Laserfiche WebLink
APPLICATiO.i FOR CONSTRUCT.JN PERMIT <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT � <br />V��� <br />HEATING SYSTEM• U GAS <br />BUILDING DEPARTMENT • ❑ ELECTRIC ❑ <br />259-8810 <br />❑ DEMOLITION L 1 COMBINATION <br />rEwwr <br />M�IL <br />OESIGNER MAILADDqE55 <br />I I BUILDING <br />cirv <br />�n� <br />CITV <br />CITV <br />I l MECHANICAL I_ I PLUMBING I_I SIGN <br />�p PMONE <br />SeLt_ �'YJi.ri9 77� _ 1c�99 <br />Z�P PHONL <br />ZQ//�. WILSI �SO� l�hMG/ /%/Q �H�E STATELICENSE� <br />„ '��o� .�� 9�io � �Oa3 -.3ac+� �c`o� /er �3�i, <br />tcrNNICALCONTRACTOR MAILAO�RESS CITV ZIP PHONE STATELICENSEI <br />PLUMBINGCONTR�CTOR M�IL�DOPESS CIN ZIP PHONE ST�TEUCENSEs <br />I_l NEW I J ADDITION I I ALTERATION I! REPAIR I I DEMOLITION I! WOODSTOVEiFRPL INSERT I. 1 BUILDING RELOCATION <br />CONTACT PERSON ANU PNONE NO. <br />.— Q � �iC.�t.G-.T <br />PflOPOSED USE OF BUILDING <br />LE6AL DESCRIPTION OF HOPE <br />LOT BLOLK <br />PROJECTADDRE55 <br />NO. <br />FOOTAGE <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOtHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTEFiS <br />ROOF DRAINS—RAINLEAC <br />SINK (SERVICE—BAR, ETC <br />FOR OFFICE USE ONLY: <br />FflONT$ETBACK REARSETBACK <br />USE ZONE / <br />R- H <br />7YPE Of CONiS. AILOWABL <br />�' I�I w <br />SIZE OF BLO(i. . <br />3sy zzi�{. <br />OCCUPANCYtOR07ujt} <br />s� �2=Z.K-: <br />REASON FOR SPRINNLERS <br />INTAKE BV <br />OF <br />PERMIT <br />TOTALFEE <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />COPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OP <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRES�IME TO GIVE <br />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 AUTHORI2ED BY THE <br />OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br />SIDE SETBACK <br />�U <br />VACMlT 91TE <br />X <br />SiGNATURE p�tE <br />FEE I NO. <br />A/G-A/HNDLG UNITS-H.P. <br />FORCEDAIRSYSTEMS-B.T.U. M E.A. <br />UNIT HEATERS-B.T.U. M <br />CLOTHES DRYERS <br />VENTIL4TION FAN <br />RANGEHOOD <br />WATEFi HEATER <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIMNEY <br />FIfiEPLACE INSERT <br />EXHAUST FAN <br />� BUILDING <br />TYPEOF ONSTRCN ouuv Cr No.orux[�uvcuxit5 <br />— �—� � �° ��, � 8 PLUMBING <br />NO.OFS7oRIES B EME MECHANICAL <br />3 � � ;�, <br />FIFE SPR LERS FEO'D HEIGHT LIMIT TION AD�ITIONAL PLA� CHECK �� <br />��S �v SPRINKLER <br />STATE BUILDING SURCHARGE <br />PLANS APPROVED BY CITY OF EYEREIT PUBLIC WORKS <br />LOCALSALES <br />.�,��-J TAX CODE IS 3105 TOTAL <br />� <br />TOTAL FEE $ � � <br />FEE HECEIPTNO. <br />VALUATION FEE <br />co9z �4 m.� � � <br />i <br />i <br />� <br />� <br />,{ � .�/�'J � J� <br />i <br />i <br />i <br />� �r <br />i� <br />i <br />i <br />�i/7� <br />