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APPLICATIC`1 FOR CONSTRUCT'-�1N PERI�AIT � <br /> TO BE COMPIETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYS7EM: �GAS J ELECTRIC ❑ �� <br /> 259-8810 <br /> I 1 DEMOUTION ! f COMBINATION I J BUILDING � MECHANICAL � � PLUMBING i 7 SIGN <br /> OWNER 61AILADDRE55 Citt ZIP PM�IIE <br /> ,%osEy.v G�RyNAM a9a � �c�a.e P.�. cvr-xETr- 98aoi ��9-/�7�.ti <br /> IENANT MAILADDRE55 CITV 21P PHJNE <br /> ���f.HITELTOROESIGNEN MMLADDNESS CITV ZIP PHONE ' <br /> f.EN[RALCON*PACiOR MAILFDDRESS CITV ZIP PHONE STAIE�ICENSE� <br /> MECNRI:IGRLCONiRAGTOR MAILpDDRE$5�q7��—�j.(IT�.Ay�((r�T� 21P PNONE STATELiLENSE� <br /> .t�E79L.ENt�?GYcTYSrEn��' T�✓�' . �Y�✓�✓uJOnO 9e��3(o 7J�/"�j/3 10E7aLESC�GJ�ff <br /> �"�'MOING WNTFACIOR MAIL ADDR[SS CITY ZIP PMONE STATE LICENSE• <br /> CONiRACT PRICE OF WORK <br /> �9Po. a [� <br /> Dr SCFIBE WOFN RND SOUARE F(XJTAGE INVOW E� CONTACT PERSON AND PNONE NO. <br /> G.os ,�✓.e � - . �o .c - F�i�_ <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMWED THIS <br /> vaoroseo use or euao�vc APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br /> iecn�oescaianor+oFvpoPeRniS�+ownee�owoNnnacnrv+ocoaies� WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEFEIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> iot BLOCN or AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW RPGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COAAPLV WITH THE STATE <br /> Paacei Tnx i.o rmMeEa CONTRACTORS LAW 18.27 RCW AND 29G200 WAC. <br /> Ssii- oob - oo7 — Ooos <br /> CONSTFUCTION lOAN LENp[R AODRE55.TELEFHONf NUMBER <br /> •.���,s.[1t,,G�- P�ti'�9Y <br /> PROJECTADDRESS � °'"""'� ���Z/S/ _ °"" _ <br /> �7 O R .�. ,.n�.�..rrss nc�N,c�+� <br /> PLUMBING MECY...NICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) A'C—A%HNDLG UNITS—N.P. <br /> BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> �AVATORY(WASH BASW) UNIT HEATERS—B.T.U. M ; <br /> T <br /> SHOWFF CLOTHES DRYERS <br /> KITCHEN SINK 8 DISP VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> LAUNDRYTRAY WATER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL ' METAL FIREPLACE(WOJD BURNING) � <br /> DRINKING FOUNTAIN FIREPLACE IN5ERT <br /> FLOOR DRAIN HEAT PUMP <br /> BACKFLOW PREVENTERS �_ GAS PIPING <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> SINK(SERVICE—BAR..f_TC.) _ <br /> — ——�— <br /> —_ i —_ —_ __—�— <br /> SUBTOTAL $ SUBTOTAL $ <br /> PERMIT S PERMIT 5 i <br /> TOTALFEE $ TOTALFEE $ <br /> FOR OFFICE USE ONIY: <br /> SpONTSETBACN FEARSETBACN SIDESET�/CK PLANCMECN rUM81'R F[E HECEIPLNO <br /> ` �'� J � <br /> usezone LOTAREA vnuN:sn[ FEES VALUATION FEE <br /> �. YES �7 NO yWLDiNG <br /> rvPE oi taxsi No.oF STORIES awr+rrcr xo a ow[uixcUNrts -- — <br /> ewouo p�U�d01NG <br /> SIZEOFB�DG. FIRESPRINKLEP.SRE00 BASEMENT � <br /> MECHANICAI <br /> G VES r NO — — <br /> GJGUPANf,y�0A0 FIREALRRMREO'0 HEIGHTLIMItATIOH �DDIi!QNALPLAA:HCCK <br /> OTHER <br /> REASON <br /> STATE BUIIDING iUflCHARGE <br /> iNtnK.ev a�nNsnnvr�oveoc� ��TYOFEVERFTT ruoucwoatcs <br /> I LOCAL SALES <br /> on,e TAX COUE IS 3105 TOTAI <br />