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APPLICATIC l FOR CONSTRUCT' 1N PERMIT � <br /> �\ TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> ` HEATING SYSTEM: U GAS U ELEGTRIC J—_� <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> i 7 DEMOLITON 1 COMBINATION ! BUILDING : ��.MECHANICAL �� PLUMBING �. SIGN <br /> ppry�q �u�rt WoaESs Uir br vNOnc <br /> ��J�r� ENbcv,Ja i�3 Ro�xEr���.. ��t ��s—ws� -- <br /> �[u.wr unM1won[55 c:n nr vwr+[ <br /> �RCNit[LiOFDES�(1NER M�RADLRC55 <br /> orv nr vnam .— <br /> GCN C041R/.CiD9 MAC/.pOP65 � C�iY Z'P P11GNE SGiCIICENSE� <br /> / ir= }cxdrR v.aKi6br,kac 4fan c»-e��9 .t�iut�u,�ia✓ <br /> �L�O ND WM/7' I L1w" Y �iln't .i rrar�E s*�-c�Kcnse. <br /> MECHI.NC�ICONLPM:LOq 4�4WDRE5$ <br /> ���y ZIC f11JNE SiA1ELILEN$EI <br /> hUMBMOCpIiqiLIOB iA�M1l�00RE55 <br /> ���rA.�,�a���,� 86��.od <br /> PiP Y�N�SW�4EfO01rGEINVIXVC� CCNt1CiPE1150NI.Mp1'lIW[NO <br /> „� r�d•�-t3� n.rri� ao s <br /> �_Ye--�- /� pn <br /> /J//✓Q�C✓ IC�IH�S Wy.�f�7�S /FtGYNl�owTl <br /> 1 HEREBV CERTIfY TNAT I NAVE READ AND E%AMINED TNIS <br /> aaaro5m us[cF Bwmnic APPLICATION AND KNOW TME SAIAE TO BE TRUE AN�CORRECi ALL <br /> Sf A PROVISIONS OF LAWS AND OfiDINANCES GOVERNING iH15 TYPE OF <br /> /L <br /> aw�o[uairrioNo�rian[ervisrw,vxor�owou�T*�o�nmcwicsi NOT 1HELGRA T�ING OF A ERh11TY OES'CNOT PRES MEERO G�VE <br /> �oi _e�aK a AUTHORITY TO VIOLATE OR CANCEL T4E PROVISIONS J`ANV <br /> ///��� OTHEH STATE OR LOCAL LAW flEGULATING CONSTRUCiION OR THE <br /> 1���Ay� PERFOPNANCE OF WNSTRUCT�C�N.iNAT 1 AM AUTMORIZED B1'THE <br /> � �� l�� OWNE9 OF iH15 PROPERTV TO PERFORM iHE WORK FOR WHICN <br /> APPIICATION IS h1ADE AND I COhIPLY WITH TME STATG <br /> ��ncci*���o NVMe[n LONTRACiO 5 LA Y 1827 flCW AND 296200 WAC. <br /> CONS1PULibNlO�H1(N�ER��DPLSS.iiIFPM'JM1ENON9CR g�j 93 <br /> — x , — <br /> Vfl0.1ECT ADDRE55e � — - — <br /> �1FO3 /�pC.(�6kL(F� MECMANICAL`�^ <br /> PLUMBINC FEE <br /> NO. TYPE OF FIXTUNE OR ITEM FEE NO. TVPE OF EOUIGMENT <br /> WFTEH CLOSET�TOILET) A�C—A HNDLG UNI15—HP _ <br /> �AiMTUB FORCED AIR SVSIEMS-8 T.U. IA E A. _ <br /> LAVATORY�WASHBASIN� UNITHEATCRS—B.TU. M _ <br /> SHOWER __ CLOTH@3DflYERS — <br /> NITLHEN SINK k Wf9 VENiILAiION FAN __�_ <br /> UISNWASHER _ �ANGE HOOD <br /> LAUN�RY TNAV 1VATER HEATER <br /> CLOiMES W�SHER _ �v�D STOVE -- <br /> URINAL METAL FIREPLACE�WOOD BURNING� <br /> DRINKING POUNTAIN _ FIREPLACE INSERT — <br /> FIOOR�RAIN HEAT PUMP <br /> BACKFL0IYPREVENTEFS __ V�SPIPING <br /> qppF DRAINS—RFINLEADERS E%HAUST FAN <br /> SINK�SLPVICE—BAR.ETCJ — <br /> _— __� <br /> SUBTOTAL S _ SUOIOTAL 5 <br /> -- PERMIT E PEFMIT 5 <br /> iOIALF[E S TOTALFEE £ <br /> FOR Of FlCE USE ONLY: m�:onr vo <br /> ru�+c�rEcxnuunrA r[r <br /> rna+*s�re�cx n��nsEio�cx =�oESEra�cx n <br /> v�cev*sne ES VALUAT70N PEE <br /> ll$(IONk LOi�FF� �� i_ <br /> .��. VE$ ' N� BUIIDiNG <br /> ttRpGOH51 ��Sid11E5 aWnxr bdV/.t:tM4iv�s "� ; <br /> "^�' PLUMBMG � <br /> &ZfOf&D6 �i�ES�PmKlCRSP[OD B�SCUENi MECIIRNICAL <br /> i. YES NO <br /> pCNPANCYIWD fIPEAURMHWO M[N'iNiIIMRG1qN <br /> AOOITiONAL PUN GIIEGN <br /> OTHER /� <br /> AE�� ST�i[BUIl01NG5UPCH4RGE �l� <br /> inu.cov nervsecrnwmer CITYOFEVEflETT .�ueucwonns <br /> LOCIILSIILES /D ��-y� <br /> oA,� T11X COOE IS 3105 rot�� �� <br />