HomeMy WebLinkAbout9401-12PER~'IIT APPLICA~~Oi
City ~of Port Townsend, Washington 98368 Phone: (206)385- 3000 Fax:
iyiEG'HANICAL ~ 1 YLUIl~Kil]ltr ~ 1
APPLIGAI~3T: ~ oaGNER ~ CONTRACTOR ~ OTHER /~//
PERMIT # `7 7 O/- /~
COMMENTS:
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SITE ADDRESS: ~ ~ i° _ __~
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OWNER: ~ ~' .. ~ ~ i~ .;
CONTni~ i O
CONTRAC i OR LICENSE
OWNER PHONE ~.
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AD
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CONTRACTOR PHONE
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NE3 TYPE OF.E E~P1F3ErtT ° (FEE < NO. 4 = 3TiFPE t1F FLYFURE Fly`:
RANGE WATER CLOSET
WOOD/PELLET STOVE ~ I BkTHTUB
GAS FURNACE ~'z LAVATORY
COtv'VeRSIONBUIL~IER bsbk SHOWER
UNIT HEATER besr% KITCHEDI SINK
BOILER brx% I DISHWASHER
GAS PIPING I LALINDRY TRAY
EVAPORATION COOLERS bra's: ; I CLOTHES WASHER
AC UNIT bra;: i ATER HEATER ~
HEAT PUMP bra's: tons: I URINAL I
~ REHEAT BOX brni: I ~ I, DRINKING FOUNTAIN I
AIR HANDLING UNiT brrs is i (FLOOR SINK OR DRAIN
}EXHAUST FA,~75 I F SLOP SINK
I RANGE HOOD (raidrncial) I !WATER PIPIING & .ALTERATION I
~ RauNGE HOOD (commercial) I ~ I GREASE TRAP/INTERCEPTOR '
CLOTHES DRYER i ~ 1 HOSE B[BBS t
INCINERATOR i I LAWN SPRINKLER SYSTEM
DUGTAI.TERATION i SWIMMINGPOOL
-['ANKS ~; I i I BLDG. SEWER (mobile /moved house)
REFRIGERATION UNIT ! ROOF DRAINS
OAR: I OTHER
MECHANICAL PERMIT FEE PLUMBING PERMIT FEE
~f. -,-_... -__ -----_
(010.322.100.00) Mechanical Fees
(010.386.102.00) State Fee
TOTAL ~~ -rye
~cPPLICANT'S SIGNATURE:
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Plumbing Fees
State Fee
TOTAL
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/ 0
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Balance Due Fees Received by Deputy-Clerk
Date Recd Receipt No. ` '"'
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