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FROMIEUERETT BUILDING Dc°T TO: 2066433475 ^-N 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 U ELECTRIC IJ_ <br /> 259.8810 <br /> I I DEMOLITION i ICOMBINATION GUILDING lIMECHANICAL <br /> OYnlf.4 L kADORCSs I [PLUMBING I SIGN <br /> I <br /> IFNANT •• , MAM1 ApDnlSS �'—��_ � ,IGI YC'0 -7 S(JO7 �p�(v �" _ -I�� <br /> ar pIIpNE P , <br /> naCURFGt UN pC31UNCn NAR wUMLS3 <br /> 1 CIIY Zlr IIIONF <br /> DlN ML C.MiaACipq NAIL ALDaCd6 �>_ ��V�• ��OLI ���-`.:J/Q. CJ <br /> CITY ZIr pmo <br /> CCY BTATFI,ICCNSC/ <br /> NfCNANICAI CONTAACf5A MA's- /'Ar•,I U0 rn <br /> CIIY Zip rnDN6 <br /> STATE LICCN6E I <br /> pkuuBlNpconrrucrpp MAnwonesB <br /> CITY ZIP rNONC -•- <br /> 6utc uccxvi <br /> C.iA63 Ur wOnK " , <br /> XNEw I I ADDITION I I ALTERATION I I REPAIR I I bEMOLITION I I WOODSTOVEiFRPL INSERT I I BUILDING RELOCATION <br /> �,\ ,` COMA TpEg6CNAND PIIDNF p, <br /> COi-AAF VMK U/wpn�TA I1 7� VV - �l _ /& <br /> DCSr.ROi WpgKANU SDW nn IDOTALaNyry yp l,'6 •• �.[[fG/ •.�_ a,3� <br /> n�7777 — <br /> rNUruC[OVs[OfOunnwp <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROVISIONS�t----• / /�J�(/,SGC-UtCL APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEMLU Cllirl7Nn panpOF <br /> UnATrnCNcOUgCOPIE57 IONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE ALL <br /> mt— BLOCK OF �^ WU K WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT, THE GRANTING OF A PERMIT DOES NOT PRESUMC TO GIVE <br /> ds AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> •-' �k"� 'v 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 WORN FOq WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> _• �(�� 9�`�A •SyCONTRACTORS LAW 18..2277 RCW AND 296.200 WAC. <br /> ' i;UJkCI IDDnCSA' ` I ��✓/ Y ,111 <br /> lJ�(c01 '� `iy`T (I ✓IA/ p 641NILP1 OaNai.�— <br /> PLUMBINO 0� qIY Bu,MIATI MIN xD. — .._ <br /> NO, TYPE OF FIXTURE OR ITEM MECHANICAL <br /> FEE N0. TYPE OP EQUIPMENT FEE <br /> BATTER CLOSET{TOILET) I A/C-AINNOLO UNITS-H.P. <br /> BATHTUB "� �T_ <br /> ' FORCED AIR SYSTEMS-B,7.U. IA E.A. , <br /> LAVATORY BASIN) UNIT HEATERS-S. M <br /> SHOWER •• _ , _ 1 CLOTHES DRYERS <br /> KITCHEN SINK 6 DISP I VENTILATION FAN <br /> DISHWASHER <br /> _�.. . <br /> LAUNDRY TMY • . I RANGE HOOD <br /> CLOTHES WASHER --i•— . .. I WATER HEATER '— <br /> URINAL - ' WOOD STOVE —' 1— <br /> DRINKING FCUNTAIN' — METAL FIREPLACE d CHIMNEY <br /> FLOOR'ORAIN .ti FIREPLACE INSERT , <br /> ' _ ••-�'-- <br /> BACKFLOW PgGVENTERHEATPUMPS I GAS PIPING -- <br /> __ ROOF DRAINS-RAINLEADERS I E%HAUST FAN •�-- <br /> SINK(SERVICE-BAR,ETC.) —" , '— <br /> _. SUB TOTAL f I SUB 70TJ.L S <br /> PERMIT '- <br /> TOTAL <br /> TOTAL FEE f I "' <br /> OR OFFICE USE ONLY: <br /> IONr SCLC OCAq p6TgICX 6100 06111 AC <br /> rLANCIIWKNIlY06p PLC ^ _ qkC jCl 0. <br /> .. - Z_ <br /> LUl AntA VACANI SITZ <br /> FEET VALUATION FEE <br /> 3 <br /> 'I DI CC1NTJA'IOWA1LE blI01 NSI.ACIUBUILDING <br /> /7LI at mbi..C1UL'i Villl <br /> T N / FlUM81N0 •Y ••� <br /> :Ly ol 7 N0,(X STOATS OAS6N6NT <br /> 'Z77777 Sri' MECHANICAL <br /> S/J S!•C�M1 Y <br /> CULANCY LOAD FIR sppNKI As REOL ML7nr LUJ�— ADDITIONAL PLAN CIICCK <br /> k JVD 3 ' <br /> 4YON rpn srawKl ia6 -8PRN71iLER— <br /> STATE BUILDING SURCHARGE <br /> ' <br /> nqc sr •I ritil:nopll USE,6Y CITY""ERETT PUPLICWORKB <br /> �J LOCAL SALES <br /> 5 44 1 TAX CODE IS 3105 TOTAL 2� <br /> r <br />