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FROM:EU-ERETT BUILDING DEP', TO: 2066433475 JI-I.. 17, 1992 2:13PM 11412 P.02 <br /> APPLICATION FOR CONSTRUCTION PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM; GAS Li-ELECT RIC IJ_ <br /> 259.8810 <br /> I I DEMOL171CN I I COMBINATION BUILDING <br /> OWjEN MAILApORCs$ C" SIIMCCHANICAL I IPLUMBING 11 SIGN <br /> f ^PYHDNL^ <br /> iPNANT MAM1 ADDa[ff •--` '� Q 900D / I/�V(y _o-3,�.� <br /> CITY f11 vuONF <br /> dafIOTFLi ON Ut$IUNCO Wq/,VUMlf4 <br /> CITY 211 rIIONF <br /> `616 NE�aoz 6z//syj" l8avj �n �g BG G <br /> OCN nALCOMRACTOR MAIL FDDRCii J <br /> CITY 211 �_.—1 <br /> (,ZS ��/'L.•Q.Y PNC BTATF I,K;lNSC! <br /> MFCIUHICAI CONTDACIOR MAILADURlSS <br /> CITY 1a1 0 I'yl <br /> PHOH$ SIATC LICCN$F.I <br /> PLVAIC,N000 7"C%M MAK AUOn[f7 <br /> CITY IIP NC <br /> InO <br /> CIAIC LICLNSF! <br /> CJ ACCW WOaK •' • <br /> ( NEW I I ADDITION I I ALTERATION I I REPAIR I I DEMOLITION I I WOODSTOVE/FRPL INSERT I I BUILUIN3 RELOCATION <br /> ��/ <br /> CONTRACT rkICk U/11'0,11 �}/) QI'7/J / '� CONTA TPER$OH AHO PIIONF 0. _ / <br /> D�CS�C"RNPM•ORnKANU YUVA,I[/OOTA.0 Ilw;C- II •' ��� PJ� <br /> p_3 -o .� <br /> rkuruclousearouanwp •SG—�--. < <br /> Kq�� �i�4 �lF�LGCn I H CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> t atu c11I� UN Dr opCefgry <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT,ALL <br /> 3 DwNiF-�4 LOW Un AirnCN FWRCgPIFi7 PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> tOT-� -. CtocK DF WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> •=�� . . �� (Cc`td.S ✓ AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> 44 C _a OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCOF CONSTRUCTION. BY THE <br /> OWNER OF THIS PROPERTY TO PER ORM THE WORK THAT I AMAUTHOR,ZED FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> A <br /> _ CONTRACTORS LAW 18.27 RC W AND 286.200 WAC, <br /> 'rNJkl'I AOOntxx' =may, <br /> �/} dap OaHa <br /> PLUMBING CIIY YLLaMM11FIMa,NO. � .,•� <br /> NO. TYPE <br /> MECH <br /> OF FIXTURE OR ITEM ANICAL <br /> 1"ATEA CLOSET FIXTURE <br /> FEE NO. TYPE OF EOUIPMENT <br /> FEE <br /> BATH,UB "" ' AIG-AMNDLO UNITS-H.P. <br /> LAVATORY(1VA$H BASIN) <br /> ' FORCED AIR SYSTEMS-B.T.U, Id E.A. , <br /> _ SHOtvEq " '' ' UNIT HEATERS-B,TU. M - <br /> / CLOTHES DRYERS <br /> KII CHEN SINK 6 DISP - , -- <br /> DISHWASHER ' VENTILATION FAN - <br /> LAUNDRY—,PAY - - I I RANGE HOOD - _ --�— <br /> CLOTHES WASHEq ---r•— . .. I WATER HEATER - <br /> _ WOOO STOVE '-;•-- <br /> DRINKING FOUNTAIN' - METAL FIREPLACE d CHIMNEY <br /> FLOOR DRAIN FIREPLACE INSERT <br /> BACKFLOWPREVENTERS _ HEATPUMP •••-:-- <br /> ROOF DRAINS-RAINLEADERS ' _ I OAS PIPING , <br /> SINK ICE-Bqq'ETC. -'- r _ EXHAUST FAN --i-- <br /> 1 r <br /> -.. SUB TOTAL f 1 I <br /> PERMITf ,- SUB TOTAL f <br /> TOTAL FEE f r •• PERIAIT S , <br /> )R OFFICE USE ONLY; ToiaLFeE f <br /> HT sriAACI n[AA SCiRACX <br /> -IOC WVAACCR / I•LMCCUCCK NIIMlVR ICL <br /> `�'• (AS! �. /'I�'/ r� AtCku• 110. <br /> • ! (01 AHe VACANT mTe <br /> Ir FEES VALUATION FEE <br /> CI CONI]Aq OWAh! I Of CCNii ALip1BUILDINGI <br /> ' utr Im PrIW10\;Vkp{ L <br /> y <br /> PLUMBING <br /> • .... - r <br /> Sips 110.(1. TOAIFS TIM C•MCM <br /> ,SF � MFCI.ANICAL <br /> JPnNCYLOAU `/�C ­ <br /> TME <br /> SSPANK,FAC REOU _ <br /> —•-�/1V 1/�LrI <br /> HCI IITLIMITATION - ADDITIONAL PLAN CIIBCK ~ <br /> - <br /> K)NYen fCRINKIFRi NJ E RPA NN en_ ' <br /> ��.;- -- <br /> STATE BUIlAINO SURCHARGE <br /> :FCY rizSAPP p(IVFr,ir <br /> CITY <br /> J+� PUBLIC WORKS - <br /> SAL <br /> 2 /173 TAX CODE S LOCAL 3105 TOTAL <br /> LI,j <br />