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TI ` FOR CONSTRUCT•:.,1N PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE P{RINT �m� k � <br /> -�cP b� � <br /> BUILDING DEPARTMENT HEATING SYSTEM: �,GAS �QELECTRIC '����.. <br /> 259-8810 <br /> DEMOLITION COMBINATION y'. BUILDING j(MECHANICAL �PLUMBING SIGN <br /> OWNER ltAIIADDPE55 <br /> .p�SW� � CITY ZiA PHONE <br /> h "l Ni1wfF lo��� E �'�u°R��c� 7F �eitY`u. �14�1i 4lC'�' crll c'1 <br /> iENANi MAILA�DRESS CITY IIP <br /> PNONE <br /> AqCHITECTOFCE5IGN[P MAILADDRESS CITY IIP <br /> PMONE <br /> ��N ,,vz5 ����5 MRn���U zvEe�� �I�o�-�s '3y� �53 i <br /> GENERALWNTRqCTOR IIAILAppRE55 CITV 21P PHONE <br /> �W ��Q STATE UCENSE v <br /> MECHANICALGONiRAC10R M1IAIL�DOFE55 CITV ZIP PHONE <br /> STATE LICENSE t <br /> PLUMBINGGONTP�CTOq lA4ILqDORE55 CIiV ZIP PNONE <br /> � w � � � STATELICENSE+ <br /> CONTPAGT PRICE OF WORN — <br /> 2 <br /> OESCRIBE{YOFN AND$OUARE FOpTAGE INVOLVED CONTAC7 PERSONANDPHONE NO <br /> C�,a�. ' �- ��ew /� <br /> �-'c C g� � e bti�� �.x 46? -� - �-lSB � b� Ic <br /> PROPOSEDUSEOFBUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> R��A� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGALDEIS1CRInPTIONOFPROPERTY�SNOWNBEIOWORATTAC11T1VOCOPIE51 WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or� g��K �Z7_ oF ���J NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ' AUTHOFITY TO VIOLATE O(i CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR IOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORAIANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> — OWNER OF TIiIS PROPERTY TO PERFORM THe WORK FOR WHICH <br /> PARCELTA%ID NUAIBER APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> /��7 C� _ [� _ CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> CON57RUCTIONLOANLENDER.FDDRESS.iELEPHONENUMBER � <br /> f <br /> PROJECTADD ESS Ul�� ����"" <br /> c�L�� ' Oc t _ cr.arunc A o..r <br /> K BLL�� nrraus�ucssu EHseno <br /> � PLUMBING MECHANICAL <br /> : NO. TVpE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � � A/C—AiHNDLG UNITS—H.P. ' <br /> BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> � LAVATORV(WASH BASIN) � UNIT HEATERS—B.T.U. M <br /> '$HOWER CLOTHES DRYERS , <br /> Klt HEN SINK 8 VENTILATION FAN <br /> CISH SHER � 2., RANGE HOOD � <br /> LAUNDR TRAY i / ' Z WATER HEATER � <br /> � <br /> CLOTHES SH WOODSTOVE <br /> URINAL METAL fIREPLACE(WOOD BURNING) I <br /> DRINKING FOUNT FIREPLACE INSERT � <br /> FLOOR �RAIN HEAT PUMP <br /> BAC LOW PREVENTE ; GAS PIPING <br /> R F DRAINS—RAINLEAD S EXHAUST FAN <br /> INK(SERVICE—BAR.ETC.1 � <br /> � <br /> � <br /> S�9 TOTAL 5 SUB TOTAL S <br /> PcR611T 5 PERMIT S ; <br /> TOTALFEE 5 TOTALFEE $ � <br /> FOR OFFICE USE ONLY: <br /> FRONi5ETB4GK REARSETOACR SiDESEi��CK � � P�ANGNEGKNUh1BER f FEE RECEIPTNO. �/ <br /> ZO� � cS �� ,`J 3 �5 <br /> us}e�zoNE �ornaen VACANTSITE FEES VALUATION FEE <br /> I`"� Z �' YES ;—� NO BUaDING �� — <br /> iVPE0FWN57. NOOFSTORIES octvpnY[v Noa�CwEmiicuNrtS <br /> _ n �ou� PLUMBING i <br /> (i <br /> SIZE OF BLD FlRE SPFINNLERS REO'0 BASEMENT <br /> I�}6L �� __ y/ MECHANICAL —� <br /> �MoO.�.�— J . . YES . . NO <br /> ocCuenrucv�oao Fiqe n�naM aeo�o HEIGMiLIMR�T10N /+ODITIONAL PLAN CHECK i � � � <br /> N a /�l� ' � <br /> OTHER ' <br /> ASON <br /> i <br /> �__ <br /> STATE BUIIDING SURCHARGE � T <br /> \/ <br /> INTAKEBY PIANSAPq9iVEDBV CITYOFEVERE7T PUBLICWORKS � <br /> J a LOCALSALES r <br /> oA,e i 3i ,� TAX CODE IS 3105 TOTAL � <br />