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APPLlCATI�1 FOR CONSTRUCT`'�N PERMIT � <br /> TO BE COMPLE7E0 IN BLA�X INK-PLEASE PRINT <br /> BUILDING DEPARTMENT �EATING SYSTEM: �GAS ❑ELECiRIC ❑ <br /> 259-8810 <br /> ❑ DEMOLITION Cv�COMBINATION �BUILDING t�IMECHANICAL �PLUMBING ❑ SIGN <br /> OWNER MAILAUDFESS CITY ZIP .. : <br /> L D �'D �o�,d.[o,P a�oo7 �17d�of.�� P��efi:�fL_ 9f�ot i �c 6 - q8.�- �/�Y�� <br /> TENM7T MRILAODRESS CITV 21P PHONE <br /> ARCHITECTORDESIGNER MAILADDRESS CITV ZIP PHONE <br /> C�,.,.� Y��1;e.. �2��.e ,v� s.r-�s k;--,F G,:o � a a6- �� � - ��.�16 <br /> DENEMLCONTRACTOR MAILADDRESS CITV 21P PHONE ST�.fELICENSE� <br /> LD^`� Co�-rvS-..�1;•d, Cvr.o aioo� 4.'e'Cn•IF J�o.Gl� 9t'oer �/�-�'-�flyy LDDeae,k i.!'Yk� <br /> MECHANICALCONTMGTOfl MAILADORESS CITY �IP PHONE STATELICENSE� <br /> PLUMBINGCONTRAC70R MAIIADDflE55 CITY LIP PHONE STATELICENSE• <br /> �N / IO��f/� �Y�.U� <br /> CONTfl CTPflICE'OIFWORK <br /> � DESCRIBE / RKANUSOU/DqEFOOTA6EINJOLVED <br /> . LONTACT PERSON AND PHON'NO. <br /> l.m .i d�Yv� /vG✓ �i� �� i'.�. a � (.7'"�s.y �l. /�i! ao6- y�s_ %3yy <br /> ' ,�pu.fc e��d,r � 709 I� U .�, ....�'� � HEREBY r,ERTIFY THAT I HAVE READ AND E%AMINER 1�HIS <br /> � Frrorosen use oF ew�ouro APPUCAi�7N AND KNOW THE SAME TO RE TRUE AND C.r.nRECL ALL <br /> i <br /> Sin���I�!_ �d....�L,. 1'C�,; � cL PROVISiUNS OP LAWS AND ORDINANCE3 GOVERNING THIS TYPE OF <br /> �eca�o flIE�G PTIONOFPROPERTV SHOWNBEIOWORATfACHiWOCOPIES� WORK WILL BE COMPLETED WITH N�HETHER SPECIFIE� HEREIN OR <br /> p�,,,,�„�,+// ,(�;,/�(,,,,� NOT. THE GRANTING OF A PERMIT pOES NOT PRESUME TO GIVE <br /> �ur� BIOCK-- OF -, c— pUTHOR�TY TO VIOLATE OR CANCEL THE PRJV�SION& OF ANY <br /> ' �� iY. OTHER STATE OR LOCAL LAW REGULATING CC�JSTRUCTION OR THE <br /> PERFORPAANCE OF CONSTRUCTION.THAT I AiA AUTHORIZED BY Th=. <br /> � QWNER OF THIS PROPERTY TO PERFORM '!HE WORK FOR WHICh <br /> � APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCEL TNt L0.NUMBEP CONI'RACTORS LAW 1827 RCW AND 296200 WAC. <br /> � CONSTRUCTIOVLOANLENOERADDFEgS,TELEPHONENUMBER <br /> c.� � � s,� c ,a,� x S �� � Cew �-. y/��/p3 <br /> � PHOJE ADDqE � �ti �( 1. / SqNA1UR D�TE ���— <br /> 5 ED3-z5 ✓'1✓Q V�/ CT'BUSINESSL:�ENSENO. <br /> PU�M91N0 � MECHANICAL <br /> ' NO. TVPE OF FlIfTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> �, WATER CLOSET(TOILE� � A/�A/HNDLG UNITS—H.P. � <br /> BATHiUB ; I fORCED AIR iYSTEMS—B.T.U. M E.A. � <br /> � LAVATURY(WASH BASIN) � UNIT HEATERS—B.T.U. M ; <br /> � / SHOWEP, i_ / CLOTHES DRYERS � <br /> / KITCHEN SINK 8 DISP � � / VENTILATION FAN ; <br /> DISHWASHER � � 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 /> .�_ <br /> BACKFLOW PREVENTERS ; 1' GAS PIPING ; <br /> � ROOF DRAINS--RAINI EADERS � EXHAUST FAN //// � <br /> ---�— <br /> �� �SINK(SERVICE—BAR,ETC.) ; ' <br /> � � <br /> � i <br /> � i <br /> i � <br /> i � <br /> - SUB TOTAL $ ; SUB TOTAL $ ' <br /> PERMIT $ � PERMIT $ � <br /> � TOTALFEE $ ' TOTALFEE $ ' <br /> F09 ONFICE USE ONLY: Sa0 3� <br /> FRONTS!*UACN flEAR^S�ET�BACN SIDESETBACK � PLANCHECKNUMBER FEE p HECEIPTNO. <br /> '�•_ M L-a7, N%� 7�d /.S = �W � �' � O p3 � <br /> �I1SE2 LOTAPEp VACANTSITE FEES VALUATION FE�� <br /> . i 3 0,3 ES ❑ NO BUILDING S � �J(� I <br /> TYPEOFCONST. NO.OF TORIES at[cP�.VCv Im.orowFluNGUNnS � I <br /> T7_Iu �/ PW� � PLUMBING i (J(� <br /> .Y !i p <br /> SIZEOFBLOG. FIRESPRINKLERSREO'D BASEMENT �O MECHANICAL D � �/v <br /> ' � 2 o s Sr isAd /��O ❑ YE� <br /> OCCUPANCY LOAD FIflE ALARM FEO'D HEIGHT�LIMpITATION ADDITIONAL PLAN CHECK a � <br /> LJ�A_ NO C.f) ' OTHEq �dpy\_ � ',(j� <br /> REASON <br /> STATEBUILDIN� 'JFCHARGE i�D <br /> INTAKE BV PLANS APPROVED BY eirr oF even�r PUBLIC WORKS �(�� pCi <br /> �„J� LOCALSALES - , <br /> DAIe S/25�93 TAl(CODE IS 3105 �T�� Q�� ;S7 <br />