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, <br />OWNtN <br />1 <br />� .' .. <br />n�rcNi, <br />ca�sT�uc�rio� <br />PEf�tvtlT APPL{CATION <br />i,;;' � /I " <br />:>C1L <br />COMBINATION • BUILDING • MECNANICAL • PLUMBING <br />w1A1L/�UUHkSS 11Y YNUN! <br />� � <br />� <br />"ul�r�_S y2 5` 6,;t,� ��. ,�,��c7fl �t�c'. v�yn,-z��� 775y �s" <br />MEC/IANICi1LCUN�RACTOF ►IO.ILAOOR <br />H <br />❑COMBINATIOfIy <br />� OUIIDING LvJ FLUAI�ING ❑MECNANICAL <br />VAlVAT1pN OF WOHK <br />5 <br />FOVfI <br />LOT _ <br />9lC�CK-Of <br />JVY NV:lMC» <br />`y� ll . <br />PLUMBING <br />NO. TVPE O <br />HA111 Ti1Bti <br />Cl0 iMES VJA <br />U�SIT Y:ASHL �� <br />Urun;r.ir�G Fo <br />FI OON Unnit <br />KITCMcN tilNl <br />- I1AR SIP�KS <br />IIJOF DHARJ: <br />SHf7P:EH f1AT <br />tiEHVICE SiNF <br />sur: vs - sew <br />U�i1NAl5 <br />1VAIE�l CLOS'� <br />WC.TEFI N6AT <br />— ( ] � p.L•(', <br />I <br />❑ NEW <br />❑ DE\AOLISN <br />0 <br />e <br />I IUIl�Lttt >I �f'� <br />BqT[R SF.RVICE SIZF. BL�G SUPPLY 517E <br />U'.:l 'fUN! <br />❑vE5 ❑NO <br />I IIIL 'LONk <br />IHEU <br />CS ❑NO <br />SPtC1AL CONDITiONS: <br />� <br />SEPA REV(Ew t_OMPLETE � ❑YES L] NO <br />contacf planninq dcpt. <br />� wLIUbUHALU11lUYV-�- RAMY_HI�t111Y�- A)�110V10 UI�V:UAKIYY <br />�� ' <br />VHON <br />PMONE <br />NO. <br />N U. <br />❑AODITIUN ❑ALTE��Af1UN HU•Nf1 <br />�FEN[E� GSIGN ❑'i1VIM11MiNt: 1'OOL, <br />)THER PERMITb OR APPROVAIS <br />�I RE ZONE �j SPECIAL USE <br />�.YARIANCE � SHORLINE <br />SEPA CHECK LIST REQUIRED <br />I� YES <br />L� N O <br />MECHANICAL . <br />TYYE OF ENERGY <br />�jr.ns ❑e�ec. <br />NO. TVPEOFEDUIPMENT —r FEE <br />AIRCONO. VtJ1T5-H.P. EA. .�..--'—+5 .._- � <br />RE�A�IiERAT10NVNifS HV EA -T- <br />OOIl6R5 H.V. EA. _ "'" "_-__.__'_�- ' <br />FORCED AIR 5'/STEhI� n.T.V. MEn. ' -�- <br />_'_ � <br />-" _'_-. '-' " _' � - 1 <br />SPACE b WAL� HEATEHS A.T.V. � �- <br />. � <br />UNtT HEATEA$ H.T.V. � <br />EVnvONnTIVE COOLEHS -�- -�- <br />L <br />__ CLUTHES DFlYEPS I T <br />VENTILA�_�ONFAN � : � <br />IiFNGE HOOD � ( � <br />__'.. <br />�.IH ��ANDLINf. VNIT , C:f_M__ 1 _ __ � <br />�_ �"'"____'_.'_'".' � <br />� T <br />-! WATENHEATER.-.-.. -... ._ _..._...t <br />����-_ FAC. BUILT FIREPLACE & CN11lNE� _�-_�-� <br />� f.AS SVSTEAI NO OP OUTlf.15 -'r-�-- ?- ^ <br />'L-� -_ .." ""__ . ." . <br />❑Ufl TUfA� 5 I <br />'___' "'" PEfiMIT 5 -"'""_-� <br />_' _�� __�_ ._ -� <br />� T07ALFEE 5 I <br />T1115 YF.NRIIT�UECOh1E5 NU� L �ND VO�U �f WUHK ��R t:UN$THUC <br />TION AV�RORIZED I$ NOT f.(1!.�ti�LNCCO W�T1:IN 1;0 U•��9.OF IF <br />CUNSTfiUCflpN 0�1 WOf1K L•: SU;i�'fNDEO [)R AOnNOPv[U FOR A <br />VEl1IOU OF 1�0 OAYS !�T /�N'/ ��ntt. nF TEfI wonK �:: C� :'.�.1ENCEU. <br />I nLRt!�Y CERTIFY TMnT I 1InVF. IIEr1U �1Nfl EYI�M1�W[f� i1�1: 4P� <br />PLICATIOY An'U ANOW THE SAA•E TO 11l TfiUE �WI) C01:Nff_L ALL <br />PfiOVI5�ON5 OF LAWS AND OIIDINnNCES GUVEf1YiNG ����5 TYP! <br />OF WOHK \YILL BE CO�dPLiEU YlIfH W��ET��FR SPECIFItp NEREIN <br />OR NOT, TnF fRAN71NG fl� A PEFbVT DDES NOT PRESUh1E TO <br />GIVE AUTIIORITY TO VIOIAfE ON GANCl� T�IE �'RUViSiONS OF <br />, AfJv OTHER STnTE Of1 IOUL I.AW IIEGUTATINt: CONtiTIlUCT10N <br />OR TME PERFOflMANCE Oi CONSTNVCTION. <br />7 �� /�� � <br />\/ <br />x �� �� . . �l.-L___ � - •___ <br />SIGNATV«EOFCONTRALTO�ORAUTIIt�CiENT nATE <br />IYL.�NCH[�� NVMUtII NLAN CIRI'� 1 LL <br />fk[ �nECEmr Nn. <br />__ FEES I VpLUATION� _ FEE <br />_ ��_ �.� <br />OUILDING <br />riiiMnwn �—'•" <br />MLCIIAN1LAl <br />orncn <br />VENALTV —_ <br />TOTAL <br />r i <br />=�E�_, ° -' _ . �J : �' . <br />I ( p c� <br />i <br />. � <br />_.. _ �-._... <br />SE�.������_ .._..L__ <br />—"_"" "_ ' _ " 1 <br />3� !f� U <br />ft <br />4 <br />i <br />