Laserfiche WebLink
APPLICATIC''"1 FOR CONSTRUCT'"``1N PERMIT �� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEM: ❑GAS ❑ELECTRIC J <br /> BUILDING DEPAR'-MENT <br /> 259-8810 <br /> ❑ DEMOLITION C] COMBINATION CI BUILDING DCMECHANICAL GPLUMBING C] SIGN <br /> p� MAILP�DRESS CITY ZIP PHONE <br /> � 1" l07// z�c�r�t' � �i1,.. /v�- SI�—�924- <br /> TENAN MAILA�ORESS CITV ZIP PHONE <br /> ARCHITECIORDESIGNER MAILADDRESS CITY ?IP PHONE <br /> GENEFALCONTRACTOR MAILADDRE55 QTY ZIP PHONL STATFLICENSEN <br /> M[F�,)(+^NICALJCyONTRACT R MAILAUDRE55 qTY O2Q1P� �[/PNONE��/�� STA7ELICENSEM �J <br /> PL MBI�CONTRR TOR � MAIL����� ��'YG�� /T�KI� J"J�N�F�W� R�IEN5�4�ID�IC <br /> CONTRACT PRICE OF W K <br /> �'�OD <br /> DESCRIBE WORK AND SQl1ARE FOOTAGE INVOLVED CONtACT PERSON AND PHONE NO. <br /> " � s Y S7 /(/�/P'//c �,��—� <br /> uL� I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PPOPOSED s oF e LDING �, APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> � �� � PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> LEGALOESCRIPTIONOFPROPERTV�SHOWNBELOW RATTACHTYIOCOPIES� WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE �3RANTING OF A PERMIT DOES NOT PRESUME TO GIVE ' <br /> �pT BLOCK oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCEI TA%I.D.NUMBER CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> CONSTRUCTIONLOANLENDER,AODRESS.TELEPHONENUMBF.R _ �� � /��/(�A� <br /> / <br /> PROJECT ADDRE�S s��" 1ie o��E � <br /> CITY BUSWESS IICENSE NO <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF PD(TURE OH ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � A/C—ArtINDLG UNITS—H.R � <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> LAVATORY(WASH BASIN) i UNIT HEATERS—B.T.U. M � <br /> SHOWER ' CLOTHES DRYERS ' <br /> KITCHEN SINK 8 DISP � VENTILATION FAN <br /> DISHWASHER � RANGE HOOD ' <br /> LAUNDRYTRAY ; WATERHEATER � <br /> CLOTHES WASHER � WOOD STOVE � <br /> URINAL ' METAL FIREPLACE(WOOD BURNING) ' <br /> � <br /> DRINKING FOUNTAIN � FIREPLACE INSERT � � <br /> FLOOR DRAIN HEAT PUMP ' <br /> BACKFI.nW PREVENTERS � GAS PIPING � <br /> ROOF DHAINS—RAINLEADERS � EXHAUST FAN ' <br /> SINK(SERVICE—BAR,ETC.) � , <br /> � <br /> � ' <br /> SUB TOTAL S ', SUB TOTAL $ � <br /> PERMIT S PERMIT $ <br /> TOTAL FEE $ ' TOTAL FEE $ ' <br /> FOR OFFICE USE ONLY: <br /> fRONTSETdACK REPRSETBACK SIDESETBACK PLANCHECKNUhIPEP FEE RECEIPTNO. <br /> USEZONE LOTAREA VACANTSITE FEES VALUATION FEE <br /> ❑ YES ❑ NO BUILDING ,'�_ <br /> iYPE9FCONSi. NO.OFSTORIES oC[uPtsCv n00�m4ELUNtu!ms � <br /> °9"p° PLUMBING � <br /> SIZE OF BLDG. FIflE SPRINKLERS REO'D BASEMENT MECHANICAL <br /> ❑ YES ❑ NO � <br /> Of.CUPANGY LOAD FIFE PLARM PEO'D MEIGHT LIMITATION ADDITIONAL PLAN CHEC.0 � <br /> OTHER i <br /> T <br /> REASON <br /> STATE BUILOING SURCHARGE � <br /> � <br /> INTANEBV PLANSAPPFOVEOBY CITYOFEVEREIT PUBLICNiORKS <br /> JM LOCAL SALES , <br /> onre � �Q , TAX CODE IS 3105 TOTAL ; <br />