3105 PINE ST 2018-01-01 MF Import

APPI�ICATIC'1 FOR CONSTRUCT'lN PERMIT � G 1h TO BE COMPLETED IN BLACK INK—PLEASE PRINT � BUILDING DEPARTMENT HEATING SYSTEM: U GAS �]ELECTRIC ❑_ 259-8810 f 7 DEMOLITION ❑ COMBINATION ❑ BUILDING I�MECHANICAL I�WMBING ❑ SIGN OWNEfl�L1�lK �!'L�GRNST cl) 1Lt� 7UPZV � Z, y 3343i�� E-�f / 71 Q TENANT MAIL qD�RE55 CITY 21P PNONE ARCHITECTOi7U SIGNER MAILADDRESS �IT 21P PNONE .�� 4��u.�s �t� ��r� �$ �oy Lu� - ..? SS433Z GENEFAL CONTRAC R MRIL ADDRE55 CRV ZIP PHONE STATE LICENSE� " t7_ �'� C� . 3a32 �suv� f„rK.�/ s�Z �s 335- ��.s�c �4� c� ��.uo MECMANICALCONTRACTOR MAILADDRESS CITV ZIP PHONE STATEUCENSE� , PLUMBINGCs�TRACTOR MAILRDDRE55 CITY ZIP PNONE STATELIGENSE• 4 b 3G3 9a`r'� 'u��c�Jd -r,gzos 3�{B=�zsJ c6 � p � CONTRRCT PRICE OF WORK � CJGO �� DESCRIBE WORN AND SOUARE FOOTAGE INVOLVED i CONTACT PERSON AND PHONE NO. � .TN sl� /I �I L.s � �, N G � fX lt.t � M�<<''�N i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS . r PROPO D USE OF BUILDING / APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL , �S <L. PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF � LEG�LDESCRIPTIONOFPROPERiY�SHOWNBELOWORRTfACXTWOCOPIES) WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE �or e�ocK oF AUTHORITY TO VIOLATE OR CANCEI. THE PROVISIONS OF ANY � ' OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE ' PEHFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE i / � OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH � PARCE�TAXI.D.NUMdER APPLIC�TION IS MADE AND I COMPLY WITH THE STATE � CONTRAC�1)RS LAW 1827 RCW AND 296200 WAC. � �i /� 1 CONSTRUCTIONLOANLENDE�S.TELEPHONENUMBER J �/ n� / / ///G� /� �� �� x � / �/ L�� � PR ECT A E � saruT �*e ; I 0 � ►. u�,c�( ,1 9820 ��r.a�MEu.�E�sE� � PLUMBIN(i MECHANICAL . 3 NO. TYPE OF FlXTURE OR ITEM FEE N0. TYPE OF EQUIPMENT FEE . � WATER CLOSET(TOILET) � A/C—NHNDLG UNITS—H.P. � . ! BATHTUB ; FORCED AIR SYSTEMS--B.T.U. M E.A. � � �; LAVATORY(WASH BAS�N) UNIT HEATERS—B.T.U. M ; . SHOWER ' CLOTHES DRYERS � KITCHEN SINK 8 DISP ; VENTILATION FAN ; DISHWASHER � RANGE HOOD � LAUNDRYTRAY ; WATER HEATER CLOTHES WASHER � WOODSTOVE � URINAL ' METAL FIREPLACE(WOOD BUIiNING) � DRINKING FOUNTAIN � F�REPLACE INSERT . ; FLOOR DRAIN � HEAT PUMP � BACKFLOW PREVENTERS ; GhS PIPING ; ROOF ORAINS—RAINLEADEFS � FXHAUST FAN � SINK(SERVICE—BAR,ETC.) ; � I — � � SUB TOTAL $ ; SUB TOTAL $ PERMIT $ � PERMIT S � TOTAL FEE $ ' TOTAL FEE $ � FOR OFFICE USE ONLY: . FRONTSETHACK REARSETBACK SIDESETBACK PLANCHECNNUMBER FEE RECEIPTNO. � USE 20NE LOi AREA VA:ANT SITE FEES VALUATION FEE ❑ YES ❑ NO BUIIDING i TYPE OF CONSi. NO.UF STORIES Dctuv��r x0 orowFw�uvrt5 � cnouv pLUMBING � SIZEOFBLDG. FIRESPRINKLERSPEO'D BASEMENT MECHANICAL � ❑ VES ❑ NO , OGCUPANCYLORD FIREPLARMREO�D NEIGMTUMITATION �DDITIOIJALPLANCHGCK � i OTHER � i PEASON STATE BUILDING SUFiCHARGE � INTqNEBY PLANSAPPROVEDBV CITYOFEYEflETT PUBLICWORKS � LOCAL SALES � onre TAX CODE IS 3105 TOT�� ;