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APPLICATIf�1 FOR CONSTRUCT ,N PERMiT � <br /> TO B� COMPLETED IN BLACK INK-PLEASE PRINT <br /> HEATING SYSTEM: ❑GAS :J ELECTRIC :,.� <br /> BUILDING DEPARiMENT ��c �i,, / •,,�.. � <br /> 259-8810 � �o�zg S " . - <br /> DEMOLITION �COMBINATION BUILDING MECHANICAL PLUMBiNG SIGN <br /> OWNER AIAILAOD/�p�g 5� � GiY Z�P PNONE <br /> Mf �i � 1 L ��'�J � W ✓� � �� <br /> iENANT h1AIL��DNE55 CI1V ZIP PNONE <br /> ML <br /> ARCHI EGTORDESIGNER MAILRDORESS CIIV 21P PNOt1E <br /> ,�ja � , �o zs3 0.-� -<— <br /> �GENERI.LCONTRAGiOR IdAILADDRE55 C�T' #ZOD Z�P PHONE STATEIiCENSL� <br /> �pu�nt�fz- I 4�i- Im- Gryc>r.r� 2A 6�tJ �uF r�o�i G=-=�'s��� C'or o,u c/�-v— F� <br /> M[LHAHI ALCONiRACTOii MAllA0DRE55 C�TV ZIP PHONE STATELICENSt• <br /> Pl MB G CONTRFCTOR MAIL r10DRESS GTV 21P PMONE STATF LICENSE• <br /> �1 /� <br /> CtA55 OF WORK <br /> NEW � ADDITION ALTERATION REPAIR . DEMOUTION WOODSTOVE/FRPL INSERT BUILDING RELOCATION <br /> CONTALi PERSON AND Pr�ONF N0. <br /> CONTRPCiPRICEOFWORN ��'� � � ���� �� �' ����� <br /> DESCRIBE WORH AND SOUARE FOOTAGG INVOW EO <br /> PROPJSEOUSEOfBUtLDING I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> �EMIOLG'JRIPiIONOF PROPERTY(SNOWN BELOW OR qTt1;H FOLIR JOPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> �S AIJ � ������ � WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �pT BLOCK OF J��j�y `�n O NOT. THE G9ANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFOPM THE WORK FOR WHICH <br /> APPLICATION !S MADE��AND I COMPLY WITH THE STATE <br /> CONTRACT09S L -18.2j�RCW AND 29620�WAC. <br /> ^ <br /> �-;� N �Z.-7� y'� <br /> __' .X,�i�n�un�. — o�rE <br /> CPP CTAD�RE55 �' /� � <br /> �-4�'� � �/ � _ � 1 <br /> �7L � I ���1� � y' ` //'�/T GIVPCSME55l SCNO <br /> - PLUMBING MECHAt11CAL <br /> ' NO. TYPE OF FI%TURE QH ITEM FEE NO. TVPE OF EUUIPMENT FEE <br /> WATER CLOSET(TOILET) A/C—A�HNDLG UNITS—H.P. <br /> BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. _ <br /> LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M � <br /> SHOWER CLOTHES DRYERS ' <br /> KITCHEN SINK 8 DISP _ i VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> LAUNDRV TRAY \VATER HEATER <br /> CLOTHES WASHER WOOD STOVE _ <br /> URINAL METAL FIREPLACE 8 CHIMNEY ' <br /> � <br /> DRINKING FOUNTAIN FIREPLACE INSERT __� <br /> FLOOH DRAIN � HEAT PUMP <br /> BACiCFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—RAINLE�DERS EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.1 <br /> - 'U�dl�'CL L�--_ _ 'uD <br /> _ ; <br /> � <br /> SUB' . � S SUBTOTAL 3 <br /> PERL � S PERMIT 5 � <br /> TOTA. :t 5 TOTAL FEE 5 <br /> FOR OFFICE USE ONLY: <br /> FRCNTSETB�CN P,C�RSEiBAGK SIOESETBALK� PLANCHECKNUM1'BER fEE n^� AECFIPTNO <br /> Z0 ' 2U S �oy ` <br /> use ior+e �or nnen VACANT SITE FEES VALUATION FEE <br /> �_� G� . ; 00 <br /> 9UILOING J <br /> 7YFEO�CONIS.ALIOWABLE 1YPEOFGONSiAG7UAl aCc�.vm xJaCµtw•;cb�.�'S � <br /> �cour PLUMBING � <br /> SREOFBLDG NOAFSTCRIES �AS[MENT MECHANICAL <br /> OCCUPANCY�OAD FIRE SPRNKIERS REOD MEIGHT LII.UTATION ADDITiONAL PLAN CNECK <br /> �'$ SPRINKLER <br /> BERSON iOR SPRINKLERS j , , <br /> STATE 9UIl01NG yURCHARGE ':x/ <br /> INTANEBY VLANSAPPROVEDBY CITYOFEVERE7T PLI�LICWORK$ <br /> LOCAL SALES <br /> TAX CODE IS 3105 T�Tp� �� � <br />