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�F �' � APPLICATI�_r FOR COPlSti'l;tJC'�. �N PERI�IIITG <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT `� <br /> BUILDING DEPARTMENT HEATINU SYSTEM: �GAS ❑ELECTRIC ❑ <br /> 259-8810 <br /> DEMOLITIUN COMBINATION BUILDING `�MECHANICAL PLUMBING SIGN <br /> OWNER MAILADORE55 CIN ZIP PHLIIf <br /> LL � /-/�m�S , .�. . <br /> TENqNT MAILADORE55 CITY ZIP PMONE <br /> ARCHRECT09�ESIGNER MAILAOORESS pTV ZIP PHONE <br /> G[NERALCONTFACTOP MAILADDflESS GTV ZIP PHONE STATELICENSEp <br /> 1�iL�,� yorneS 3zyo E l,e A� e 5,�����Z <br /> � CH�CO ACTOR MAILAD RESS CITY ZIP PHONE 3TATELICENSEa—�� <br /> {�S •r�Ce. �� /x-�x �o/o/ /�LLL. 9$cx�� �'7/�3� /��5'��I� ��3c ff <br /> PLUMBINGCONTRACTOR MAILA�ORESS CITY ZIP PHONE STATELICENS[> <br /> CLASS OF WORK <br /> ��:JEW '�, I ADDITION � I ALTERATION �, REPAIR . �� nG;,�OLITION . . WOODSTOVE�FRPL INSERT . BUILDING RELOCATION <br /> CONTACT PERSON AHD PHONE HO. <br /> CGIJTFACTPRICEOFWOPN y��-- � '�_y�-/� 3� <br /> OESCRIBEWJRKAN�SOl1AREFOOTA EINVOLVED <br /> �nS{gr.r. �rrv�te �- T nC c9m k.�e <br /> PROPO"sE�i;5EOF9UIL�ING i HEREBY CEF�IFY THAT I HAVE READ AND EXAMWED THIS <br /> {���) S S � �— APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> �eca� . caiario OF PROPERTV(SHOWN BELOW OR A7TACN FOUR COPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK 6VILL BE CCP�IPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> ior z�_ e�ocK oF NOT. THE GRANTWG OF A PERMIT DOES NOT PRESUME TO GI/E <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> �7 l'c-T� OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR TH[ <br /> PERFO�'MANCE OF CONSTRUCTION.THAT I P.M AUTHORIZED BY THE <br /> OWNEF, OF THIS PROPERTY TO PERFORM THE WORK fOR VJHICH <br /> APPLICATION IS 61ADE AND I COAIPLY WITN THE STATE <br /> CONTFACTORS LAW 18.27 RCW AND 296200 WAC. <br /> X �_ �,�� � Z <br /> PFOJEGi ADOqESS sv.4'^�nrun[ on*e <br /> �-3l — ! 5i �L , ��r.�,�,,:��s, <<�,s�„� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> , WATER CLOSET(TOILET) 1 FVC--AiHNDLG UNITS—H.P. � <br /> BATHTUB ( FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M <br /> SHOWER CLOTHES DRYER; � <br /> KITCI�IEN SINK&OISP VENTILATION FAN <br /> . DISHWASHER � RANGE HOOD �— <br /> !_AUNDRY TRAY ; WATER HEATcR <br /> G�OTHES WASHER WOOD STOVE � <br /> URINAL � METAL FIREPLACE 8 CHIMNEY <br /> DRINKING FOUNTAIN � FIREPLACE INSERT ; <br /> T <br /> FLOOR DRAIN HEAT PUMP � <br /> BACKFLOW PREVENTERS ; GAS PIPING ; <br /> . ROOF DRAINS—rIAINLEADERS � EXHAUST FAN <br /> SINK(SERVICE—BAR, ETC.) ; ' <br /> � <br /> � <br /> � <br /> � � <br /> SUB TOTAL $ ; SUB TOTAL S J"O ; <br /> PERMIT S PERMIT $ / � <br /> TOTAL FEE $ ; TOTAL FEE 5 9I <br /> FOR OFFICE USE ONLY: <br /> FRONTSETB�CN BE4RSETOACK SIOESETBACN PLANCHECKNUlA6ER FEE REGEIPTNO. <br /> /�l_ 3 �2� <br /> USEZONE LOTAREA VACANTSITE FEES VALUATION FEE <br /> �UILDING � <br /> TVPEOFC01li5.ALLOWABLE iYPEOFCONSiACIDAt octuvu�[v rv0ofolvElun,uNuS ' <br /> ceouv - PLUMBING ; <br /> SIZE OF BL�G. NO.OF STORIES BASEMENT � <br /> MECHANICAL r � -- <br /> OCCUPANCYLOAD FIRESPPNKLERSREO'D HEIGNTLIMITATION ADDITIONALPLANCHECK i <br /> � <br /> SPRINKLER ' <br /> i <br /> REASON FOR SPRINKLERS — <br /> STATE BUILDING SURCHARGE i <br /> i— <br /> INTANE BV PLANS APPFOVED BY CITY OF EIIEREI"f PUBLIC WORKS <br /> LOCALSALES <br /> TAX COD[ IS 3105 TOTAL �J'" j �i <br /> . ' ' �. � .a '�o�r, , r<,� � - _ - -.- -c-a <br /> F��y' a. � '�' 7;3- _ — ``"._ '( ' ' �.. _ � z , .. _� <br />