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APPLICATiQ`I FOR CONSTRUCT,; 7N PERMIT � <br />TO BE COMPLETED IN BLACK �NK—PLEASE PflINT <br />BUILDING DEPARTMENT <br />259�8810 <br />I i DEMOLITION ' . COMBINATION <br />HEATING SYSTEM: ❑ GAS ❑ ELECiRIC O_ <br />f�BUILDING I.I MECMANICAL <br />;_]PLUMBING I i SIGN <br />1[N�M WL�WPE55 LIiV IIV V1qNh <br />`�c�l'h`2 _ <br />AFCNRECidIDLSqN[N YAIIMOPE55 GIIV IIP FIIONE <br />�� � I�Q <br />G[H[NMLplIPACiOR NARADDPE55 CitY ZIP PNONE SLi[IICEHSE• <br />iG. lti�� <br />I.M1CnANqQLON1R�Ciq1 14M1�DOPESS CIfY ZIV C`qNE S1NElICCNSE• <br />MUM9MOCCNiMCLOP MAKADURE55 Clry ZIV 1'NOME 51�tElICCNSE• <br />CF WqiN <br />a ewiomc <br />ior s�r � B�ou �i or <br />v�nc[���M�o Muue[H <br />Hr/�,i71' n,r' <br />Cp151PUL11CN LO�N L[xD[R. ED�PES <br />FOR OFFICE USE ONLY: <br />moH�sc*oncx n[�n� <br />� �. / <br />�sczonc <br />v-2 <br />oiq <br />4� <br />scrio•o <br />IJ <br />Ci VES i- NO <br />p'[ieY� � 'IdM�llAY4i <br />4Nl> . <br />15EMEN� <br />Cl YES NO <br />PF115p1.W0 PIqNE NO <br />i HEREBY CERTIFV THA? 1 HAVE READ AND E%AMINEl1 THIS <br />APPLICATION AND KNOW TNE SAME TU BE TRIIE AND CORfIE�i. ALL <br />PROVISION$ OF LAWS AND ORDINANCES GOVERNIN3 THIS fYPE OF <br />WORK WILL BE COMPLETED WITM WHETHER SPECIFIEO McqEIN OR <br />NOT. THE GRANiING OF A PERh11T DOES NOT PRESUME TO GIVE <br />AUTHO(71TY 10 VIOLATE OR CANCEL TME PROVISIONS Oi ANY <br />OTHER STAiE OR IOCAL LAW REGULATING CONSTRUCiION OR THE <br />PEflFORMANCE OF CONSTRUCTION. THAT I AM AUTMORIZED BY THE <br />OWNER OF THIS PROPEFTV TO PERFOR�A THE WORK FOR WHICM <br />APPLICATION IS MAOE AND 1 COMPLY WITH THE STATE <br />CONTRACTORS LM1\V 183i RCW AND 296 200 WAC <br />Fonceo niq <br />CLOiMES <br />MOO� <br />DUIL�ING <br />PIUMBING <br />MECHANICAL <br />AOOITIONRI PtAN LNEGN <br />OTIIEq <br />STATE 9UIlDING SURLIURGE <br />PIIB'JC WORKS <br />TOTJIL <br />C`� <br />