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HomeMy WebLinkAbout9406-05- _ PERMIT APPLICATION City of Port Townsend, Washington 98368 Phone: (20385- 3000 ~'ax: '(20!}385-4290.: APPLICANT: ~ OWNER ~ CONTRACTOR ~ OTHER: P/~J~lA1~ gl'TwBr~/ ~NCact/iu(~ cvLA wa4TE2 SuPP~y p'/~, S;' ~' ~ s TwaTER S/'Q%I'}~L~ 1fIAJlI ~ PERMIT # 9~~^ O LAY S T! ~tJl., HeT w,4TC /Z ?.4.vt; SITE ADDRESS: ~~~ 7 ~~/t-J ~~ /l _ s~q v~lZ OWNER:! e/VA/f/~~_~ ~- y!/i//-,VV ADDRESS: C^vNTRACTCR:~ CONTRACTOR LICENSE »< ADDRESS: TgNK 'rp A a~p,El~ E~Q'IRATION DATE: h iNk" S a?h 4a 7-8"g'j OWNER PHONE x~~4 0~2~" CONTRACTOR PHONE NO. TYPE OF E UIPMII!IT - FEE • NO. TYPE €TF:`FI?CTUURE <' FEE;:: RANGE WATER CLOSET WOOD/PELLET STOVE BATHTUB ~ GAS FURNACE br„y; LAVATORY CONYeRSION BURNER bra's: SHOWER L'N1T HEAT'r1t beu}: KITCHEN SINK BOILER btn's: DISHWASHER GAS PIPING LAUNDRY TRAY ~ EVAPORATION COOLERS bra's: , CLOTHES WASHER AC UNIT bru% f WATER HEATER HEAT PUMP bra's: tons: URINAL REHEAT BOX btui; I DRINKING FOUNTAIN AIR HANDLING UNIT bsrr is OOR SINK OR DRAIN EXHAUST FA~~1S I SLOP SINK ~ RA,'VGE HOOD (ruidenrial) ~ ~ WATER PIPIING & ALTERATION RANGE HOOD (commcrcial) GREASE TRAP/INTERCEPTOR CLOTHES DRYER HOSE B[BBS I INCINERATOR ~ ~ LAWN SPRINKLER SYSTEM DUCT' ALTERATION ~ SWIMMING POOL TANKS e: BLDG. SEWER (mobile /moved house) REFRIGERATION UNIT I ROOF DRAINS OTHER: OTHER: MECHANICAL. PERMIT FEE PLUMBING PERMIT FEE _ o';.O )10.322.100.00) J10.386.102.00) Mechanical Fees Plumbing Fees =' State Fee State Fee TOTAL TOTAL ~~PLICANT'S SIGNATURE: DATE: $ 3/ Balance Due Fees Received by Deputy-Clerk Date Rce'd Receipt No.