Laserfiche WebLink
� Iho Evoipraen <br />CITY OF <br />e �;��� ett <br />• BI:ILDING DEPARTM[NT <br />� 2!i9•8810 <br />APPLICf#'TiOt�B F'OR �ONS'TRll�GTi I�N <br />RERMIT <br />TO BE COMPLETED IN INK— PLEASE PRINT <br />evricu <br />� <br />01'MER MAILFOpqE55 GIIY ZIP PIIONE <br />Vizlj Lorr���n�l�/ 3(oC�� �'-��'�° �Vc. S.E. ���LY� T;�L-"LLIt1UC c��'�OC�L� ��'''�-����.ii <br />TEN4NT MAILADot1E59 GIIY 21P PMONE <br />VI I)�b 1'-'Q-LI� CE <br />ROC111iECTOR0ESI0NEP IdRILA�DRE55 GIiY ZIP FNONE <br />OENERALCONiR�CIOR �ARIL�00l;ESS GIiY ZIP PHONE LICENSE• <br />MEGIIANICALCONiNAGi00 MpILA�DRESS GIiY ZIP PMONE LILENSE� <br />PLUMOINOCONIMQGR MAIL�0011E55 GILY zin � rnou[ UC[N9[• <br />CLASS OF WOPK <br />� ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ Y;OODSiOVFJFP.PL.INSE(7T ❑ BUILDINGREIOCATION <br />� '__ _. _._._ -___... __. <br />CANTR�GT PPiGE OF WOPK <br />�ESGRI�F WORK �ND 50 W <br />. t�� �ti 1 L <br />LEGAL OESCRIPTION OF PPOPEFlN ISNO'i <br />LOT BLOCK OF <br />`1 bo � �� � �2\\ � i-r- �c <br />PLUMBING <br />NO, TYPE OF FIXTURE Ofl ITEM <br />—rWATER CLOSETITOILE71 <br />LAUNDFlY TfiAY <br />CLOTHES WASHER <br />FLOOR DRAIN <br />BtCKFLOW PREVENTERS <br />ROOF DRAINS — RAINLEq0ER5 <br />SINK ISERVICE — BAR. ETC.I <br />TYPE OF CONST. <br />� iLLOW�6LE/ACTUPI <br />6 <br />SUB TOTAL <br />F 1M1T <br />TOTAL FEE <br />FIpESPPI�KLERBFEOUIRE� ❑ YES O NO <br />or <br />o r� <br />sr <br />❑ YES ❑ NO <br />1 H L�EBY CERTIFV THAT I HAVE REA7 AND EXAIdINED THIS APPLICATION AND <br />KNOW ?HE S�ME TO BE TqUE AND CORRECT. AlL PROVISIONS OF LAWS AND <br />ORDINANCES G�'; _pNING 7HI5 NPE OF WORK WILL BE COIv1PLETED WITH <br />YlHETHERSPECihiED f IEREIN ORNOLTHEGRANTINGOFAPERMITDOES NOT <br />PRESUME TO GIVc AUTHORIN TO VIGLAT[ Ofl CANCEL THE PflOVI510N5 OF <br />ANY OTHER 3TATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PER� <br />FORMANCE OF CONSTRUCTION. TH�T I AM AUTHORIZED BY THE OWNER OF <br />THIS PROPERNTO PERFORM THE WORK FOfi WHICH APPLICATION IS MAOE <br />AND I COMPLY WITH THE STAL CONiRACTORS LAW 1027 RCW ANO <br />296.200 WAC. <br />SGNAi011E0FCONfpACiOPORAUi110RIZ[OAGENT DRtE <br />����,���— ia a� � <br />PPPL NISpTYBU51NE55L1 .NSENO�N�OUSMESSNAh1E <br />ME(:HANICAL <br />FEE NO. TYPE <br />A/C—A/HNDLG L <br />FORCED AIR SYS' <br />UNIT HEATERS— <br />CLOTHES DRYER <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />8 CHIMNEY <br />FIREPLACEIN <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />FEES <br />�UIlDI1JG <br />PLUMBING <br />MECHANICAL <br />OTHER <br />STATE BUILDING SURCH�RGE <br />STATE ENEriGY SURCHAqGE <br />PUBLIC WOFKS <br />TOTAL <br />FEE <br />