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APPLICATIQ-1 FOR CONSTRUCT�' 1N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />BUILDING DEPARTMENT HEATMG SYSTEM: �(GAS ❑ ELECTRIC U � <br />259-8810 <br />.' OEMOLITION I I COMBINATION I i BUILDING �iAAECHANICAL ! I PLUMBING I I SIGN <br />� ��H--�Ic� uuuuoncss cnr :ir Pew+� <br />�• T �L�ck—�3�o �A�� KR�. E�,��/ 9sar� �s�-��+9 <br />iCN�NI N�IL�OONE55 UIV SIV P�qN( <br />•qCn'1fC10��F.9GICP Y�4MDRC55 CIiY IIP PNP4E <br />GFH/C/MlCIX,/11�MLt0 MLM1ADOPESS CIiV �j ptiV PWNL SIEiEIIL[NS[� <br />Jf7Lycnl�m��d��Mr� 503�- iUS'AC// /So�C�L aP�,�%�/.� ����/16cSTI�/�i <br />UEGN��� <br />CLU✓11iNuCCN1MLlq1 IA�M1�DDfl[55 CRV SIP PIqMi SV.tEI�CFNSE� <br />C.[�i11F�CLPPICEOiWONN � <br />�/s�— <br />pf SCIVb. MVBN ANO SCU�RF i001�GE INV0.VLD CIXliALT PERSON AN� P1�ClIE NO <br />V'No�`OSFDUSEOFBIR��NG �� <br />i rani o�xnicta� a rnovca*v isNrn <br />ior B�oc� — <br />I��N(.[l lAY1D NU�IBCfl <br />���,.,n��rrirn� � o�n icnocn. eoon¢ss. <br />LAV�TORY IWASH BA! <br />SH�WGR <br />KI7CHEN SINK 6 DISP <br />I HEREBV CERTIFY THAT I HAVE RE�U AND E%AMINED TNIS <br />, APPLICATION AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND OF�IN�NLES GOVERNING THIS NPE OF <br />�owonnrrecntwccon�[s WORK WILL BE COMPLETEO WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GR�NTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />�� AUTMORITV TO VIOLATE OR CANCEL TME PHOVISIONS OF ANY <br />OTNER STATE OR LOCAL LFW flEGULATING GONSTflUCTION OR THE <br />PERFOflMANGE OF CONSTRUCTION. THAT I AM AUTHORIZE� BV THE <br />OWNER OF THIS PROPERTV TO PFRFORIA THE WORH FOR WHICH <br />APPLICATION IS MADE AIJD I COMPLV WITN THE STATE <br />CONTRACTOAS LAW 1827 RCW AND 29G200 WAC <br />rHa�[ Nwocn � <br />,�� `i _ 3-� - .� <br />n.i� <br />FOR OFFICE USE ONLY: <br />fIqNI5C10NL� IiCFP$(16�LN <br />IISCZP\'E lOiAflE� <br />ni t or coNSi i+o a Stoqm. <br />nl �'oH <br />�Y11nE OY <br />oAic <br />PERh11T <br />Ut.li <br />WATER HEATEfl <br />WOOD STOVE <br />MCT�L FIREPLACE <br />FAN <br />S�DE SEIB�CY. <br />'�; VES �� NO BUiLDrvG <br />m�we. .o er re�uite �.:�s <br />°^0" PlUM01NG <br />B/SEUENi MECNANIGAI <br />fl VES '.7 NO — <br />NEicHiLiuiuiqN AOOITIONALPIANCNECN <br />OTHER <br />STATE OWLOING Sl1RCHRRGE <br />CITYOFEVEHETT PUOlIC1VORK5 <br />LOCALSALES — <br />TAX CODE IS 3105 TaT�� <br />� <br />