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APPLICATIvN FOR CONSTRUCTION PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT .✓cv�iurr <br /> BUILDING DEPARTMENT HEATING SYSTEM: GAS ❑ELECTRIC ❑ ] <br /> "59.8810 <br /> I i DEMOLITION 11 COMBINATION BUILDING I I MECHANICAL LI PLUMBING SIGN <br /> OWNER MAIL ADDRESS CITYZIP PHONE <br /> TENANT MAIL ADDRESS CITY ZIP PHONE <br /> ARCHITECT OR DESIGNER MAIL ADORE'S CITY ZIP PHONE <br /> e-5Zunw_ CT.S n-onZ✓— _ <br /> GENERAL CONTRACTOR MAIL ADDREF', CITY 7P PHONE STATE LICENSE P <br /> MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSER <br /> PLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE STATE LICENSE B <br /> CONTRACT PRICE OF WORK <br /> DESCRIBE WORK yD6WARE FOOTAG VPLVEO CONLn PFRCIW Axn PN ENQ r <br /> ��sSKe <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PPOPOSED USE OF BUILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGAL 1'CRRIpIPT)ONOFPROPERTY( BELOW ORA ACHTWOCOPIES) WORK'NILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> LOT elocK of � ��' NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> 7tJy-7it�L Q�l'(./.L��$ /r17 ✓, 02 OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> PARCEL TAXI.O NUMBER APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> CONSTRUCTION LOAN LENDER,ADDRESS,TELEPHWE NUMBER <br /> P-�CTADDRES8� ) !V er? IL tA Bax+IX, � ' wTee L o�o2/' /��q <br /> I .�� _ Cm MKwEf9llt[xsE ND <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> I .1 WATER CLOSET(TOILET) A/C—A/HNDLG UNITS—H.P. <br /> _ABATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> LAVATORY(WASH BASIN) UNIT HEATERS—B.T.U. M <br /> SHOWER j I CLOTHES DRYERS <br /> KITCHEN SINK 8 DISP VENTILATION FAN <br /> DISHWASHER <br /> RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER <br /> — CLOTHES WASHER 'WOOD STOVE <br /> URINAL METAL FIREPLACE(WOOD BURNING) (at . <br /> DRINKING FOUNTAIN , FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP T— <br /> BACKFLOW PREVENTERS ; GAS PIPING ' <br /> RF,OFDRAWS—RAINLEADERS I EXHAUSTFAN , <br /> SWK(SERVICE—BAR,ETC.) , <br /> , <br /> IT <br /> I , <br /> SUB TOTAL SM SUB TOTAL $ ' <br /> PERMIT $ I PERMIT S I <br /> TOTAL FEE S TOTAL FEE $ ' <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBACK REAR SETBACC SIDE SETBACK PLAN CHECK NUMBER FEE RECEIPTNO, <br /> USE ZONELOT AREA VACANT SITE FEES VALUATION FEE <br /> '� }� YES ❑ NO BUILDING <br /> TYPE Of COAST 2Q � <br /> df s <br /> NO. FSTORIES pCUMMr gpORlIINBIMt{ ♦�`" <br /> :'MMS / PLUMBING <br /> ELME OF LOG f * FIRE SPRINKLERS REO'D BASEMENISALES CHANICAL i <br /> SJ ❑ VE <br /> OCCUPANCYLOAD FIRE ALARM REDO HEIGHTLIDITIONAL PLAN CHECK <br /> NIAU ZER <br /> REASON <br /> TE BUILDING SURCHARGE L ' <br /> INTAKE BY PLANS APP50VED <br /> By CITY LIC WORKS Q� <br /> 11� LOCDATE TAX CAL /_;j <br />