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F APPL AT" N FOR CONSTRUC'"rION PER 11T <br />lot B TO BE COMPLETED IN BLACK INK -PLEASE PRINT 4m <br />L= <br />J _ <br />r <br />11 <br />left <br />BUILDING DEPARTMENT HEAIING SYSI EM. 4 GAS J ELECTRIC J <br />259.8810 <br />I DEMOLITION COMBINATION BUILDING 4-MECHANICAL �t PLUMBING I SIGN <br />ovrtlEn Nan nnunrps5 (Ov ]m MK1rm <br />C. W �13ic�htA�,NIn.AC�• P)v�.��ro_ S_^►lml'o__5�_l_�Po�41 Y85'I3�I <br />TENANT <br />1J_/J_—F/-Y.1/_I_�lY.— <br />OCNERAL CONiRNaOR VVV MA0. AIK,M 5s <br />u• dam%%l%_C" <br />NEC HANICALCONITIACT1OR MAIL AOMIESS <br />:i.3so MlAATNeA}iysly1 S' <br />UMBM6 CONTRACTOR! <br />MCTOR MAIL AWBs <br />CAMS OTLVDIIK <br />IX NEW I I ADDITION 1 1 ALTERATION <br />,11v IIP pox*R: <br />-------''—y-� <br />O Y_ <br />city <br />MKNi STATE LICENSE <br />S►'�fl. licv SLVO <br />i3S(t-- IIOmalIfJ719t�11 �lu6RIGlEI� <br />City ln. PIKAiE STATE LICENSE <br />�13t1 p/ 11V_U�GtwA �071��0o g6soCt13d rt 7 <br />city Zm MIONE STATE LICENSE <br />&A oa-13o1_1.ell,_7xno I k C K IBw x x /4Q. <br />REPAIR DEMOLITION I I WOODSTOVEIFRPL INSERT I I BUILDING RELOCATION <br />//JJ <br />CONTRACT rnCt Or VAOTIK 1Q 3/ _ _ <br />DEscnME Whin Ann SO Mnr rooTARr I vrn <br />_ .- <br />C(Iri jfl PffION AND MOVE IA)1 L,�� �31 <br />__ �11 C.k 1[]��C{-hT 7 q <br />J <br />roar y useM IA74YAIIIIII.DoNCI' I� neLoe j 0_ I KSI <br />� q 1� �Am1;11,/_� a I 4N + <br />LEaaDE RmrKKIaF rllorE 99yy n <br />—Yf <br />LOT elacK Or <br />//�, ----- ---- <br />GQt GL.Ljl � _- <br />I PEREBY CERTIFY THAT I HAVE READ AND EXAMINED THV <br />A[I <br />APPLICATION AND KNOW THE SAME C BE TRUE AND CORRECT. AI l <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE of <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN 01 <br />NOT. THE OflANTINO OF A PERMIT DOES NOT PRESUME TO 61Vi <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF AN% <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THl <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THI <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHIM <br />APPLICATION IS MADE AND I COMPLY WITH THE STAII <br />CONTnACTORq LAW 1B 27 RCW AND 296.200 WAC. <br />— <br />rMurcl AlxmEss <br />- <br />Aaulu_� a 5g, 11 MIT <br />Cllveww <br />nixrm NO <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) _ <br />�— <br />_ <br />NC-AMNOLO UNITS-H.P. <br />BATHTUB <br />FORCED AIR SVSIEMS-B.T.U. M E.A. <br />Z. <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS-B.T.U. M <br />_�— <br />SHOWER <br />CLOTHES DRYERS ' <br />( <br />KITCHEN SINK 8 DISP <br />VENTILATION FAN <br />F <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />; <br />WATER HEATER <br />} <br />-_ <br />CLOTHES WASHER <br />I_ <br />WOOD STOVE <br />_ _ <br />URINAL <br />METAL FIREPLACE 8 CHIMNEY <br />- <br />_ <br />DRINKING FOUNTAIN <br />i--- <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />--�— <br />_ <br />HEAT PUMP <br />�— <br />_ <br />BACKFLOW PREVENTERS <br />OAS PIPING <br />' <br />--r- <br />ROOF DRAINS-RAINLEADERS <br />I <br />EXHAUST FAN <br />_ <br />SINK (SERVICE -BAR. ETC.) <br />_ <br />I <br />— <br />SUBTOTAL S <br />i <br />SUBTOTAL $ <br />PERMIT $ <br />TOTAL FEE $ <br />' <br />PERMIT E <br />I <br />_ <br />TOTALFEE E <br />FOR OFFICE USE ONLY: <br />F ONT SEIBACK INEARSEIBACK-- <br />_ _ <br />SEIE SETBACK <br />MAf § _ 4 <br />REC{ n <br />�1 <br />aFEEB �TJO`VVAA,LUATION <br />oVV <br />USF�LOTAnFA <br />vAc <br />_ <br />FEE �_ <br />EILUIDING <br />-_.. - _ <br />_ <br />Q; <br />IYM Bf ST ACIUAI <br />nnA+uKr <br />Ao nBKn MIAnn <br />PLUMBING <br />NO.OF810nR:S <br />BAST.MENt <br />MECHANICAL <br />Q� <br />1 <br />—_-- <br />ADDITIONAL PLANT CCHHEECCK��jn' <br />� <br />TIRE SM+IN'KLEnsBLOB <br />11r K1111 IMITATION <br />BTAIE BUILDINO SURCIIATIOE <br />v;IAKE BY MANSAMnIOVEDeY Ulff OF EVERETT Pt nuC WORKS <br />JN LOCAL SALES <br />TAX CODE IS 3105 1 TOTAL <br />