Laserfiche WebLink
APPLICATIC '1 FOR CO�NSTRUCT �lNI PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT I <br /> f HEATING SYSTEM: '�GAS '�J ELECTRIC U. ___� � � <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> ;x DEMOLITION I COMBINATION BUILqNG I MECHANICAL !P�UMBING _SIGN <br /> CWNER AUILADORE55 CITV ZIP PHONE <br /> FII��vA R.D �"i�/o ka�f f � ��vM�vo���7 9�Q.�Z—���7 7'� <br /> TEIUNT MAILADORE55 CITV 21P PMONE <br /> APCMRECTORDESIGNER AUIL�O�RESS CiTV ZIP °HONE <br /> �� 'S`� � <br /> GENEHAL CONTRACTOA MAiL/DDHESS ' CIT� 21P PHONE STATE VGENSE N <br /> � � n _ � �� ��. <br /> MECMANIC�LC �ITRACTOR JilA0�RE55 GRV 21P PNONE '/ STRTELICENSEY <br /> __$(9i –70lay <br /> PLUMBINGCONTRr1C M�ILADDFE55 CITv ZIP PNONE STATELICENSE� <br /> �ONTR T PPIGE OF WORN <br /> �S/d0 �' <br /> DESCRi6E WOHN/ND SOUARE FOOT�GE INVOLVED CONTPCi PERSON AND PMONE NO . -� �:>.6�,2' <br /> �.T_ ��—'�'�� - L� I� T � � <br /> � <br /> IC4hC C'Jt�s 1� � 1 HEREBY CERTIFV THAT I HAVE READ AND EXAM�NED THIS � ��'%?���� <br /> VROPOSED USE OF BUIL APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL �� <br /> �� i � tj n t PROVISIONS OF LAWS AND ORDINANCES GOVEHNING THIS TVPE OF . .. <br /> IECvLLOESCRIPTION PROVERTV�SIIOWNBELOWORARRC Two OPIESI WORK WILL BE COMPIETED WITH WHETHER SPECIFIED HEREIN OR ` <br /> NUT THE GRANTING aF A PERMIT 60ES NOT PRESUME TO G�VE <br /> �o LOO� �F � ' AUTHOF7f i` T� VIOLATE OR CANCEL THE PHOVIS�ONS OF ANV a <br /> ' . my� �fr OTHER STATE OH��C.qL LAW REGULATING CONSTRUCTION OR THE *, <br /> A ' ��"-�'— PERFORMANCE OF CON51 iSl�CT10N. TMAT i AM AUTHORIZED BY THE a� - <br /> � �S� 'O���LIO I�OO lJ'� OWNER Of THIS PROPERTV T(S F€�F�RM THE WORK FOR WHICH y�. <br /> APPLICATIOTJ IS MADE AND I CC7Rk,^{_Y WITH THE STATE ; <br /> PARCEL i4%1.�.NUMBER CONTRACSORS LAW 1B27 HCW AND 296200 WAC. � - <br /> GONSTRUGTIONLOANLENDER.RDORESS,TELEPHONENUMBER �`-e„JA/,y'��I`�� , _ � � /�� ,__.; <br /> � � �oe i�i�i�i j �. <br /> A SIGNATU F a'T�-^ . . <br /> CIiY BUSINE55�ICENSE N0. .. <br /> PLdMBING NECMANICAL �•� . <br /> Np. TYPE OF RXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE _ � ��d -� <br /> WATEFI CLOSET(TOILET) A/CrA/HNDLCi UNITS-H.R � � ��� � <br /> BATHTUB FORCED AIR SVSTEMS--B T.U. M E.A. - <br /> LAVATORV(WASH BASIN) UNIT HEATERS-B.T.U. M <br /> SHOWER CLOTHESORVERS _ <br /> KITCHEN S�NK 8 DISP VENTILATION FAN ___ <br /> DISHWASHER rReNGE HOOD � � �''�� <br /> LAUNDRV TRAV WATER HEnT€? _ , ��r <br /> CLOTHES WASHER i WOOD STOVE .*�`• <br /> URINAI <br /> METAL F�REPLACE(W(k�D BURNING) � ���� <br /> DRINKING FOUNTAIN FIREPLACE INSERT � <br /> T <br /> FLOOR DRAIN HEAT PUMP � � � <br /> r <br /> BACKFLOW PREVENTERS GAS PIPING ' . . <br /> T <br /> ROOFDRAINS-RAINLEADERS E%HAUSTFAN . . � <br /> SINK(SERVICE-BAR,ETC.) ��, . . ° <br /> ':y <br /> �� r�✓�:dy� <br /> �`l'� <br /> ��� <br /> � <br /> ). <br /> SUB TOTAL $ SUB TOTAL $ �.-�'. � <br /> PERMIT $ PERMIT E - ''= � <br /> TOTAL FEE $ TOTAL FEE f � "��`� � <br /> .�.�: <br /> �� <br /> FOR OFFlCE USE ONLV: -�! <br /> FqONTSETB�CN REAflSET&�CK SIDESETB�:n PLANGXEC UMBER FEE RECEIVT/q �-, <br /> � <br /> USE ZONE LOT�REA VAC,iNT SITE FEES VALUATION FEE <br /> —�VES -- NO euaon+� � <br /> tVPEOiCONST NO.OFSTORIES Mn'�owcv uca�axF�:vr.ux�5 — — �i <br /> c+av PUIMBING �, <br /> SIZE OF BLDG. FIRE SPRINNIEHS PEO'D MSENFNT MECHANICAL —� �I <br /> "- VES � NO �--� ---�— � <br /> OGCUP�MCY�04� FIRE rIURM AEO'� HEIGHT LiMrt4TiON ADDITIONAL PLAN CMECK — , <br /> V OTHER <br /> RE450N --� <br /> STATE BUILDING SURCHARGE <br /> INT�NEB� � PL�NSAPPROVEDBV CITI�OFEYEREiT PU9LICWORKS <br /> LOCAI SALES ' <br /> oa.e TAX CODE IS 3105 rot�� <br />