivE6 ���Pr/ ' <br /> MEGMO"ICALCONTRACTOR MAILAD�RESS CITY ZIP pNONE STATELICENSEv <br /> ���G�r C7 PWAIBINGCONiPACTOF MAILADORE55 CIN ZIP PNONE STr1TELICENSER <br /> �y� LLASSOFIYOPN � <br /> T <br /> ��y NEW I�ADDIT10N ALTERATION REPAIR . DEMOLITION WOO�STOVE/FRPI INSERT � BUILDING RFLOCATION <br /> �y � Cd yn �D� CONiACTP[BSONANDPMONENO,. / / <br /> ��� CONTRACT FRICE OF WORN � 1— Ul I/S�-c� /�/ ,3f�"71N� , <br /> �`4yv �ESCRI�E\VORN AND SOUAPE FOOTA(TE iNVOLVEO (J � <br /> y y /� Y / . .d� � �i�� //����� q���a <br /> 0 a a o a o s e U S E OF B W I DIN G i H E R E B V C E R T I F Y T H A T I H A V E R E A D A N D E X A M I N E D T H I S I <br /> ��y�.�f��nyr� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL � . <br /> LEGAlOESGPIPT10NOf PROPERTV�SHOWNDEL0140RAtTACNFOUR COPIESI PROVISIONS OF LAWS AND ORDINANCES GOVERNWG THIS TVPE OF ' <br /> ./ WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> ior S�� � o�ocK �S7Y oF 71t�_c.�<<, c�� Ce%�- NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GNE <br /> i <br /> y./y l`>�,� .,. AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> E-s- OTHER STATE OR LOCAL LAW FEGULATING CONSTFUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION THAT I AM AUTHORI2ED BY THE <br /> OVINER OF THIS PROPERTY Tfl pERFORM THE WORK FOR WHICfI <br /> APPLICATION IS MADE AND I COAIPLV WITH THE STATE <br /> �Y d' CONTRAC RS LAW 1827 RCW AND 296.200 WAC. <br /> S/ 'i_ 5"7� _ po _ o on <br /> x ��-/ /��L.t.:ti //�/O -9a <br /> PRQIECTA�ORE55 f s�cH+�on[ o��t: <br /> asa 3 s��,�� ���.a,�sy.�. _E,=E„o I <br /> '�' PLUMBING MECHANICAL <br /> NO. TVPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE I <br /> ' ' WATER CLOSET(TOILET) r AC—A�HN�LG UNITS—HP. 1 <br /> � BATHTUB 7 FORCED AIR SYSTEMS—B.T.U. M E.A. i <br /> '�1 LAVATORY(WASH BASIN) � � = UNIT HEATERS—B.T.U. M � <br /> SHOWER 7 � CLOTHES DPYERS I <br /> 1f KITCHEN SINK 8 DISP � VENTILATION FAN <br /> � �ISHWASHER RANGE HOOD � <br /> '�� LAUNDRY TFAY WATER HEATER i <br /> ' ' CLOTHES WASHER � WOOD STOVE �_ <br /> URINAL � METAL FIREPLACE 8 CHIMNEY i <br /> DRINKING FOUNTAIN FIREPLACE INSERT i <br /> '�1 FLOOR DRAIN HEAT PUMP � I <br /> 1�' _ BACKFLOW PREVENTERS GAS PIPING ; � <br /> � ROOF DRAINS—RAINLEADEFiS EXHAUST FAN <br /> SINK(SERVIC�—BAR,ETC.) <br /> ' 7 _ <br /> ' <br /> ' SUB TOTAL 5 '?,j� ;' SUB TOTAL 5 ,j'; <br /> � PERMIT S PERMIT S <br /> �' TOTAL FEE S TOTAL FEE 5 <br /> FOR OFFICE USE ONLY: <br /> FRONTSETpACY. � REARSETOACN / SiOESEiBAGN/ PLANCNECNNUMBER FEE � iiECEiPTNO <br /> 32[r.� v /�i'. �5 � <br /> USEZOVE� LOTRR[R VqCANi51TE FEES VALUATION FEE <br /> BWLDING J1�v ;3� .aa <br /> ttPEoftOH15.AL:OWAAIE 7YVEo![Ur,Srac�u4l acuv�xcr xaaLmuu•.cv,�R <br /> _u Lpp$ � PLUh1�ING � �o� <br /> SREOPOLDG NOAFSTORiES DASEMENT MECHANICAL �00 <br /> 260 SF I J ��' <br /> OCCUPANCYLOAD flqESPRNNLERSREOD H[iGirtUTARAilO A�DITIONALPLANCHECN i <br /> NJ SPBINKLER � <br /> RERSON ONSPRINKLERS --�— <br /> STATEBUILOINGSURCHARGE v ;SG <br /> INTAKEBV PLANSAPPPOVEDOY CITYOFEVEHETT PUDLICWORKS <br /> ' I LOCAL SALES <br /> /���`f. � t� 2� 9 TAX COUE IS 3105 TOTAL ��� �� <br />