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- CONSTRUCTION 310 <br />PERMIT APPLICATION y13117' <br />COM13INATION • BUILDING • MECHANICAL • PLUMBING <br />n RCMITFCt OR15ESIUN R <br />MAIL ADDRESS IHONE LICE NYk NU <br />❑ COMBINATION <br />❑ BUILDING ❑ PLUMBING ❑ MECHANICAL <br />LOT <br />PLUMBING <br />BLOCK <br />TER SERVICE <br />BLDG SUPPLY <br />❑NEW ❑ADDITION DAL T L It I"IN_ ❑IIE PAI11 <br />❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL. <br />DYES ONO <br />)THER PERMITS OR APPROVAtb <br />Xj RE ZONE $j SPECIAL USE <br />VARIANCE SHORLINE <br />S'E PA CHECK LIST REQUIRED <br />i:t YES <br />=1 NO <br />MECHANICAL <br />TYPE Of ENERGY <br />❑6AB ❑FLTC. <br />'- '-'" --- FEE <br />TYPE OF EQUIPMENT- „`_�s <br />AIR COND. UNITS-/I.P.EA. _ _.—�---� <br />JFIIP. EADIItRS /LP EA.R.T.U. ME A. PACE A WALL HEATERS - P.T.U. NIT IIEATERS R.T_U. _ VAPORATIVE COOLE145 �__�_�_- - <br />•- AIR IIANDLINO UNIT- C;F _MC. __ 1 <br />-•WATER HEATER-- - _••��� <br />-. <br />FAC BUILT FIRLPLACE A CHIMNLY _.I •, �••_•,,,�, �.� <br />OAS SYSTEM NO OP OU 7L115 <br />-'- - - -null 10TAL <br />-' --»- ---- PER f ... <br />S 1 _ <br />71115 MEI�MIT II EEtnM kS N1111 AN() VOID II WU11 P. 0H CONSTTIUC <br />TIDN AV 111OOIZED IS NOT CO`.IMLNCLR WITIIIN 1?0 U•%YS. OR IF <br />CUNSi Rl1CT1UN OR WORK 1!; S,01Y`I'NOE0 O11 ARANDDNED FOR A <br />PLRIOD 01 170 DAYS AT ANY IIMI. AFTEII WOIIK I5 CnhIMF NCEU <br />I IIERLRY CERTIFY THAT 1 IIAVL RLAD ANO t-IAMINIn 1`1115 AP <br />PLICA110N AND KNOW TIIE SAME 1011L TRUE AND CLI11111 CF. ALI <br />PROVISIONS OF 1 AWS AND ORDINANCES O(/VERNINO IIIIS TYPI <br />OF WOIIK WILL BE COMPLIFU Willi WHETHER ETER -.PECIFFED HFREIF <br />OR NOT. TIIE OnANTING OF A PERMIT DOES NOT PRESUME TC <br />Off CANCEL Jim PROVISIONS Of <br />ANY OT/ILRIniTY STAT ET OR LOCALVIOLAIFI AW HLOULATING CONSTIlUCT10F <br />OR TOIL PEnFORMANCE OF CONSILIUCTIONI <br />SIZE OF ULUU•- <br />tt <br />11-I�L .'il'N IINK I. [II?4 SIUNATUREOFCONT RIACTOII OOP AUtN. AGENT <br />1 •III�LGN-����- IIA{i1�1-�NI REUWIIE0 LAN C/IECK NUMNIi/ PLAN <br />❑YES ❑NO ILC <br />SPECIAL CONDITIONS: _ <br />SEPA REVIEW COMPLETE: DYES ❑ NO <br />contact plannlnq dept. <br />RECEIPT NO <br />FEE <br />BUILDING <br />: <br />._.... 1 <br />PL IIMOI NII <br />1 <br />MECIIANICAL <br />F•-- <br />- <br />1 <br />OTIIER <br />�. 1 <br />PENALTY <br />- �_ <br />SEC 000( d <br />_,..�--•_�_ ._. <br />1 <br />...�.••••. Il..�_ <br />TOTAL <br />I <br />I <br />