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APPLICATIQ 1 FOR CON�TRUC7 �N PERMIT � <br /> TO BE COMPLETEO IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: ❑GAS ❑ELECTRIC ] <br /> 259-0810 <br /> DEMOLITION . COMBINATION BUILDING �(MECHANICAL PLUMBING __ SIGN <br /> ovnca uui�oonEss cirv r�c <br /> _,�C��,�.ti� e�. ai� �z.�n, w�� ��2G/ a�,�-a�:�s— <br /> *[rvr.e�r u+n�oaiEss citv nr v�c <br /> ��6aiELipqpESIGNEF 44M1A�ONE55 LIiY 21P MqNE <br /> f.Ll l �LLqI1PACtOB e M/.Il�U0PE55 CIIp" n ZIP PNONE S1/iELCENSE� n <br /> �L/ ��tcw �Gi��'� ��i...� d/cb-f�lc� r7/nruu�Y J�'c17'6 'i�'7��� iflANNI�NDS'I'-X! <br /> A�l6��4iUlCCNLP.1CN11� R� A�DFES. Gi I1p PNONE S1MElCENSE� <br /> �tCVP01f.CONiR�LtOF NAR�DDPE55 CIiV IiC hqNE 51R[OCENSE� <br /> LIAiSO�WORK <br /> NEW � ADDITION ALTERATION flEPAIR DEMOLITION � WOODSTOVbFRPLINSERT � BUIIDINGPELOCATION <br /> •� C� CONiAGi VENSLIN AN�PIqNE NO <br /> fO41H/.CiCPIL[OGWOIIN � [� ' <br /> Uf 1C��9E KVR6 AND SOJ�flE fOJO.GE MVClVEO <br /> rnc�+>sFnusEaoutomc i HEREBV CERTIFV THAT I HAVE READ AND EXAMINED TMIS <br /> APPIICATION ANO NNOW THE SAME TO BE TRUE ANO CORRECT.ALl <br /> uu.�rescmr*ia+orvnav[arv�sr.arreciowonerrec�vwncovics� PROVISIONSOFLAWSP.NDORDINANCESGOVERNINGTHISiVPEOF <br /> WORK WiLL BE COMPLETED WITM WHETHER SPECIFIED HEREIN OR <br /> ��� a�� a NOT.TME GRANTINC�OF A PcRM1T DOES NOT PHESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHEfl STATE OR LOCAL LAW REGULATM�CONSTRUCTION OR PIE <br /> PERFORMANCE OF CONSTRUCTION.TNAi I AM AUTHORIZED BV 1r1E <br /> OWNER OF THIS FFOP[RTV TO PERFORM THE WORK FOR WHICH <br /> - APPLICATION IS MADE AND I COMPLV WITN THE STATE <br /> CONTRACTORS LAW 1827 RC A 296.200 WAC. <br /> z �(t/✓ ���C''`'� <br /> vnwter�onnfss G s.ev.��v� n.�e — <br /> �/� U�rP'�cv ��KfX�M <br /> PLUMBINC MECXRNICAI <br /> NO. TVPE OF FI7(TUNE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> \YATER CLOSET(TOILET) AC—A:HNDLG UNITS—HP <br /> BATMTUB FORCEDAIRSI'SiEMS—BTU. M E.A. <br /> LAVATORV�N'ASHBASIN) UNITHEATERS-9.iU. M <br /> SHOWEA CLUTHES DFiVERS <br /> KITCHEN SINN Q DISP VENTILATION FPN <br /> OISIiWASHER RANGE MOO� —T— <br /> LAUNDRVTPAV WATERMEATER <br /> CLOiMCS W�SHFR WOOD STOVE <br /> UFINAL METAL FlREPLAfE R CliIMNEV <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR ORAIN NEAT PUMP <br /> O�CKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—RAINLEADER$ E%HAUST FAN <br /> SINN�SERVICE—BAR,ETQ) ) <br /> — �— <br /> SUBTOTAL 4 SUBTOTAL $ <br /> PERMIT 5 PERMIT S <br /> TOTALFEE S TOTAIFEE S —T <br /> FOR OFFICE USE ONLY: <br /> ilqNi5ll0ALM PUNSEiWCI( S�pES[iBI.CN tt�NCHCGx UMPER FEE RCL[IPiNO <br /> ;��r�U <br /> ust2a+e io*uiu veuxTSnE FEES VALURTION FEE <br /> OUILUIN6 <br /> bRIXC011i5qlPV�BI( lYGfpCINI5i4L1UAl 00MwO' MpCntuAu��Y'S — <br /> f1°" vw�.miNc <br /> S�IEOF&�G NOO�SiOH:ES OISfM[Ni AIECHRNICA� <br /> OCCUvu�CYLMO vinESwwKlEn5nE00 NE�cNiuMli�iroM ADDIiIONALPUNCHECN <br /> SPNiNNL[R <br /> nusorvroesrnineicns -- � <br /> Sir1T[OURDiNG SIIRCMARG[ <br /> INI��CPV YANS�PCflOVE00V CITYOFEVEflETT ppBLIC\YORNS <br /> LOCRLS�LES <br /> TA7(COOE IS 3105 tou� <br />