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APPLICATIQ"` FOR CONSTRUCT!'1N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEK�: '�,GAS ❑ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> ❑ DEMOLITION ❑ COMBINAllON ❑ BUILDING ❑MECHANICAL �1,PLUMBING ❑ SIGN <br /> OWNER MAILAO�RESS CITY ZIP PHONE <br /> Lrai,4 /�G F.91Jot.J zoo; 2 ? s� �rr,e�sr urA, gsza� 3.39- 27. �S 7 <br /> TENANT MAILADDRE55 CIN 21P PIIONE <br /> ANCHRECTORDESIGNER MAILADDXESS CITY ZIP PMONE <br /> GENENAI.CONTPRCTOR MAILAODFiESS CITV ZIP PHONE STATELICENSE� <br /> MECHANIGALCONTRACTOF MAILADDRES`u CITY ZIP PHONE STATELICENSEI <br /> 1 <br /> ' - � PLUA6IN(3CONIiUCTOH MAILADDRESS CITY 21P PHONE STATELICENSE� <br />� ' ' ' �o,,�,o���� ,,�s Sfa✓rc� 23z8 `r,���� Lv�.. 98��/ zss /87 �o�e� so8o�� <br />� i � CONTMCT PRICE OF WORK /�7 <br /> i /7.5.� L.,� �C !ln/ 2Sc1 -8/8�7 <br /> � � � � OESCRIBE WORK ANO SOUARE FOOTRGE INV0IAED CONTACT PEBSON AND PMONE NO. <br /> I � <br />� i. � . <br /> I. I���. I i HEREBY CEFTIFY THAT I HAVE READ AND EXAMINED THIS <br /> � ����� ' � I PROPOSED USE OF BUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br /> ! ��� PROVISIONS OF U1WS AND ORDINANCES GOVERNING THIS TYPE OF <br /> � - � WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEHEIN OR <br /> i �.'� � � � LE6ALDESCRIPTqNOFPROPERTY�SMOWNBELOWORATTACXTYOCOPIES) NOT. THE GRAN7ING OF A PERMIT DOES NOT PHESUME TO GWE <br /> I' i ��.� � �oT . e�xK oF AUTHORITY TO VIO.ATE OR CANCEL THE PROVISIONS OF ANY <br /> j � �'��� OTHER STATE OR LOCAL LAW fiEGUU1TING CONSTRUCTION OR THE <br />� . �,�:. �� PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHOPIZED BY THE <br /> �� -�. j . OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPIY WITH THE STATE <br /> '� � �� PARCEL TA%1.0.NUMBER CONTRACTORS LAW 7827 RCW AND 296.200 WAC. <br /> j��+� ^��„.�. . CONSTRIICTKKJ LWN LENOER.�DUflESS,TELEPHONE NUMBER �_-- �'/�— q� <br /> I / <br /> . .� � �' EOZH7O� OATE � <br /> PAOJECTADDRESS MD� 3/�( S�. <br /> .' ,•��... � v�V CiTY8115ME554CEN5Erv0 <br /> PLUMBINQ MECHANICAL <br /> NO. TYPE OF EGUIPMENT FEE <br /> �� � � Np, TYpE OF FlXTURE OR REM �E q��.q�HNDLG UNITS—H.P. ' ' <br /> � '� WATER CLOSET(TOILEn , � <br /> BATHTUB ' FORCED AIR SYSTEMS—B.T.U. M E.A. . <br /> - . LAVA?ORY(WASH BASIN) � UNIT HEATERS—B.T.U. M ' <br /> � SHOWER ' CLOTHES DRYERS ' � <br /> ' KITCHEN SINK&DISP � I VENTILATION FAN � <br /> � � DISHWASHER i RANGE HOOD � � <br /> LAUNDRY TRAY , WATER HEATER � . <br /> � CLOTHES WASHER � WOOD STOVE ' . <br /> URINAL ' METAL FIREPLACE(WOOD BURNING) ' � <br /> DRINKING FOUNTAIN � FIREPLACE INSERT ' �. <br /> � FLOOR DRAIN � HEAT PUMP � � <br /> BACKFLOW PREVENTERS ; GAS PIPING ' <br /> � ROOF DRAINS—RAINLEADERS � EXHAUST FAN ' <br /> � �SINK(SEFVICE—BAR,ETC.) ; k/A�L �fATP/L � <br /> � .✓J� f� � <br /> , � <br /> � <br /> � <br /> � <br /> , <br /> SUB TOTAL $ ' SUB TOTAL $ ' <br /> �� PERMIT $ � PERMIT S ' <br /> �� � TOTALFEE $ ' TOTALFEE $ ' <br /> FOR OFFICE USE ONLY: Aeceirrr+o. <br /> � REARSETBRCK SIDESETBACK PLANCHECKNUMBER FEE � <br /> . FRONTSETBACK /��/ <br /> / <br /> LOTAflEA VACANTSITE FEES VALUATION FEE <br /> USE ZONE ' <br /> ❑ YES ❑ N� BUILDING <br /> i <br /> � TYPEOiCONST. NO.OPSTORIES occUPnxcY Noo:OwnurvGuxitS � <br /> GRWP PLUMBING ' <br /> I <br /> SIZEOFBLDG. FIRESPRINKLERSRE�'D BASENENT MECHANICAL i_ <br /> ❑ YES ❑ NO � <br /> ADDITIONAL PLAN CHECK ' <br /> OCCUPANCVLOAO FIREALARMRE�'� HEIGMTLIMITATION i <br /> OTHER � <br /> REA50N STATE BUILDING SURCHARGE ' <br /> INTAKEBY PUNSAPPROVEDBV �iT1fOFEYENEIT PUBLICWORKS ' <br /> LOCAL SALES ; <br /> onre <br /> TAX CODEIS 3105 TOTAL � <br />