Laserfiche WebLink
APPLICATI(""'`� FOR CONS'TRUC7 JN PERMIT �� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT ��T <br /> BUILDING DEPARTMENT I HEATING SYSTEM: GAS J ELECTRIC U______----- 1 <br /> 259-8810 <br /> DEMOLITION COMBINATION �'BUILDING MECHANICAL PLUMBING SIGN <br /> J'::GEii MAILFDOPE55 CITY 2iP PHC�iE <br /> � ���_�/ a?/.l. � //rG ��.,c--Qp._/ �/.v.l �'e S�C 75�3-3.ri9 <br /> i@NMYT MAIL ODRE55 CIiY I ZIP VHONE <br /> �r9 y,� yi <br /> ARCHii[GTOROESIGNER ldAILq00RES5 CITY ZIP PHONE <br /> ��y GF AL C^ONTRACTOR NFIL RDDRESS CITY 21P PIIONE STRTE UCENSE I � <br /> �W/`�"'V <br /> ay 6�ECIIANICALCQNiRACTOR M11pILq00RESS CITY ZIP PHONE STATELICENSEt <br /> ��H <br /> ^�.a I-3(n Pl UIlpING CONTR�CTOP MRIL ADOR°55 CITV ZIP PNONE SiAiE LICENSE f <br /> rx <br /> Haa <br /> y zH «a55oFWaAK <br /> O x O T(' NEW � ADDITION ALTERATION REPAIR DEMOLITION WOODSTOVEFRPL INSERT BUILDING RELOCATION <br /> � F,,,�� (��1 >-� � CONTACT PE N FNO PMON ^] (� <br /> y y� CCt1iFALiPFICEOFIM1'ORK � �✓ � _y �1 � cTJ� - / -��/ <br /> � 7f� U[SCRIDEWORRANDSOUARFFOOiAGE NYOWED <br /> yr `�J�'w 5� ��— <br /> O H rvoreseouSeoFem�mr�c i HEREBY CERTIFY THAi I HAVE READ AND EXAMINED THIS <br /> H C�J <br /> APPLICATION AND NNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> L)� C] �� � � PROVISIONS OF LAWS AND ORDINANCES GOVERNING TNIS TYPE OF <br /> LEGAL�ESLFiPTIGN OF PROPEiiTY ISM0IYN OEIOW OR ATTdC��fOU�CO�aESi <br /> � �o,� �0// WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> lOT OIOCN UF T.Gt LG}�j� <br /> j y NOT. THE GRANTING OF A PERMIT DOES NOT PRESU�dE TO GIVE <br /> r" H y AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW fiEGULATING CONSTFUCTION OA THE <br /> � �H � PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY iHE <br /> n d�"� OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR SYHICH <br /> � [rJ[i APFLICATION IS MADE AND 1 COI,iPLY WITH THE STATE <br /> z y y CONTRACTORS LAW 1B2i RCW AND 296200 WAC. <br /> y O V� <br /> � � <br /> aaOJEerneC��[55 / � —_ — _ �•�., . nur - 1�'— <br /> X'J� /�a o� �n a n ---- � <br /> PLUMBING MECMANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> � s WATER CLOSET ITOILET� � I � A C—�NNDLG UNITS—H P. <br /> I � _ BATHTUB FORCED AIR SySTEIdS—BS.U. A1 EA. <br /> LAVATORV�WASH BASIN� UNIT HEATERS—B.T.U. M <br /> Q SHOWER 1 CLOiHESDFYERS <br /> 'Q' + / KITCHEN SINK 8 DISP VENTILATION FAN <br /> {� � DISHWASHER J � RANGEHOOD <br /> LAU4DPYTRAV W�TEiiHEATER <br /> CLOTHES WASHER _? � WOOD STOVE <br /> IhA ' URINAL h1ETAL FlAEPLACE 8 CHIMNEV ��, <br /> ~ DRINKINCa FOUNTAIN FIREPLACE INSERT <br /> FLOOR ORAIN � HEAT PUM17P <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ^^•� ROOF DRAINS—FiAINLEADERS EXH�UST FAN <br /> SINK(SERVICE—BAR,ETC.) <br /> � "h � !1 J <br /> t� ..�' — i <br /> SUB TOTAL 5 SUB TOTAL S � <br /> ^+ s PEFMIT 5 PERMIT 5 <br /> TOTALFEE 5 TOTALFEE 5 —��— <br /> FOR OFFICE USE ONLY: Q . � <br /> fR011L5E10Af.K REAqS[1pACK SIOESELpALN VIRNCII[CNNl1A1p[R �[,E/�) RECEi�iNO <br /> � �0� �M �$� .S' ��3 j�-+ '7 /U• !7`•� �ia3 7 <br /> use ior+e iotnAea VRGRNf SITE FEES VALUATION FEE <br /> �/ 7G73 �� c <br /> eui�owc�� <br /> l�ilOfCON�S.AlLOV/ABIE iYPE fCON51AG1UAt o.ara�¢v r,aw[nuuY.u���5 I. IU ��I �� I � / � <br /> 7/�� �, �'�0i'r � � PLUMBING � <br /> J- �' <br /> �Ly��SYt ��OOFSTOBIES OASEMENT h7ECHANICAL O '(��) ' <br /> .�• s, c. 'Z Es' <br /> OCI.UPANGYLOAD FIFESPRNKLEqSfiEOD NEIGHTLiMItNION ADDITIONALPLANCHECK <br /> N A Z SPRINKLER <br /> n[nsor�Fo�srqp�rc�[ns —� <br /> STATE OUIL�ING SURCHARGE �i j_,) <br /> ___ _' _ <br /> �r�rn�co� rinr�snrvnoveoor CITYOFEVEflETT ruoucwor+Hs O ; ,,j � � <br /> J�, LOCAL SALES <br /> �y :�L TAX CODE IS 3105 Torn� 3 <br /> �� <br />