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, APP�.�CATIQ+��' F <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> �� HEATING SYSTEM: J GAS �ELECT RIC J I <br /> BUILDING DEPARTMENT - <br /> 259 8d10 <br /> DEMOLITION COMBINATION X BUILDING _ MECHANICAL ,��PLUMBING SIGN <br /> �.W41u 1lMLnU[�n�Fti r.rtv '_ _'l6' r��oryt <br /> � �]_'L4�_�—' '1 � �t ' 33'!- 7yUU <br /> �AFI n SC� 6y' I22L s'. � E �A'a_K r �_ CK_; TcbENs _ /�_. 5f -- <br /> rn�nNl MniLMnncss utv tM1� ����)br <br /> nnCNrtECtOR0E51GNEA MniIAlIDRE55 CITY 21P �'HONL <br /> /�+A�'r� 0 SE�B�' llzz S/'rvw'��K�'cw� RI' ci� S�eder» 9°�5�: 33y �Y�� <br /> iqNFRAIf,ON.�RGTOR M4il AODRE55 Crtv IIP PNON[ STPLEUCE��SEt <br /> /'��1� 5� �84' I2z2sVd��cBK��1��0 � STco Ns �s�' 33Y- �'lw /?A!'1�5F[l7/Mu <br /> 1.11 I�.HANiCAi CONLRRCIOR MRII A�ORE55 CITY !1� PHONG StAiE Uf.ENSE� <br /> f�LL�ut�^(f �'13L�51�71��-0{" �7L !' G .tiul4�h'��cc �l.`'77 � �73 /y/5 /�cL!'C/��Yd`, <br /> Piii6�0iNf.GONtPAf,TpH MAil�0�RE55 ❑i'/ lIP P��OAE SiAiEI�CENS[� <br /> /�1�. uw� 3nJuRiNw�si S7/`1 a�'- Lti'f ���s✓r�c - .2.7 �31Y! •5 fjLcp��/�y <br /> cor+�pPcr rnicv o� wonrc ��c� <br /> dC�� (JOd.Uv ��fP��"� �ws.._.Jhl�vc �,.t- — <br /> 0[SCR�OFW MAlIDSQURRC�( TAG[INVOlVEO CONiALiPERSUNANOPHONENO ��, �/���^ <br /> ___�_/Ei,!_�cul57�Z�.�[.,l¢d1.Er1^.,rL,s� L11/��� �i <br /> !k(PG�C 15�E5� -����, s�.o� _ zo� _ 337-y7.�� _ <br /> /' 1l �/� ,� �,i . �„r <br /> I�6 Sf f,r� /�/`i � ` 5� Y�+ ���" I HEREBV CFRTIFV THAT I HAVE REAU AND EXAMINED THIS <br /> raorosru use,,�o wi.0�yc / APPLICATION AND HNOW?HE SAME TO BE TRUE AND CORRECT. AlL <br /> f-qM I I� �f�(�� �� PROVISIONS OF LAWS AND ORDINAN�ES GOVERNING THIS TVPE OP <br /> 4 ircniDPSGnmTioNOF� ventvisNowN�E�o AuutNtWocaPiFs NOTTNELGRANTMGOFA ERMIWDO SENOTPRIES MEETOGNE <br /> ir,r— e�or,K oF AUTHORITY TO VIOLA7E OR CANCEL THE PROVISIONS OF ANV <br /> �)���� �� — —_ OTHER STATE OR LOCAL LAW REGULAT�NG CONSTRUCTION OP.THE <br /> �I" PERFORAIANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNCR OF THIS PROFERTV TO PFRFQRM THE WORY. FOR WHICH <br /> � ___ APPLICATION IS MADE AND/1 CO PLV WI7H THE STATE <br /> rnnce��nx i o nuMnr�� ,� CONTRACTOFS L W 1827 RCW ND'<?52 0 WAC a I <br /> ��telsi_�!