Laserfiche WebLink
`�E �"� '`� C'`�NSTRUCTION �� � <br /> Pverett PERMIT PERMIT NO. 2� �� 2 <br /> 259 -8745 <br /> ❑ DEMOLITION rxl COMBINATION ❑ BUILDING � MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNER MAILAOpRESS CItY ZIP PHONE <br /> Ewer reen � <br /> AflCHITECTOF0E51GNER MAILADOPE55 TV ZIP PNONE <br /> West Star Developm�nt 6600 SW 92nd Ave Portland OR 97223 (50'�) 244-6e24 <br /> GENERALCONTRPCiOq MAILAODf1E55 CITY ZIP PHONE LICENSEM <br /> Owner <br /> MECMANICALCONTRFCTOR MAILADDRE55 CITY ZIP PHONE LICENSE• <br /> PLUMBINGCONTRFCTOfl MAILAODFE55 CITY 21P PNONE LILENSE• <br /> GLASS OF WORK <br /> ❑ NEW ❑ ADDITION C�ALTEHATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br /> VALUATION OF WORK <br /> S rJ��O.�� <br /> DESGRIeE WORK - <br /> Relocate d�xx Door <br /> MEATSOURCE <br /> ❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE � OTHER <br /> PflOPO5E0 USE OF BUILDING <br /> Convenience Store I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> - LEGALOESCRIPTIONOFPROPERTY�SMOWBELOWOflATfACHFOURCOPIE51 CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> GOVERNING THIS TYPE Or WORK WILL BE COMPLIED WITH <br /> LOT_BLOCK _OF WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br /> PERMIT DOFS NOT PRESUME TO GIVE AUTFiORITY TO <br /> VI ATE OR C NCEL THE PROVISIONS OF ANY OTHER <br /> S T L C L LAW RE ULATING CONSTRUC�ION OR <br /> T P CE OF�y^ UCTION. <br /> JOOROORESS SIG T NT TOf1,AUtMORR AGENT.OHOWNE DATE��/ <br /> 5129 EVergreen Way X ���FS b <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> � WATERCLOSET(fOILET) NC—A/HN�LGUNITS—H.P. <br /> BATHTUB HEFRIGERATION UNITS—H.P.EA. <br /> � LAVATORY(WASHB/1SIN� BOILERS—BT.U.MP. <br /> SHOWEH GAS FIRED A.C.UNITS—B.T.U. <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS—B.T.U. M EA. <br /> DISHWASHER WALLHEATERS—B.T.U. M <br /> LAUNDRY TRAV UNIT HEATEFS—B.T.U. M <br /> �. CLOTHES WASHER EVAPORATIVE COOlERS <br /> � URINAL CLOTHESORVERS <br /> DRINKING FOUNTAIN VENTILATION FAN <br /> FLOOR DRAIN RANGE HOO� <br /> BACKFLOW PREVENTEPS WATER HEATER <br /> ROOFORAINS—F7AINLEADERS WOODSTOVE `� � ��k��� <br /> SINK(SERVICE—BAR,ETC.) METAL FIREPLACE 8 CHIMPIEV <br /> FIREPLACEINSERT � <br /> HEAT PUMP t <br /> GAS PIPING <br /> E%HAUSTFAN L ` <br /> L <br /> SUB TOTAL S SUB T <br /> PENMIT S PENM ` � <br /> TOTALFEE S TOTAIFEE <br /> FRONTSETBAGK REARSET�ACK SI�ESET�FGN PLANCHECKNUMBER FEE RECEIPTNO. <br /> BB/21312 46.60 14742 <br /> USEZONE IOTAPEA VACANTSITE <br /> ❑ves �No fEES VALUATION FEE <br /> TYPEOFCONST. OCCUPANCYGROUP NO.OFDWELLINGUNITS BUILDING � SOOO.00 7Z OO <br /> V—N B-2� � PLUMBING <br /> 512E OF 9LDG. NO.OF STORIES MA%.OCG LOnD , <br /> 2688 1 EX15t MECHANICAL <br /> INVES'i IGATION FEE Sec.30A(e) <br /> FIRE SPRINKLERS REOUIRED ❑YES �NO STATE BWLDING SURCHARGE I <br /> 3 50 <br /> STATEENERGYSUPCHARGF <br /> HPPLICATION ACC.BY PLANS CMECNED�Y FPPN.FOR ISSUANCE�Y <br /> DRIVEWAY PERMIT <br /> S.H. J.W. J.W. TOTAL � Q ' <br /> PENMIT VALIDATION <br /> WHEN PROPERLV VALIDATED(IN THIS SPACE�TFIIS IS VOUR PERMIT � <br /> N <br /> � � <br /> M I <br /> c- <br /> N <br /> i; .;�iciiS P�'�. c <br />