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' ' APPLICATI"�N FOR CONSTRUC"'10N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> B I PLAN• ALDER (Cit no. l0� ) <br /> BUILDING DEPARTMENT HEATING SVSTEM: d GAS ❑ELECTRIC ❑ _ � <br /> 259-8810 <br /> I DEMOLITION I�0 COMBINATION ❑ BUILDING f7 MECHANICAI_ I I PLUMBING I I SIG <br /> ONTlFR AUIl�D0fiE55 CI7V ZIP PHq1E <br /> CFT.Ff`T FthMF$y_TNC_ 737 F.TM RT FVFRF.TT4 WA 98203 258-1503 <br /> ����µ� NMIADDRE55 CRY IIP �HONE <br /> nHCNITECTORUE5IGNEN IAAqADDRE55 CITY 21P F110NE <br /> �IENEML CpJTNl1ClOR MA0.�1DDRE55 CRY 21P PMONE SUTE 11LEN5E� <br /> SFrcrm u�n��g� rt�C �'t7 oim Gm FVFnt'TT� WA 98204 256-1503 SELECHI110KN <br /> MECHAry1LµCONipACTOR 1MRAppqE59 CITY 21P PIIONE Si�TEl10EN5E� <br /> PIUMBINGCONTRAGTOR MA0.�DOPESS • CT' ZIF PIIONE ST�TELICENSE� <br /> CONTRACT PRICE OF WOqI( <br /> an000 <br /> DESCRIBEWOIiK�NJ50U�REFOOT�GERNOLVED . CONTACTPER507M1 %qNENO <br /> _ Gar Klic�C 339-0555 <br /> SFR Randy Clark 258– 0 <br /> I HEREBY CERTIFV THAT I HAVE READ AND ExAMINED T- <br /> �'�NSED U!SE OF BULDIHG APPLICATION AND KNOW THE SAME TO BE TRI,E AND CORRECT. <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br /> �fG�LOESGRiP(�OIIOFPRpPENTY�$HpWNBELOWORARApITWOCOPIES� YYpAK WILL BE COMPLETED WITH WHETMEFl SPECIfIED HEREIN <br /> Hanabrook Div '� rypT. THE GRANTING OF A PERMIT DOES NUT PRESUME TO G <br /> �ot� aiorx � — AUtHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF { <br /> ' ^ OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR" <br /> � � PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV' <br /> OWNER OF THIS PRQPERTY TO PERFORM THE WORK FOR WH <br /> APPIICATION IS MADE AN� 1 COMPLV WITH THE ST� <br /> vARCEL T�%1 D.NUMBER OpryT���W i .E��ND 2�6.YOO WAC. <br /> i CL � <br /> r.ONS1pUGTIONIOANLENDER.�ODPE55.TE1EP110NENU1IBER � b+tiCi <br /> PROJECTADDRESS tYa�"'f� � � 7,i,�E `�S _' <br /> 57�. T � emeue+rtssicEwaw � <br /> PLUMBINfi MECHANICAL � <br /> NO. TVPE OF FlXTURE OR ITEM FEE Np. TYPE OF EOUIPMENT FEE <br /> . WATER CLOSET(TOILET) • � IV�MHNDLG UNITS—H.P. <br /> BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> UVATORY(WASH BASIN) i UNR HEATERS—B.LU. M <br /> SHOWER � 1 CLOTHES DRYERS <br /> KITCHEN SINK 6 DISP � � VENTILATION FAN <br /> DISHWASHER � 1 RANGE HOOD , <br /> UUNDHY TRAY ' 1 WATER HEATER <br /> � CLOTHES WASHEH � WOOD STOVE <br /> URINAL � METALFIREPIACE�WO000URNING) <br /> DRINKING FOUNTAIN � FIREPUCE INSEHT � <br /> FLOOR DRAIN � HEAT PUMP <br /> BACKFLOW PREVENTERS ; GAS PIPING ' � <br /> ROOF DRAINS—RAINLEADERS � ,j EXHAUST FAN <br /> SINK(SERVICE—BAR,ETC.) ' <br /> � <br /> � <br /> ' � <br /> � <br /> � <br /> SUB TOTAI f � SUB TOTAL S <br /> PERMIT S � PEHMIT S <br /> TOTAL FEE S ' TOTAI.FEE E <br /> FOH OFFICE USE ONLY: <br /> ff10NTSETBAGI( pE�q$ETg11CM 310EBETMCK qN/C1IECNNUMBER fEE RECEIPTNO. <br /> 2U 2U Z�i 3 30 — � <br /> use zon¢ LOT AHE� v�ciwr sth � • FEES VALUATION FEE <br /> - Z �s ❑ No euaomo $/ Z �S '% � 'cJ <br /> tvr[a co�st. ra.a sron�s oms.wc. b.n owu�cum <br /> Z a�Ma��xi � ; v,� <br /> SIZEOFBLIXi FIRESPflIM(LEHSREOD B�SEMFYT MECH�HIC�L �C� ' UC' <br /> I L v ❑ :es �e <br /> OCCUP�HCYI FWEiWIRMPEO'D HEqMTW�(T'��'�TqN A�TIOI'ULPUNCHECK i <br /> � D Z 6 07HER O �D_'�1 <br /> REASON <br /> STATE BUILDING SURCHAHGE ;�� <br /> �N,uceev wws�r,r�veoar CITYOFEVEREIT auei�cwo�xs _'Sp ��� � <br /> �� LOCAL SALES <br /> n.*elo�L TAX CODE IS 3tn5 mi�i. , rj�� � <br />