Laserfiche WebLink
APPLIC�,ITIOF�FA.R CONSTRUCTI'�N PEFiMIT � f: <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT • n•c�rerT <br />L'sUILDING DEPARTMENT I nr�� ���' SYSTEM: ❑ GAS ❑ ELECTRIC p_ <br />269-8810 � • — <br />L7 DEMOLITION O GOMBINATION O BUILDING L7 MECIiANICAL . O PLUMBING SIGN <br />OWNER M�ULNIDRE55 CIfY ZIP p�pNE ' <br />�uF mN,.,�-. i a o� �� �- �I� �� ���t����y�ln i i � <br />iENANT untiwor+ess ..� <br />OF WOFiK <br />�. on <br />ND SOUME FOOIAOE INVOWED <br />; 1 1� <br />a � <br />� <br />FNO°DSED USE OF BU0.DIN0 <br />LOT BLOCN <br />PMCEI TA%I.D. NUMBEq <br />SINK d <br />WASHER <br />CITY <br />nrTncii rwo coriEs� <br />OF <br />" OU.–� – '-i ^ <br />LTELEPNp1ENUM0ER <br />OR ITEM <br />ROOF URAINS—RAINLEADERS <br />SINK (SERVICE—BAR. ETC.1 <br />FOR OFFICE USE ONLY: <br />---� � � /�- <br />ivrcacoxsr. <br />SILE OF OL00. <br />� OGGUPANCYlOAD <br />� REASON <br />SUD TOTAL <br />PUNSAP OVEUOY <br />o �h <br />aae �_a9� <br />SIUE SElOAGK <br />ZIP <br />CON7AGT PEfl50N AND PHONE NO. <br />I HER60Y CERTIFY THAT'I HAVE READ AND EXAMINE:7 THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRLCT. ALL <br />PROVISIONS�OF LAWS AND ORDINANCES GOVERNING�THIS 7YpE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEf7EIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME "O GIVE <br />AUTHORITY TO VIOLATE OR CANCEI THE PROVISIONS OF ANY �' <br />OTHER STATE OR LOCAL lAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCC- OF CONSTRUCTION. THAT I AM AUTHORIZEO 3Y THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOF WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 10.27 RCW AND 296.200 WAC. <br />AIR <br />FIREPLACE INSCRT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />vnwwiSiiE fEES <br />O YES ❑ NO ouaowc <br />oc(+inxcr xauwuuxcuxns <br />�OUP PLUMOING . <br />MSEMENf MECHANICAL <br />O YES o r,o <br />HEIaHTLIMIiATiON ADDITIONALPLl�NCHECK <br />OTHFR <br />� STATE BUILD�NG SURCHARGE <br />CITY OF EV[RETT PUOLIC WOHKS <br />LOCALSALES <br />TAX CODE IS 3105 TOTAL <br />� , / I PECEIPTNO. <br />1 <br />R <br />