Laserfiche WebLink
APPLICATIQ 1 FOR CONSTRUC� �)N PERMIT � <br />�^ I TO BE COMPLETED IN BLACK INK�LEASE PRINT <br />V HFATING SYSTEM: ❑ GAS ;] ELECTRIC ❑ <br />BUILDING DEPAflTMENT <br />259 8810 <br />I 7 DEMOLITION ❑ COMBINATION Cl BUILDING L] MECHANICAL ❑ PLUMBING ❑ SIGN <br />.,...<e .... ..�wr« crtr zm AquE <br />M�4I.DGPESS <br />31P <br />NCB4CCHiM tOq MA ODNE S t� �� GTY Ii0 RUNE ST�LELCENSFI <br />��a �/ n�i� IHSI /1L� 5 <br />MiCN�NIG4LONiR�CiOR M�II.�MI 5 CI1V Z�o PI�P1E SUtCIKCME� <br />RINBMGCpI1R�Lip1 N�IMOfl[55 OiV ZIP PIIOYE S1�LElKCNSE• <br />Cp�TN�1Cl P110E OG YANx <br />&CCM � � � OF <br />FOR OFFICE USE ONLY: S(�A, <br />f1A:Ni5ElBACN� PE�95E10ACK� <br />Zo � :. <br />IIAIONF WiAqEA <br />��� � <br />IYH q CONSi. . CK S1p1iE5 <br />-J Z <br />SISE OL Bl0 � FIPE SFPMRLLRS <br />19c't s�F� p <br />uccurnr�cria.o rineuuiunm[ <br />A A <br />nc�sarv <br />iNV.x£BY R�NS�PPQOYE[ <br />�� µ <br />aiF (O O <br />6i0E SEiB�CN <br />S� <br />V�1LANt SrtE <br />❑ YES �NO <br />ar�n�n xowoKumci <br />4�0.'V <br />BASEAIENT � � <br />❑ YES 7+'NO <br />� <br />I NEFEBY CERTIFY TH4T ! HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW 1 HE SAME TO BE TRUE ANO CORRECT ALL <br />PPOVISIONS OF LAW$ ANO ORDINANCES GOVERNING TMIS TVPE OF <br />WORN WILL BE COMPLETEO WITM WHETHER SPECIFIED HEflEIN OR <br />tjOT. TME GRANTING OF A PERMIT DOES NOT PRESUUE TO GIVE <br />AUTNORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OP LOCAL LAW ^EGULATING CONSTRUCTION OR iNE <br />PENFORMANCE OF CONSTRI :ION. TMAT I AM AUTHOPIZED BY TME <br />OWNER OF THIS PPOPERT` O P@RFORM TME WORK FOP WHICH <br />APPLICATION IS NADE `"!D I COMPLV WITH THE STATE <br />CONTRACTORS LAW 1827 RC�Y AND 296200 WAC. <br />xMC�' �YY1a��'1 <br />oui <br />BUtLOiNG <br />PWM01N0 <br />MECHAN�LAL <br />noortioru� aurv a�ecrc <br />OTHER <br />STATE BUIIDINa SIIRGNARGE <br />VUBLIC WOPNS <br />T�.�� <br />��PnCE. <br />/J I <br />