Laserfiche WebLink
APPLICATIC�I FOR CONSTRUCT'"1N PERIOILIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEA7ING SYSTEM: �jGAS U ELECTRIC J _ —� <br /> 259-8810 <br /> DEMOLITION COMBINATION BUILDING MECHANICAL PLUMBING SIGN <br /> OWNER M�RApDPE55 �py --- <br /> IIP pHONE <br /> FA+L� �• t��'6cF Soo� efNe ,.t U�,� �cc � cJ�, ��1.� 3_�L�b) JSg 7��'u <br /> TEN�NT M4R�pDNE55 y CITY 2iP PMONE <br /> �/��0 f+,t.� e Cac rw^�G ���.•w,i l .Sa....._�. <br /> ARCMIIECTORpE51GNEH I,IAIL�DDRESS t,ITV IIP PIqNE <br /> Jr � <br /> P�6 T(v�w�.e MI�AS� 'S UU <br /> GENER�L CONTq�L70R � M�L ADDF�~ CITY IIP P�IONF S7ATE UCE SE� ' <br /> J,� G rlw... <br /> MECH�NICIIL CONT TOR EUII�DDRESS CITV 21P PNONE ST�TE LICENSE� <br /> PIOMBINGCONTR�CTOR M�ILAUDNESS CITV 21P PMONE SUiEIILENSEt <br /> CONTR� T PNICE OF WORN <br /> DESCPIBE WORIt�N�E FOOTAGE INVOLVEO CONT�G7 PEHSON�ND PNONE NO II <br /> �E A�..�1 IX r LIsQ. �-� l �r�. � rt n._ ay 4„" " <br /> `�a " 9 I HEREBV CERTIFV THAT I HAVE READ AND EXAMINED iHIS <br /> vROPOSED USE OF BUaDM� APPLICATION AND HNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> MG.�L�4� CC.n.... PROVISIONS OF LAWS AND ORDINANCES 60VERNING THIS TVPE OF <br /> LE�ALOESCRIPTIONOFPROPERTY�SHOWNBELOWORATTACNiWOCOP�[51 WORK WILL BE COMPLETED WITH WHETHER SPEGFIED HEqEIN OR <br /> iot '�-2� Z6 e�ocK ov C�'^^^'r<<��< • _ NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATING C)NSTRUCTION OR THE <br /> PERFOR67ANCE OF CONSTRUCTION. THAT I AM AUTHURIZED BY THE <br /> OWNER OF THIS PFOPEHTV TO PERFORM THE WORK FOR WHICH <br /> APPIICATION IS MADE AND 1 COMPLV WITH THE STATE <br /> P�NCEL TA%I D NUMBER CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> CONSTRUGTION LW N LENDEN.AUDPESS.TEIEPHONE NUMBER <br /> ,.,✓1 �'2 7•5 5/ <br /> PROJECT ADDpE3S �^n ) spH.� A�� ,,,,� <br /> W✓/��L / Ci1YpU5MFS51G1N�lNO � <br /> � PLUMlINO MECHANICAL <br /> N0. TYPE OF FII(TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> � WATER CLOSET(TOILET) � AiC—A�HNDLG UNITS—H.P. <br /> BATHTUB ; FOPCED AIR SYSTEMS—B.T.U. M E. . <br /> LAVATORV(WASH BASIN) � UNIT HEATER�—B.T.U. M <br /> SHOWER � CLOTHES DPYERS � <br /> KITCHEN SINK d DISP ; VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> LAUNDRV TRAY ; WATER HEATER <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL METAL FIREPLACE(WOOD BURNING) � <br /> DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRAIN HEAT PUMP � <br /> BACKFLOW PREVENTERS ; GAS PIPING <br /> FOOF DRAINS—RAINLEADERS EXHAUST FAN <br /> SINK(SEqVICE—BAR,ETC.) <br /> SUB TOTAL 5 ; SU8 TOTAL S 1_ <br /> PERMIT S PERMIT S <br /> TOTALFEE S TOTALFEE S <br /> FOR OFFICE USE ONLY: ' ,(}� r�I� � <br /> FRONTSE7B�CN PERRSE'B�Ck SIDESETBTCR PUNCH CNNUMBER fEE RECEIPTNO <br /> ..O" _ .,a �U � �lo So. � Os�sd <br /> use 1a+e l07�RFR veeeHT srte fEES VALUATION FEE <br /> g'L . � YES � � NO BUILDING 7 �� 2 /3 � C/ ;s� <br /> 1VPEOftON51 NOO�STORiES aair�vrv qoanwni�xeuh���s <br />' � 2 � �' PLUMBINIi � <br /> i <br /> SREOFBLDG FIRESPRI�NN/lER5RE00 B�SEMENT i <br /> 53 J� /VQ l VE$ xN� MECHANICAL � <br /> �' i <br /> OCCUPANCY LOAD FIRE AIARM REOD HEIGNT LIMITRTION AUDITIONAL PLAN CHECK <br /> 5� Y�� � � <br /> OTHER � <br /> REASON ` <br /> L�IN/lIVG'G� STATF BWLDINC SURCHARGE 'S� <br /> INi�NEOV PLANS�PPNOVE�BV CITYOfEVENETT PUBLICWORKS i <br /> �M LOCAL SALES <br /> onre C e� TAX CODE IS 3105 Tot�� <br />