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CI:LUERFTT DJI LAIN7 DE--T TO: 20GS433475 JAN 17. 1992 2113PM U412 P.02 , <br /> APPLICATIOw FOR CONSTRUCTION PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEM: 6A5 U ELECTRIC U <br /> BUILDING DEPARTMENT <br /> 259.8810 <br /> y ro I I DEMOLITION I I COMBINATION K% BUILDING 11 MECIiANICAL I I PLUMBING I I SIGN <br /> Ca CITY IM PHONk <br /> 0 :o <br /> OWNER Homes �4�1�'F el-Red Rd #200 Bellevue, Wa. 98007 644-2323 — <br /> F .f In TFNAW MAC,ADOnCei CITY Lr PHONE <br /> M IIyL� t <br /> hC f-1 ARCNITFCIO NAI AU�UR�Bf�n ,�' ( CUY ZIP r'IONF <br /> o 0 � I' 1L Nle" I--�L�� ���� "141n' '��(n _ <br /> AR AODRC68 1 CI Y LP /1 r�•/�/��] PNON! 81ATF1glN8el <br /> N M OLKIA&COVIRACICIA ` n "17CO 1 <br /> 1�C //�77}�,,�.����-,�1I']I0� i S I �y IC Qir'1'K�llUll Cif `~., rNON6 61MCLKCN6FC -- <br /> kq ((�� FAQ CNANgALC[MMCTOR MAX AUURC88 CITY x1P <br /> M M PWM81Ki CONTRACTOR MAIL ALOIIISS GIT IIP PNOM 6TMtuccuw1 <br /> C) <br /> H fA A6$CW Mn% <br /> M IXI NEW 1 1 AppITION I I ALTERATION I I REPAIR 11 DEMOLITION I I WOODSTOV&FRPL INSERT I I BUILDING RELOCATION <br /> y •' 1n TACT PERS04 P1IONF NO. <br /> ling .cc V 11� M �¢1�=�3 �LIz <br /> O N r t <br /> C r pryITRACi P-ick OF MAX <br /> PO tq `DCCB.ORR,F WORK ANA)TIMMC fOOIAOC MOVED r 1 <br /> In AuLLI.`[l`1fi��Ln �. c r 723 1T <br /> P oruNe0 u6e ar CNAlIWn 31 4 { � I HEREBY CER7�FY THAT 1 HAVE READ AND EXAMINED THIS <br /> �1��k. p �(l 0 n1A 0 APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> L OALUk Illrl M PROPFRIY SHOWN BELOW URATTACN FOURwNEn PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> I� WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> LCT _ eLlKK of NOT. THE GRANTING OF A PERMIT DOES NOT PRESUMC TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING I CONSTRUCTION OR THE <br /> —L1dSL1dYI 1 1 ' PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> Q A I�`1 OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> Pft it, G1 APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 18.27 RCW AND 208.2DO WAC. <br /> -- X [M <br /> ' PUMAIIn( ^ Mi( <br /> PIIWECI AODnCRR - ` ZL 2 -- -- •� <br /> j-,f'C✓ uli nnmrA Irc.xe .q <br /> qI PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET TOILET) <br /> AC-AMNDLO UNITS—H.P. ' <br /> BATHTUB, ' FORCED AIRSYS7EM3—B.1,U. M E.A. _ <br /> I�" i LAVATORY pYABH BASIN / UNIT HEATERS—B.T.U. M { . <br /> SHOWER J` I _,•,� CLOTHES DRYERS .. - <br /> KITCHEN SINK A DISP _ { VENTILATION FAN <br /> DISHWASHER, • RANGE 11001) ' <br /> LAUNDRYTRAY { _ WATER HEATER ., <br /> ATL► �_ CLOTHES WASHER • WE STOVE <br /> METAL FIREPLACE d CHIMNEY .. <br /> URINAL — FIREPIACE INSERT <br /> DRINKING FOUNTAIN ' ••"'-- <br /> WA� P <br /> BACKFLOW PFLOOR DRAIN <br /> j BIZ _ REVENTc <br /> '(i 1 ROOF DRAIN 5 1 4 EXHAUST FAN _• '-- <br /> SINK(SERVICE—BAR.ETC. .�. - <br /> ( <br /> SUBTOTAL S { r SUB TOTAL 6 } <br /> _ PERMIT i l PERMIT <br /> �� • TOTAL FEE S '�o TOTAL FEE S i y0 ' <br /> 'OR OFFICE USE ONLY: /TiP3ic /pz< <br /> nONT I.YTRACK RGR FCTRIOK tlOC SCTBACK PLNI CIICCK N)16/K9 <br /> Pee RkCkPt Aro. <br /> skxunc� <br /> 70-- FEE <br /> oVADANISR���e((( FEES VALUAl10N FEE <br /> BUILDINO <br /> .rea w6r6.ulowrl Imor uw6T.AtTuu oasw.uta .R n'+TurlAn6 . .... • <br /> ✓- � l�- A/ 3 PLUMBING .. ..�I o <br /> aeardtq LG No.nr RTOAWf 8ASSMIWT MECHANICAL <br /> y <br /> ADDRIONAI.PLAN CtICCK <br /> CCOIANDY LOAD cwC fPRNKl cR6 REDO MCKOIT LWIfA1� { <br /> SPRINKLER <br /> eAJON fPRWq FRI P <br /> STATE BUILDING SURCHARGE y Isa <br /> FAKCIrr "NUTp`F*wDfiY �CITYOFEVERETf PunucwDRKe J {aa <br /> th <br /> TAl(CODE 18 9105 TOTAL / 0 6 3 t n- <br />