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APPLIC�►Tlt'N FOR CANSTRl1CT,�N PERMIY ���� <br /> TO BE CUMPLETED IN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEM: �G�S ❑ELECTRIC U_ � <br /> BUILCING DEPARTAdENT <br /> 259-8810 <br /> I"I DEMOLITION I I COM8INATION ➢Q Bl11LDING I I MECHANICAL I I PLUMBING I I SIGN <br /> OWI�EO fAAILAUU0ES5 CIIY 2�V P110t1E <br /> 1JF1LCY1-+Qmc� .3� �lG - C�S741Yr Avct �-':olf�o �vi1SN ;',1''�: � 3�? ,Y�.7) 7C. F_rl2.tC-. <br /> IENANT MAILA�DRE55 CIiY 2�P PIIONE <br /> ARCHI7EC�OOOESIGNER MAILAUOIIESS CI7Y ZIP PI10NE - <br /> GENEfiALCONIRAC70(1 MAILAD�IlE55 GIfY ZIP �'��ONE SIMELICENSEP <br /> SA�»� f!S D[uNch PA« YH �- i2 .�� 7 <br /> MECHA111CAlCON70AC700 M�ILAOD(1E55 CIIY � 21P PHONE SfA7ELICENSEF <br /> PLUTAOINGCONIRAC70R MAILADUflE55 CIIY ZiP ruoNE STA7ELICEIISEI <br /> CLA$$OF Wpf7N <br /> Ijt NEW I 1 ADDITION I- I ALTERATION I I FIEPl11fl I I DEMOLITION I I WOODSTOVE/FRPL IFlSERT I I BUILDING RELOCATION <br /> � CONT�C��ERSON1 AND PHONE NO. n <br /> CONTMCT PPICE OF WOfiN � l `��. ���� <`�' r /� V i� = _ <br /> DESCf11B2 WOfiH AND SOUARE F/O�O7ACc INVOLVEOh'N j�r r � �i j �.1 � _ 3 � � �'� - �_ 1' �T �- �� C^ <br /> '�/N:ll2 �LWNI �X /Y+ISI �aN1Cf �i�l�� .� `.�Y(. <br /> rno^oSEDUSEOFeUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> -� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> -'�^'�Q=�" ��l' �� '` ���°"` � PROVISIONS OF LAWS AND ORDINAtJCES GOVERNING THIS TYPE OF <br /> LEGAIDESC01PfIONOFPf10PERIY�SHOWNBELOWO�NIACNFOURWPIES� yyORK WILL BE COMPLETED WITH VIHETFIER SPECIFIED HEREIN OR <br /> 10T�_ ���K oF �i��'�'NN�^�%� �"T NOT. TFIE GRANTING OF A PERMIT DOES NOT PRES�RdE TO GIVE <br /> F��r,� �A,�h AUTHORITY TO VIOLATE OR CANCEL TI1E PfiOVISIONS OF ANY <br /> OiHER STATE OR LOCAL LAW PEGULATING CONSTRUCTION OR THG <br /> PEflFORMANCE OF CONSTRUCTION.THAT i AM AUTHORIZED 6Y THE <br /> OWNER OF THIS PHOPERTY TO PERfORM THE WORK FOR WHICH <br /> APPLICATION IS M11ADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 10.27 RCW AND 296200 WAC. <br /> � " � <br /> ('n,7 S- <br /> �lc "=, �',�2,� � x � ' •�/i; /�%1�✓ �- j - �5i i <br /> •rnwecrnooness . s�" `,"� __ ���� I <br /> C11Y BIK�^i[L'�M1.ENSE NO <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM17 FEE N0. TYPE OF EOUIPMCNT FEE <br /> WATER CLOSET(TOILET) � __ NC—NHNDLG UNITS—H.P. '.— .,, <br /> BAiHTUB �_ FORCEUAIRSYSTEMS—B.T.U. M E.A. ' <br /> U�VATORY(WASH BASIN) i UNIT HE4TERS—B.T.U. M � <br /> T <br /> SHOWEfl ' CLOTHES DRYERS '_ <br /> KITCIIEN SIPlK 8 OISP _�_ VENTILATION FAN _ � _ <br /> DISIiWASHER � RANGE HOOD <br /> LAUNDRYTRAY i WATERliEATER ' <br /> CLOTHES WASHER � WOOD STOVE � <br /> URINAL ; METAL FIREPLACE&CHIMNEY ' <br /> — i FIREPLACE INSER7 � <br /> DRINKIN�FOUNTAIN —� <br /> FIOOR UFAIN HEAT PUMP ' <br /> BACKFIOW PREVENTERS � GAS PIPING <br /> RUOF ORAINS—RAINLEADERS ; EXHAUST FAN _ _�— <br /> SINK(SERVICC—BAR,ETC.) _�__�. — ' <br /> � <br /> � ' <br /> --�— <br /> — � �i � � <br /> � <br /> � ---r— <br /> �— � <br /> SUB TOTAL $ ' SU�TOTAL 5 ' <br /> � <br /> PERMIT $ —�— PERMIT S � <br /> TOT�IFEE $ ' TOTAI.FEE $ ' <br /> FOR OFFICE USE ONLY: <br /> F(10NTSEtBnCK REAf15ETB�CK � SIDESEIBACK PLnNCHECKNUMBEA FEE REGEIPTNO. p r <br /> �G'c.–r ' �'' � � �����/1 J�� ��U').'1�� <br /> usezoue IOTAPEA vncn�usiTe FEES VALUATION FEE <br /> � <br /> ��� � BUILOING :J'k . '1'. �7 �'� � <br /> IYPEOfC0il1 �ILOWABIE 1YPEOFLOIISI.ACIWL CccmurtY NoofowflUxcmnls r � <br /> ` I_ � ��WP PLUMBING � <br /> �..ti - ��� V� �\.� �I ' � <br /> I <br /> SIIEOF�LDG.. NO.OFS70RIE5 BASEMENT . MECHANICAL � <br /> � ;'� �� � . � -. i <br /> OCCUPANCYLOAD PInESPfiNNLERSREOU uEiGufuMlinuou , �DDRIONALPLANCIIECK � <br /> q � <br /> �J;- � I� ! SfqINKLER � � � � i t. <br /> FlEASOB FOB SPNNKlEf15 �— <br /> STATE BUILDING SUFiCHAFlGE �/ �� <br /> i <br /> INTGNEBY f-LA05APPIlOVEDBY CITYOFEVEF�F.TT puoucwonKs ' I <br /> ; ; �ocn� sn�.es �— <br /> Tnx cooe is a�as TOTAL i ; , ; <br /> '. '�r` � � . �59.- z}+ <br /> -tp,„•_ — .. r <br /> _ '_ .....-1y„�.�"s.'1.��L1'.'_' - � ,u'�� y._.�._� a"i�C £`!��`q�.�;'a��y�•"'` >>.,. . � x�;.. ����~� <br />