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�9PPLICATIDk FOR CONSTRIJCTit�N PERMIY ,�/s""� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT r�'� <br /> L HEATING SYSTE��1 6GAS J ELEGTRIC J __ ___ -- ----- _ . . <br /> BUILDING DEPARTMENT <br /> `�� R810 MECHANICAL PLUMBING SIGN <br /> DEMOLITION COMBINATION BUILDING <br /> v.^.La n4�LncDn[6s <br /> —u,v ziv vr�orv= <br /> Bsw�—Cc�Si,--3_51`f j3road�du,!_��ratLt'�,1_a�98��37� <br /> -rrv!ur ����i�ooaEss <br /> ��,. :,� <br /> �,�_ _ --„ z�� P�o�E <br /> :,o,:,.nao��o�s�.a.tn ❑nr�noua�ss <br /> _SQ�__Qj ({�U. ��T� ZIP PHONE tiiAIELiL[NSEv <br /> GfYLRnlCON1RACtOR IANLAO��C55 /�,�'T� ///�/�E. <br /> C_ �l�/II .l�—V"__. <br /> _�Vj�L�P.—�—u�Y CIiY 21P PNONE SirtEIiCFNSC� <br /> I.�LO�Ar.i^nLCONLPPQCP IAI.ILADDRE55 <br /> C�IY ZiP PHONE SiGTE LiC6N`:6� ��—�� <br /> � � � r�wni�cor�?anctor+ r.�ni�nuoecss .__ <br /> � H -r <br /> A '� ]". CLASSOFIYOfiN <br /> � y N / NEW ADDITION ALTERATION REPAIR DEMOLITION WOODSTOVE-FRPL INSERT BUILDING RELOCATI <br /> �p6iAbt{'ERSON ANp PNONE NO <br /> H � � /U�,<i�(o 6�Il F�dshamZ58-�'331 - <br /> 1-3 H ��;-�pqnriPRiCEOFIVOFM — -- <br /> Ky � r,uu��aE�vo/r+�rcnNosounve�oomcecu�o�.cm S�F+ _ — <br /> � H� S1lV_1'iJle-tW41tI(��«<7�-3��+ � HEREBY CER7IFY THAT I HAVE READ AND EXAMMED THIS <br /> y y p.� �rr.;:.,,.,�ouseoFow� irv, y y I ��� � h�� pppLIC�T10N AND KNOW THE SAM11E TO BE TRUE AND COPRECT.ALL <br /> xz PFOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LT7 O � um�oesca�vnci =�t���'u�rv,'.'mcr+ouocm:annnc���ouncovies y�ORK WILL 8E COMPLETED WITH WHETHER SPECIFIED HEREIN OP. <br /> O H � � � ,�LpSJ_�CS.���CSr NOT. THE GPANTING OF A PERAIIT DOES NOT PRESUME 10 GN[ <br /> LOL PLOLN 1:1 <br /> H � �y AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS <br /> 'n` n ���V LG�C'Ce:S�—A_VE _ OiNEF STATC- OR LOCAL LAW FEGULATING CONSTRUCTION OR THe <br /> �.,,� � _ PERFORM1IANCE OF CCNSiRUCTION.THA�I AM AUIHORIZED BY T1,E <br /> OWNER OF THIS PROPERTY TO PEiiFORM THE WORK FOR WHICH <br /> C��C� ` 1 $� __ APPLICATIOtI IS �dADE AND I C01.1PLV WITH THE STAT[ <br /> H <br /> r H H L w �� CONTRACTORS LA\N 18 27 RCW AND 296.200 WAC. <br /> gN <br /> e� s-5 -�z <br /> �, � r 5'�1o(LTPI.A� � A" 9D "�-��?"`s ., - <br /> � -. . 2'�(v�7 <br /> x H [o ��rn�ca nooness . _ _-6_ <br /> yo � 2 I . � � ,., :,.. , ,,.. <br /> � PLUMBING MECHANICAL <br /> C` __ FEE NO. TYPE OF EOUIPMENT FEE — <br /> N0. TVPE OF FIXTURE OR ITEM q�-q NNDLG UNITS �'�P- <br /> J 3 6YATEPCLOSE7(TOILET) —�--- --- <br /> � v � _L FORCED Alq SYSTEMS-E?U. A1 EA. ' <br /> � BATHTUB � liN1T HEATERS-B.T.U. M <br /> LAVATORY 1�NASH BASIN) --r <br /> I �� � � � CLOTHES DRVERS � <br /> '+ ' _' SHOWEF - <br /> ` r ', VENTILA":ONFAN _—�� <br /> � KITCHEN SINK 6 DISP � qANG[HOOD <br /> _� DISHWASHER —�� � — WATERHEATER <br /> � LAUNDRY TRAY ����- - WOOD STOVE —� <br /> �� CLOTHES W�SHER <br /> � ' � MEL1L FIREPLACE 8 CHIMNEY ��� ' <br /> I �� Ufi1NAL FIREPLACEINSERT <br /> DR�NKING POUNTAIN —��� — HFAT PUMP <br /> � FLOOR DRNN --�—`,-- 1 GAS PIPING <br /> I t�' _ BACKFLOW PREVENTERS _ E%HAUST FAN — <br /> �� ROOFDRAINS-RAINLEADERS _ � <br /> _' SINK(SERVICE-BAR,ETC.) � � _ <br /> L <br /> ,� e-•v- 2c�- J1�-" �'O <br /> 's>O' <br /> ' SUBTOTAL 5 � ( ,�� SUBTOTAI 5 /o I <br /> PERMIT 5 _ <br /> '=1�' PEORA I FEE 5 TOTAL FEE 5 <br /> FOR OFFICE USE OMLY: � �� �`� <br /> PLANGMELeNIIMBER fLt FLLP�INO <br /> f{iONiS[i�ACR HGARSLI�/�K�. SID[SEIDALN �� r/ � -� <br /> 4 Q �/�� � <br /> � -� ,�j 7.,� J5 C.i_ �., J�_l I - — <br /> use zor+e �ot nnen vacnrvt srtE <br /> FEES VALUATION FEE <br /> _S �z�_ �j 7 nuaoiNc _ �Q ���—CYJ �/ g ''u' <br /> t�R04LONI5.AllOWABtE i+PE fG045IPL1Wl �xc;r��,cr� u�r�oaw'�.-�:•',s PW6IBING ��'' `• <br /> .rN �IJ R���rn� I — <br /> NO OF STORiES OrSEMENT MECHANICAL ��� �°��-- <br /> SIZE DF BLD(i i <br /> 3:17i SFr533�3C/uta ` AJO �� <br /> j(p� Iki AODITIOAAL PLAN CHECK ' �� .' <br /> OGCUPPNLYtORO iINESPRNKLERSR[O'0 HEIGNTUM�TAT��4 i <br /> r��/ 1 <br /> �� NL` /{c�— SPRINHL�n ' <br /> �— <br /> REASON FOB SPflINMlERS <br /> STATE DUILDING Sl1RCNAHGE � '�S T_. <br /> PUNSRPPROV`DUV CITYOFEUERETT PUl3LICWORN$ �� � OC) <br /> V:1�NC OV `^'� <br /> LOCALSALES <br /> �'� • JM TAX COOE IS 3105 rorn� / SS � -� <br /> _�1 �i� <br />