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APPLICATI�1 FOR CONSTRUCI�N PERMIT � <br /> TO BE COMPLETED IN BLACK INK�LEASE PRINT <br /> HEATING SYSTEM: GAS EIECTRIC O <br /> BUI�DING DEPARTMENT <br /> 259•8810 <br /> I 1 DEMOLITION I ! COAABINATION BUILDING 'QiAECHANICAL XPLUMBING SIGN <br /> py/qEq M�IL ADDRE55 Cltt ZIP PNONE <br /> c�+,� � �� ��c�,� �uA .�,z ulaf�e a�e � wa ��/ zs9 -�� <br /> TENANT � r -_--`'M�AIL�DDHE55 L � n��n' Z�P P�E <br /> LI N �'t ��JC�Cis �M1P d.A CUIM L�--� . <br /> ARCNITE OF OES�GNER MAIL ADDRESS CITY ZIP '/ PMONE <br /> TA'E N7B�T(�D I(I 5, JuC�boNS-I; � Ct�"i� ��`� ZZ3 SSSS <br /> GENEMLCAHTMCTOR MAILADDRESS CITY 21P PMONE ST�TELICENSE• <br /> 5�� Cve� �/sU R�c�� �v s� �rle�,.ue r�a `2�-'9 �y9-f�c� <br /> MEGN/JIICALCONTR�CTOR IMILADDf1E55 CITY 21P PHONE STATELIGENSE� <br /> Iv�.(,�,s4rJ Co S'ps 3z1 A�S. �t31�. U�• 98i3� 7�2 3311 <br /> PLUMBMOCONTiUC MAILADDRE55 Cltt ZIP PHONE SiRELICENSE� <br /> �.,�.�.�.jL ('r, �aoe�nr� � o�l� <br /> CIASS OF WORN <br /> � NEW I. I ADDITION , ! ALTERATION � REPAIR I I DEMOLITION �. � WOODSTOV6FRPL INSERT �. ! BUILDING RELOCATION <br /> GONTRACTPRILEOFWOPK �ISOOQ7 �.I�LON � (N14NPEPSONANO HONENO. �_� � � <br /> oTl� <br /> DESCRI E M/O KNID SOU�HE FOOTAf.E INVOIVED <br /> 41 Q 1 � <br /> rAoroseo EOFBUILDIN i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> �� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> IEGl�LOESCHIPTqN PROPERTVISHOWNBELOWORATTRCHFWRCAPIES) PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTVPEOF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or e�ocu oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOIATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTflUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WFfICH <br /> APPLICATION IS MADE AND I COMPIV WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> �� Sa . ►n �� y�,u °17. <br /> PRQIEGTADDRE55 5 N�, _\��l �� .\ /1' o�iE -� <br /> �V 7F IV'C/ <br /> cn eusmEssuccr+s[r+o <br /> PLUMBINfi ,t9 �. MECXANICAL <br /> Np, TYPE OF fl)fTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATERCLOSET(TOILET) S �Ot� A/�A/HNDLGUNITS—H.P. � <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> / UVATORY(WASH BASIN) G �Ov UNIT HEATERS—B.T.U. M � <br /> SHOWER p ' O CLOTHESDRYERS ' <br /> KITCHEN SINK 6 DISP � VENTILATION FAN � <br /> DISHWASHER � RANGE HOOD � <br /> UUNDRY TRAY � ; WATER HEATER ' <br /> CLOTHES WASHER WOOD STOVE � <br /> URINAL 'UO METALFIREPLACEBCHIMNEV ' <br /> ORINKING FOUNTAIN � �p0 FIREPLACE INSERT � <br /> fLOOR DFlAIN �/O HEAT PUMP ' <br /> BACKROW PREVENTERS S �00 ( GAS PIPING � <br /> ROOF DMINS—RAINLEADERS / �DO ExHAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) �� � <br /> � <br /> � <br /> � ' <br /> SUB TOTAL $ SO '�O SUB TOTAL S /S 'OO . <br /> PERMIT $ — � — PERMIT $ /.S �00 <br /> TOTALFEE S O �� TOTALFEE $ 33S'OC� � <br /> FOR OFFICE USE ONLY: <br /> FFONTSETBACK RE�RSETBACK SIOESETBALK PLANCHEGKNU�MBER� FEE FECEIPTNO. <br /> 37J� <br /> USE 20NE LOT�REA VACANT SITE FEES VALUATION FEE ` <br /> BUILDING ' <br /> 7VPEOfCLATS.�ILOWABLE ttPEOFCONST.ACiURL otcuwNcr xa orDWnuxtuxns � <br /> �^Wo � pLUMBING i <br /> SIZEOFBL06. NO.OFSTORIES BASEMENT � <br /> MECHANICAL ' <br /> OCCUPANCY LOAO FIRE SPRNKLEPS REO'D NEIGNT UMITRTION ADDITIONAL PLAN CHECN � <br /> i <br /> SPRINKLER i <br /> REASON FOR SPRINKLERS <br /> S7A7E BUILDING SURCHARGE � <br /> INT�NEBV PUNSAPPROVEDBY CITYOFEYEHE7T PUBLICWORNS i <br /> LOCAL SALES , <br /> TAX CODE IS 9105 �T�� ; <br />