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APPLICATIO� FOR CONSTRU�T''iN PERMIT � <br /> TO bE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: �GAS rj ELECTRIC O <br /> 259-8810 <br /> i i DEMOILITION i � COM8INATION i i BUILDING �GMECHANICAL I I PLUMBING I i SIGN <br /> �yyNER M�IL ADDRE55 CITY '/ 21P P110NE . <br />, -�. � 13u�uzc�w I Ood l 7 7��sSE fv��c 71� 9��`� 3�/7-I.�.��� <br /> 7Eryiy({ MAlLl100RES6 CITY ZIP PMONE <br /> ARCNITECTpiGESqNER IMk�DDRESS CITY 21P PM�ME <br /> I� GENEMLCONTMCTOR WILAODRE55 CITY ZIP PIip1E STATEIJCH�6E• <br /> � ,� l�lalva�LGAs l�o t�snSo3G, tLe,�� �i - L�-s`Z�. �S`�rs�/S� (IAl/Enc'nS38�M <br /> y�airer <br /> yE�IUNIGILCANipA.10(i MMLADDPE55 CITY 21P PNIX/E STATEIICEN8E1 <br /> PLUAIBMOCANiRM1CTpi IMILADDi1ESS CITY LP PHONE ST�TELICENSEI <br /> CLASS OF WJR1( <br /> i I NFW I I ADDITION /yG ALTERATION i ! REPAIP. i I DEMOLITION I I WOODSTOVEIFRPL INSEFT fl BUILDING RELO:'ATION <br /> — �/ CONTACT PEHSON NID PMONE NO. <br /> CONTMCT PRICE OF WORN /� S� <br /> OESCRIBE WONI(�ND SIXUNE F00TI1GE INVOLVED <br /> / <br /> ✓ �'� 17e- (�/DIQ � <br /> PROPOSEDUSEOFBU'LDING i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> S APPLICATION AND KNOW THE SAME TO BE TRUE AND CORR�CT.ALL <br /> LEGN.DESCRIMION OF PRWERTY 1`�OWN BEIOW OR ATTACN FWR CUPIES� °�OVISIONS OF LAWS AND ORDINANCES GOVERNINCa THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIEO HEREIN OR <br /> �or a�ocK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRESIIME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OFi LOCAL LAW REGULATING CONSTRUCTION OR TME <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PFOPERTY TO PERFORM THE WORK FOR WMICH <br /> APPLI.:ATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTO LAW 1827 RCW AND 296200 WAC. <br /> x /-- ,,�-�'3 <br /> s tune w�¢ <br /> PRO.IECT ADDRE55 /� y/-, <br /> ' �i• C (,�(,/'C�C CIfvBUS�NE551�CFN5EH0 <br /> � � PLUMBIN(i MECHANICAL <br /> ' Np, TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> � � WATER CLOSET(TOILET) � AI�A/HNDLG UNITS—H.P. � <br /> BATHTUB ; FORCED PIR SYSTEMS—B.T.U. M E.A. ' <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M � _ <br /> SHOVJER � ' CLOTHES ORVERS � <br /> KITCFIEN SINK&DISP ; VENTILATION FAN T_ <br /> � DISHINASHER � RANGE HOOD ' <br /> LAUN.DRY TRAY ' WATER HEATER � <br /> CLOTHES WASHER � WOOD STOVE ' <br /> URINAI ' METAL FIREPIACE 8 CHIMNEY � <br /> DRINKING fOUNTAIN � FIREPLACE INSERT � <br /> FLOOR DRAIN � HEAT PUMP � <br /> BACKFLOW PREVENTEFS ; GAS PIPING . i <br /> ROOF CRAINS—FAINLEADERS � EXHAUST FAN ' <br /> SINK(SEflVICE—BAR,ETC.) � , �. <br /> ; ' � <br /> � <br /> SUBTOTAL S ' SUBTOTAL S ' <br /> PERMIT $ PERid1T S � <br /> TOTALFEE S TOTALFEE S ' <br /> FOR OFFICE USE ONLY: <br /> FflONT SETBACK flE�R SETBACK SIDE SET&�CK PUW CMECN NUMBER FEE ���T�� <br /> >�3 � <br /> us�Lp�E LOTAREA v�cu+tsrte FEES VALUATION FEE <br /> i <br /> BUILDING � <br /> TYPEOFLONTS.�LLOWABLE TYPEOFCONST.ACiUM otavu1cY WarvMuixGwu�S � � <br /> i <br /> �' � PLUMBING ' <br /> � . <br /> g�pF g�p�, NO.OF SiORiES BASEMENT MECHANICAL � <br /> � <br /> � <br /> � ADDITIONAL PLAN CHECK � <br /> OCCUPANCVLOAD FIRESPRNNLERSREO'D MEIGNTLIMITATION � <br /> SPRINKLER � <br /> REASON FOIi SPRWK�Ei15 � <br /> STATE BUILDING SURCHARGE ' <br /> i <br /> INTAICEBY PV�NS�PPROVEDBY CITYOFEYEHEIT PUBLICWORKS � <br /> LOCAL SALES � <br /> TAX CODE IS 3105 TOTAL � <br /> F ��� <br />