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�� <br />��. <br />APPLICATI .� ��R CONSTI�UCTi�N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />BUILDING DEPARTMENT <br />259-8810 <br />� HEATING SYSTEM: GAS ❑ ELECTRIC O= --- <br />I"1 DEMOLITION 1=1 COMBINATION <br />BUILDING LI MECHAkICAL I.] PLUMBING _(] SIGN <br />OWNER MAIL�DDRESS � CITY 21P PHONE <br />�V�REtT �OVS/,✓G �AUTi/Ot's r>' /4oi � P�eR EYE,e�r'i' .GV�1 S�P�ZC� / abG � a��ZZL <br />TEN�NT M�ILADDHE55 Cltt .:IP PNONF. <br />A9CtlIT[CTORDESIGNER MAIL�OORESS CITY 21P PHONE <br />DYkEsI/L✓ A,ec�/rrerJS i�oz �,Tr ��o �vE,eE�r wa �'�aoi ao�. a5s��i <br />GENERALGONTMCTOM M�ILAODFE55 GITY 21P PHONE ST�TELICENSE� <br />Y� 3 <br />�� <br />°c':;ii • :*; , ;�'. <br />MECHMIIWlCON7P�CTOR AUIL�DDPE55 CITY ZIP PHONE STATELICENSEI e ,. <br />FLUMBINOGONTP�CTOF M�IL�DDRE55 CITY 21P PMONE SUTELICENSEI <br />G1A55(1FWOflK � . . <br />L I NEW I I ADDITiON � ALTERATION '� REPAIR I. I DEMOLITION I I WOODSTOVE/FRPL INSEFT I.1 Bl11LDING RELOCATION ' <br />. COl�T�GT PERSON /J! HONE N0. ` <br />car+rnncTrn�ceoFwonK —��w <br />DESGRIBE WIXiK �ND SOU�HE FOOTP E INVOLVE� <br />' PROPOSEDUSEOFBUIIDING <br />LEG�L DESGNIPTION OF GROPEPTY �SIqW`I Oi101 <br />� LOT BLOCN � <br />1; <br />f.i <br />ROOF <br />r'OR OFFICE USE ONLY: <br />FBONTSETBACK REARSEfB�GN <br />� <br />OR ATTACH FW R GOPIES� <br />7YPE JF CONSi. ACTIIq <br />OCGUPANCVLOAti �� � FINE <br />.fli�?.�:i <br />RE09 <br />� `= lon�. �!ssc� ,DY!'ccH.4n/ A�uI!?pci � <br />ass-3�4� ; - <br />i HEREBV CERTIFY THAT I HAVE HEAD AND EXAMINED THIS ,_ <br />APPL�CATION AND KNOW THE SAME TO BE'fRUE AND CORRECL ALL � �� � '` <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF ti�. . " <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OP. ."t ' �. - <br />NOT. THE GRANTING Of A PERMIT DOES NOT P!iESUME TO GIVE „ <br />AUTHORITV TO VIOLATE OR CANCEL THE PRGVISIONS OF ANV � �- - <br />OTHER STATE OR LOCAI LAW REGULATING CONSTRUCTION OR THE , <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORI2EU BY THE ` - <br />OWNER OF S P PERTY TO PERFORM THE WORK FOR WHICH ���� � .• <br />APPLICA N IS AD AND I COMPLY WITH THE STATE <br />CONTR TORS LA 1827 W AND 296.200 WAC. . <br />• / .. � � ..r..�.�—�- _...� <br />x «/�" <br />SGNetUnE a� <br />-/Y�/G .�//1 <br />�S <br />SIDE SETB.�CK <br />VACMIT SITE <br />oaur�xcr �ro <br />�� <br />BASEMENT <br />CITY Of EYEHETT <br />LOCALSALES <br />TAX CODE IS 37D5 <br />EMS—B.T.U. <br />T.U. M <br />6 CHI': NEY � <br />GAS PIPING <br />7ao 9 <br />BUIIDING <br />PLUMBING <br />MECH4NICAL <br />ADDI710NAL PLAN CHECK <br />SPAINNLER <br />STATE BUILDING SURCHARGE <br />PUBLIC WORKS <br />TOTAL <br />FEE <br />E <br />PELEIPTNO. <br />�o9s'r <br />�y ; oa <br />S <br />