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APPLICATIC"9 FOR CONSTRIJCT"7N PIERMIT � <br /> TO BE COMPLETED IN BLACK INK-PLEASE PRINT <br /> HEATINGSVSTEM: UGAS ❑ELECTFiIC ❑_ <br /> BUILDING DEPARTMENT <br /> 259-9810 <br /> I I DEMOLITION � I COMBINATION I I BUILOING ��iM€CHAtJICAL "'PlUM81NG _' � SIGN <br /> ��E� � u�2�ponEss urv zm r��w:e <br /> ��,s �- �RB 1���1 ,�.r �6 s%� scJ 4JFn€rT`�8�3 .z r�- 2 yy� <br /> 1[xANr i M�R�oD ss Qir br PMONE <br /> . ARCNRtCi0i1�0ESIGNCf1 M�1���11E55 LIIY ZIP P��GIE <br /> I <br /> Lt9ERKCp1IMGiOfl 11AM1IODPE55 CItY IIP P�RJME S1AlELICfl15E� <br /> MEtlUNiCRtpllMLlOfi MMI.��D11E55 LILY tIP PIbNE SiQELILENSE• <br /> r�wap�+`9So�EAT7�RAap�E s�/S•z2 N6'/90sLr,�piivu/�G��+/A 4ROf1wNz H86v'A83EY//o�M11A/!/NOB�V <br /> i _ <br /> cuss o�worM <br /> I I NEW �I�I A�DITION J�'PLTERATION I I PEPAIR I I DEMOI.ITION � I WOODSTOVFJFRPLINSERT I I 6UILOINGRELOCATION <br /> �i � mriucrrensounnorum+ervo 2 <br /> tannncroaiE�won� �� 7� LT��O l�✓�' yglo'l/��✓ <br /> o[scmoe wonK am:nu+ne rootRCE iwavco <br /> reoroseouseorou/ao�nw i HEREBV CERTIFV THp7 I HAVE RE�D AND EXAMINED THIS <br /> �N7I TRM �S APPLICATION AND KNOW THE SAME TO BE TflUE ANJ CORRECT.ALl <br /> iEaeioE NlptqNOFV110PEPiY�L10WNBEWWOfl�LIACNiGUNCCPIE51 PROVISIONSOFIAWSANDOR0INANCESGOVEFNINGTHISiVPEOF <br /> WOflK WILL BE COM('LETED WIT4{WHETHER SPECI�IED HEREIN OR <br /> mt B�ocK or NOT.THE C�FANTING OF A PERMIT OOES NOT PRESl1ME TO GIVE <br /> � AUTHORITY TO VIOLATE O�CAOCEL THE PqOVI510NS OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATINC COHSTRLICTION OR TNE <br /> I PERFOFMANCE OF CONSTPUCTICN.THAT 1�h1 AUl HORIZED BV 1HE. <br /> OWNER OF TI{IS PflOPERTV TO PERFOFiM THE WORK FOR WHICH <br /> � — pPPLICAiION IS MADE AND I COMPLY WITN THE STATE <br /> � CONTRACTORS LAW 182]FCW AR0296200 WAC. <br /> v�ccr�oone s ������ ��� <br /> � 95zo3 ��;-st9z_ <br /> �. �� sr w ���..� —�_,,,«„_�„� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TUfiE OR ITEh1 FEE N0. TVPE OF F.OUIPMENT FE9 <br /> WATEflCLOSEi�iOILET� __ A/C—NHMDLGUNITS—H.P. <br /> BATHTUB FORCEDAIp5v5TEMS—�.T.U. M E.A. <br /> LAVATORY�V7ASH9ASIN) UNITNEATEPS—O.T.U. M � <br /> SHOWER CLO7HES�RVERS <br /> KITCHENSINKBDISP VENTILATIDNFAN � <br /> �ISHWASHER RANGLIIOOD <br /> LAUNORY TRAV VlATEF HBATER <br /> CLOTHES WASHER 'NOOD STOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEV <br /> DRINKING FOUNTAIN FIflEPLACE INSEflT <br /> FLOOR ORAIN HEAT PUldP <br /> BACKFLOW PFiEVENTERS GAS PIPING � <br /> ROOF DRAINS—�R�MLEADERS EXHAUST FAN ' <br /> SINH(SERVICE—B4P,ETC.) �S O'�� <br /> --� <br /> ' SUBTOTPL 3 SUBTOTAL $ <br /> '. PEPMIT S PER611T S <br /> ' TOTALFEE S TOTALF6E S <br /> FOR OFFICE USE ONLY: <br /> ifiON15E10�CN PE1115E10I.CM SIpC5E1Bi.CM �WICNE[NINMBEfl fEE �[CflPINO <br /> 7 <br /> 1 V <br /> u:[zw�e lo*enEe vecnrviSnE FEES VALUATION FEE <br /> � BUII�ING � <br /> lvf!CffAxlSulUM�OIf IVLEOfCON51.IL1U.LL Ct[i✓+4'V WdPN�.iY.�nns ' -- <br /> � �"'"� PLUM9ING <br /> SIIEO�BlDO� M1b�0i5ip11E5 oASEMEIIi IAECf1ANICAL <br /> OCCU:ANGYLO.V fIflESFPiMLEP511EO� NflGIRlI1.UlAIlIX1 �DOITIONALPIANGHEGK <br /> �� SPpINNLE(1 <br /> PG�Splf0115PPiNXLEflS <br /> STATE BUilOiNO SUqGIIAliGE <br /> �NMeEOY M�N9�FCPOVEDBY CITYOFEVEflETT PUOLICWO�NS <br /> LOCRL SAIES <br /> � TAX CO�E IS 3105 TOT^� <br /> .a�.-.,-..-...�-"-_--.-...-_.—.�- sw�� <br />