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APPLiCATlO► �OR COWSTFiUCTf ..P! PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT �,� <br /> — ------ <br /> _ -- -- _ . <br /> HEATINGSYSTEM: y`�GAS JELECTRIC J _- __._ ._-_-- _ _� <br /> BUILDING DEPARTMENT � <br /> 259-8810 SIGN <br /> DEMOLITION COMHINATION BUILDING �fuIECHANICAL _ PLUMBING __ <br /> LItY LIP �� ���- <br /> M1tAIL�DORE55 - /"� /` � <br /> _M'tJ[R . � 1 - J iC /l ��� )(.' Q G <br /> ._'. ' / ' i !:G.�!'E--7T//�///:�,� / / �� 7 � _ . <br /> y (] � � r ��^�� . - �r � .r. , , _ ,i_ cilv iia ' vHarvE <br /> C G' 'V q:NAM h1AILMDRG55 <br /> [9 -- <br /> b � CITY ZIP PNON[ <br /> C y y •,RCHIIECtOR�E5IGNER IAAILAppHE55 <br /> M q � <br /> GITY ZIP PHONE,35.i �S/��� SiN[LICRISE a <br /> K Z n GENEPALCONiBACTOP l.INLADORB55 - �r � �' <br /> ,.� � i � � i ;"' �nNT!'_/�'�,G �� <br /> o m O �,�E��',n�f-on���� 7jr• //.7 Si. iit�_'e�T /i�1TMiIL:J�, ,- r zP tt77 /L" a�o ' srnreucer�sea <br /> � y H L�F.CNANiCALCONTRACTOR MNLAO�RE55 ^ � <br /> cz � Hr" , ""z1"�c siDf S,n,r�� i RFCN£.T *Jv096��, <br /> L'1 y O PLUil�iNGCONLRACTOF IdML�JDRE55 <br /> CITY 21P PHONE STATEUCENSC <br /> O H <br /> �"� � �p C�nSSOFWORK <br /> z H 1' NEW ADDITION ALTERATION REPAIR DEMOLITION WOODSTOVE:FRPLINSERT BUILDINGRELOCATION <br /> CONTACT PERSON Ak��'��ONE NO <br /> � N y «'/ �b� L�'�// ;:.F'a�Gc.= 7- /,.SC�o — <br /> CONiRACTPHICEOFWORK 7�C'�' -- <br /> (1 tl N OESCPIBLWORKANDSOU��EFOOT�GEINVOLVEO <br /> a a � , .�. N�,,T - Ze�� ei�.�i�.yti��� <br /> a5 �v '. r�- <br /> � � � PROPOSEDUSEOFBUILORlG i HEREBY CERTIFY THAT I HAVE READ AND EXAMWE� THIS <br /> y yp N � !J , _ APPLICATION AND KNOW THE SAIdE TO BE TRUE AND CORRECT.ALL <br /> ���� � - ``p/y� �C<<i'�� LC r_ PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> L[GALOESCRIPTIONOFPFOPERTYISHO'NNBELOWO�R1AiTACHFOl1RCOPiES) yyORK WILL BE COMPLETED WITH NJHETHER SP[CIRED HEREIN OR <br /> � //��'1 �%Eit�.!d���• � I NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> LOT n dLOCH OF <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AA1 AUTHORIZED�Y THE <br /> OWNER OF THIS PROPERTV TC PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COWPLY WITH iHE STATE <br /> � CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> , , <br /> , ��,�, <br /> � �1C; /l�r�' /;F' - /_-'f�'c7i" l/"4' %� ._._' _ x � v� c� � a� 4 <br /> - ,:� _ , ,;.,�— <br /> r.o�eernooaess > - <br /> — , r,o <br /> �'��r PLUMBING MECHANICAL <br /> V' NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> � WATER CLOSET(TOILET) _ A�C—ANNDLG UNITS—H.P . <br /> iBATHTUB ' ( FORCEDAIRSYSTEMS—BT.U.) � F.A . <br /> �� LAVATORV(WASR BASIN) UNIT HEATERS—B.T.U. M <br /> �I SHOWER �r CLOTHES DRYERS_ _ � � <br /> ' KITCHEN SINK 8 DISP �� VENTILATION FAN .T— <br /> DISHWASHER RANGE HOOD <br /> � WATER HEATER , <br /> LAUNDRVTRAY ; <br /> i �4 CLOTHES WASHER WOOD STAVE � <br /> METAL FIREPLACE 8 CHIMNEY 3D' O'� <br /> URINAL <br /> ORINKING FOUNTAIN FIREPLACE INSFFT <br /> � FLOOR DNAIN HEAT PL1MP <br /> Q�� ' BACKFLOVJ PREVENTERS '� GAS PIPING � <br /> ROOF DRAINS—RAINLEADEFS Q EXHAUST FAN <br /> SINK(S[RVICE—BAR,ETC.) <br /> T <br /> s' ' p�' D� <br /> SUBTOTAL S SUBTOTAL S //D ' d� . <br /> — PERMIT 5 /� � <br /> �' l ' — PERMIT 5 TOTAL FEE 5 `� '- <br /> � TOTAL FEE $ <br /> FOH OFFICE USE ONLY: — receir.No <br /> � pi.nuo�ecrcNw.�uGn F[[ . <br /> PHOIliSETBAGN P[ARSET�ACK 9pE5ETBACK , nr�C �, <br /> � r,1 <br /> UFEZOHE LOTAflEA <br /> VACnNTSITE FEES VALUATION FEE � <br /> BUILDWG __ _. ' <br /> 1�+VCOfCON75AlLOWABLE IYPEOFCOflSLALiOAL occu;x�.� �1oa�owRw.aw�'�s PLl11ABING <br /> I II <br /> Gaoup � <br /> �-�-- <br /> SiZEOFBLDG. NO.OFSTOflIES �ASElAENT MECHANICAL . I� <br /> i <br /> OCCII°ANCYLOAD FIRESPRNKLERSIlEO'D NEIGHTLIMITAiION <br /> ADDITIONAL PLAN CHECK � <br /> SPRINKLER <br /> ---�-" <br /> ��FiA50N i095PRINKL[RS I <br /> STATE DUILDING SUfiCHARG[ <br /> iurnKeov c�nnsnrrr�eveoov CITYOFEIIERETT PU9LICWOFKS I <br /> LOCALSALES ' <br /> TAX CODEIS 3105 TOTAL � <br />