Laserfiche WebLink
- APPLICA7`ItY'� FOR CONSTRUCT�N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT er <br /> BUILDING DEPARTMENT �EATING SYSTEM: ❑GAS ❑ELECTRIC ❑ <br /> 259-�t810 <br /> 1=1 DEMOLITION ❑ COMBINATION ! I BUILDING ;_'MECHANICAL LI PLUMBING f ' SIGN <br /> OWNER MAILADORE55 GTY IIP PMONE <br /> ��•�.I.�. .,. -� �u to � z o Z'��_ i�a; r,,,.,- �u�.,. � <br /> TENANT MAILADDAE55 CITY 21P PHONE <br /> •1 Odl�r/V��L <br /> � Sfd!_ � <br /> ARCHIT CTORDESIGNER MAILADORE55 CITY IIP PMONE <br /> � <br /> 1 GU �i GpZB- fs/ s-ff�c,i � �s' . /�•u�a�Lo..i:sC Yr'2�70 �Gfr- 77/Z �G(�S�q Z 3NG <br /> GENERAL GONTRACTOR MAIL ADORE55 CITV ZIP PIIpNE STATE LICENSE• <br /> � <br /> MECHANICFLCONTRACTOfl MAILADDRE55 CITV 21P PHONE STATELICENSE� <br /> ��� <br /> PLUMBING CONTRACTOR MAIL ADDRESS CITV ZIP PHONE STATE LICENSE� <br /> GONTRA ICE OF\YORK <br /> �2. v 6 0 �=- <br /> DESCRIBE WORK AN SOUARE FOOTRGE INVOLVED CONT T PEFSON AND PNONE NO. <br /> << [ �li�� 77/Z. <br /> 'fA� � �O� �S U � i r <br /> / D ��� I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PRO OSEDUSEOF7B�UILDING APPLICATION AND KNOW THE SAME TO BE TRUE AND COFRECT.ALL <br /> U � � R . �� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> �E ALOESCRIPTIONOFPROP RiY�SHOWNBELOWOHATTACNTWOCOPIES) WORK WILL BE COMPLETED WITH WHETHER SPEGFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE ' <br /> �or BLOCN 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 COMPLV WITH THE STATE � <br /> PqRCEL TA%IA.NUMBER CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> 2 S7S - <br /> CONSTRl1CTION LORN LENDER.ADDRESS.TELEPMONE NUMBER . <br /> ,�ly_ '__ r. /,'' /r <br /> x J-U'�--wr�_ (�! 1..�/� G/- ZFs-�3 <br /> PR CT ADDRESS S�GN�1pP[ o..c <br /> � �J G�4C QiYBU5ME55UCEN5EN0 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF fll(TURE OR ITEM FEE NO. TYPF OF E�UIPMENT FEE <br /> WATER CLOSET(TOILET) � NC—NHNOLG UNITS—H.P. <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M ; <br /> SHOWER ' CLOTHES DRYERS � <br /> KITCHEN SINK 8 DISP � VENTILATION FAN ; <br /> DISHWASHER RANGE H000 � <br /> LAUNDRY TRAY ; WATER HEATER <br /> CLOTHES WASHER � WOOD STOVE � <br /> URINAL METAL FIREPLACE(WOOD BURNING) � <br /> DRINKING FOUNTAIN � FIREPLACE INSERT ; <br /> FLOOR DRAIN � HEAT PUMP � <br /> BACKFLOW PREVENTERS ; GAS PIPING ; <br /> ROOF DRAIIJS—RAINLEADERS � EXHAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) ; ' <br /> � <br /> � <br /> SUB TOTAL $ ; SUB TOTAL $ 1 <br /> PERMIT 5 � PERMIT $ � <br /> TOTAL FEE $ ' TOTAL FEE $ <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBACN HEAR SETBFCN SIDE SETBACK P�4N CNEGK Nl1MBEii FEE j� PECEIPT NO. <br /> S IJ <br /> USE ZONE LOT�REA VACANT SITE FEES VALUATION FEE <br /> {�..-z� � ;1 YES 7 NO BUILDING � � ` <br /> .v <br /> 1YPfOFCONSi. NO.OFSTORIES ocNr`aNtr xaaov.'FWNGUNns i <br /> �J I LP01P PLUMBING i <br /> ! <br /> SIZf.OFBLDG. FIRESPPINKLEFSREO'0 OASEMENT MECHANICAL <br /> � ' G� /� r; YES X� NO <br /> OCCUpP�NCV LOAD FIFE�LARM REOD H HT UMIT TION 'r ADDITIDNAL PLAN CHECK ��3 <br /> 1 U UT'�- OTHER ' <br /> REASON <br /> STATE BUIl01NG SUFiCHARGE � � <br /> i <br /> INTAHEOY PLANSAPPROVEOBV CITYOFEVEREIT PUBLICWORKS �— <br /> �M LOCAL SALES � <br /> DATE �p 3 TAX CODE IS 3105 TOTAL Q j ; <br />