�hq ,� 5/1�4 ` Z � � <br /> cor+stnucnor:�.nnr+ii.nocnnnnnessrrirrv�oNeNUMnrq� 1, ��C ` - .-.t/`/ � �'�`jy <br /> ����P/C �il� [t�4 C `J�/� v y 'l _ � — <br /> — � ^�-��-__ i�.� <br /> PROJECTA�D y� ,h /1 OZ�'=�y- . / .. <br /> �/ � / C ,:n.xi�..�nssi,,.:..i •.�. <br /> PLUMBING `AECHANI�AL <br /> NO. TVPE Of FIXTURE OR ITEM FEE k0. TYPE OF EOUIPMENT FEE <br /> WATeR CLOSET�TOILE7� ��� _ __ _A C-A HNDLG UNITS-HP ___ ;_ <br /> BAiHTUB ____ FORCED AIR SVSTEMS-D.TL. M E A _ __�__ <br /> LAVATORY(WASH BASIN) / � UNIT HEATERS-B.T.U. M ____� <br /> SHOWER z CLOTHESDRVERS - _ _ . <br /> KITCHEN SINK 8 DISP VENTILATION FAN _. <br /> OISHW,ISHER _ RANGF HGOL' � . <br /> LAUNURV TRAV WATER HEATER � . <br /> CLOTHFS WASHER � WWD STOVE T_- <br /> � ME7AL FlFCPLACE(WOOD BUFNING) ' _ <br /> URINAL� _ — -- � <br /> DFINKING FOUNIAIN FIREPLACE INSERT _�__ <br /> FLOOR DFAIN _ HEAT PUMP � - <br /> BACKFLOW PREVENTERS GAS PIPING __—�--- <br /> ROOF GRAINS-FAINLEADERS E%HAUST FAN ._ ' __ <br /> SINK(SERVICE-BAR_ETC.1 <br /> _ _ — -- _—�_— <br /> SUB?OTA�_ $ _!' � _ _______ SUBTOTAL S _ 2Qi_ <br /> FERMIT $ ___ PEFMIT S _ <br /> — TOTALFEE $ TOTA�FEE $ <br /> 7 > .l :� <br /> FOR OFFICE USE ONLY: �� y ' �� �I <br /> — - - - ��im,i�n��.u�nniin rrt (� [cFir�r,o <br /> ianrntit�un�.n � n6nasn:°�KZo� fn�M � siu�tii�enrn � , . ��� � �,l' <br /> _ 5 �'4 <br /> �� v.�cnnrsne '--� VAlUAT10N FEE <br /> �O .nav.b + 9�f_ <br /> u�r �o`�r �o.man FEES <br /> � � J(J�/ <br /> /(—� Z 2213ZS � /VES No _ nuiLrnNr., f�j 1�c1�7- /,7_l��� <br /> . 1�I'�qrr� NOOrSrOmEs � .�.,y:, ,nrxl�,�,�. ,.i —_— .__ _. .. . _ . _. -_— _ /(, <br /> �� �� PLUTA[71NG _ ____1�J��__ <br /> - �-1�l-- -- —�'---- �� — -- <br /> !HIFO��illlf1cE t {'i�ESPRMnIERSfitOU flPSEA1fNi � � MLCHANICAL — _ ._ ___ ____�ZU�_ _ <br /> ��9 � � VES �NO � � / (J <br /> �.5.�_4� pUDIT10NAlPLANCHFCK '_( 3 <br /> c��.�uPnNL�IOaD P�RE nLn� HEIf.HI LIM�T��ION � — . -- — � <br /> � � <br /> L- � OTNFR <br /> -h_/� '�L_ _--!Y r� - �----- -- -- - - -'� <br /> „t�>,��� �; , -,. <br /> STFTF A1111.DING SURCHAR(if _ _����,� <br /> ._ ._ _ _'._ _ <br /> ——_—_ . _ . ' <br /> ,���nh� i�+ � rine�snrrnovrnt+r � �ITY�fEVEflETT vuuucWoaKs ��� <br /> LOCAL SALES /� li 7' �� <br /> � ;��� <br /> TAl( CODE IS 3105 rotn� <br />