Laserfiche WebLink
.�� <br /> i�� f,; -: <br /> .. -- <br /> : <br /> APPLICA'r10.. FOR COI�ISTRUCT► JN P�RMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: [,J GAS J ELECTRIC U _ 1 <br /> 259-8810 <br /> DEMOLITION COMUINA'fION ;�BUILOING MECHANICAL PLUMBINO SIGN <br /> OVRIF.R M�IVD`�1L55 UTY 21P PMONE <br /> ^ I r <br /> `!�'� (��7�i�IC� i�i > � J7 \ � I��� ��:�'t/ 'I_�.�i.11 ��//t `�" :'�� �L;� _S��', �� <br /> � <br /> TENANT M�k�DDRE55 dTV � TIP " VHp1E <br /> '; /!/�it� �� •7'�P�S/�.- <br /> •RGHITEGTORDESK3NEP M�IL�DfIRE55 �IT^v ZIP PIIONE p <br /> C(Jr�M/�'� ��/UCniN„ruT/C� . v�t�� 5 � /+� ��)�✓ .`�Kf,�'7lLui'< <✓R � (��� �7 Z1f7' 'J <br /> OENERALCdITRACTOR MAII.�UURE55 GITY IIP PHONE ST�TELICENSE• � <br /> `/_��Q�..�-� �.�� . .SL'S" , �E Q_�. .�o_ �'��.�T�°. � yis v ��z sro.s� /bC.Ci.v if 3Y 2 No <br /> rM ANICALCONiR� OR M�I��OORE55 CITY � 21P P1qNE Si�TE L1LENSE I <br /> \��� ���� <br /> PLUMBING CdITR�C70R MML�DOPE55 CITY IIP PHONE STAiE IICENSE� <br /> CUSSOF WONK /� <br /> I . NEW � '�. ADDITION ,GC ALTERATION REPAIfi DEMOUTION WOODSTOVE/FfiPL INSEHT BUILDIN6 REIOCATION <br /> OC �--)..�� CONT�GT PENSON�ND PNIXIE NU l-�'— S E lS <br /> ^V V • � <br /> CONTPACTPRICEOFWORK _ �'-�h!�A/1,L� j=� .TMQ�1/C�:r.' <br /> Ui�SCRIBE WJRN A D EOl1ARE FOOTAOE INVOI�(ED ` <br /> �.tlRlteS�c� �Jlti6�rna, o,RP.•✓� V�NT'�-f�'� <br /> rrroroseouseoceuno:ao /J_;; 1 HEHEBV CERTIFV THAT I HAVE HEAD AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> IEO�L OE5CPIPTION OF PROPERTY�SNOWN BELOW OR�TT�CH FOUR COPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNINO THIS TVPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEqEIN Ofi <br /> �or e�ocK ar NJT. THE GRANTING OF A PERMIT DOES NOT PRESiIME TO GIVE <br /> AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAI LAW REGULATING GONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CON7RACTORS LAW 1827 RCW AND 296200 WAC. <br /> - -�-- x � � �,. .,.//, �,:(,�...l.-/,� ,��/ ��� <br /> FRQIFCTADDRE55 ,/ s::Nenmr b D�rE <br /> � itJ� �N� <,�S/.Y. /Ln "1��—)� ,.rtveusnrcss��cEn�[rro —' <br /> PLUMl�NO MECHANICAL <br /> N0. TYPE OP FU(?URE OR ITEM FEE N0. TYPE OP EOUIPMEN7 FEE <br /> WATER CLOSET(TOILET) A�C—A,'HNOLG UNITS—HP. <br /> UATHTUB FORCED AIN SVSTEMS—B.T.U. M F..A. <br /> LAVATORV(WASH BASIN) � UNIT HEATERS—dSL. M �_ <br /> SHOWER �_ CIOTHES DRVERS <br /> KITCHEN SINK 6 DISP VENTILATION FAN <br /> �T <br /> DISHWASHER � HANGE HOOD I <br /> LAUNORVTRAV ; WATER HEATER � <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL METAL FIREPLACE 8 CHIMNEV � . <br /> DFiINKING FOUNTAIN FIREPLACE INSERT <br /> �� �T <br /> FLOOR DRAIN HEAT PUMP � <br /> BACKFLOW PREVENTER i GAS PIPING <br /> ROOF DRAINS—RAINLEADERS T EXHAUST FAN T— <br /> SINK(SERVICE—BAR.ETC.) ; li <br /> � <br /> �— i <br /> SUB TOTAL S ; SUB TOTAI S <br /> PERMIT E � PERMIT S <br /> TOTAL FEE S 70TAL FEE S ' <br /> FOR OFFICE USE ONLY: �_ <br /> FRONT SETBACIf REAR SEiBACN SI�E SETB�CN PUN CHECN NUMBER FEE RECEIPT NO <br /> 0��0�3/ <br />� use ia+e LOT�RE� V�C�NT SI1E FEES VALUATION FEE <br /> BUILDING d' ��'Y7r' a.sa ' OG <br /> iYP[Of LON75 1LLOW�BIE 1YPf Of CONST�CIU�I o[mwxa ea a Dw1wxG uxns --- <br /> �"0p° PWMBIN4 <br /> 61ZE OL BLDO. NO Oi 6TOi11E5 B�SEMENi MECHANICAL � <br /> OC OVNICYLOAO flRESPRNItLER5RE0'0 HEIOMTLIMIUTION ���PUNCNECN �` .� � S'O <br /> � YE S SPRINNI.ER � <br /> PE�SON FOR SPRINNlENS � <br /> rph� <br /> ST�TE NWLDINQ SUHCMARGE � SD <br /> INi�NE BY MAN ^PPOVFD BV CITY OF EVEHETT PUBLIC WORKS � <br /> LOf,AL SALES I <br /> TAX COOE IS 9105 �o*�� ya c� ; ;6 <br />