Laserfiche WebLink
� �. <br /> APPLICATIO.J FOR CONSTRUCT.JN PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT � <br /> BUILDING DEPARTMENT HEATING SYSTEM: GAS ❑ELECTRIC ❑ <br /> 259-8810 <br /> t_I DEMOLITION COMBINATION BUILDING �AECHANICAL ' I PLUMBING SIGN <br /> OWNEH MAILADDRESS CITY ZIP PHONE <br /> L�U�r�'f`�C .(�'(1S /a��6 �� h�33C✓ '��° 71 ,� ��D� �I�I - �7c� <br /> TEN�NT MAILADDRESS CITV ZIP PMONE <br /> S''1', r�� ►.,.;i ��J� ° �]S.c 4Ti f.h�� �Of ti°s j� 9�'�ac� � <br /> ARCHITEC P D SIG ER� MRIL ADDRE55 CITV ZIP PHONE <br /> GENER�L CONTRACTOR MAIL�DDRESS CITY 21P PHONE STATE IICENSE� <br /> � r�, � ►�i n�',� l � � ' �.� �ik.�� l,�_`.�i ��o-S9-l�C� �'mNF,6.7���`"rf� <br /> MECNANICAL CONiRACTOR r MAIL ADDRE55 � GTV ZIP PHONE STATE LICENSL R <br /> PWMBINGCONTR�CTOfl MAILAODRESS CIN 21P PHONE STATELICENSE� <br /> CU55OF WORK <br /> I I NEW I I ADDITIUN I I ALTERATION I '�, REPAIR I I DEMOLITION ! I WOODSTOVE/FRPL INSERT ; I BUILDING RELOCATION <br /> ,/ x ACT PERSON AND PHON NO. 9�jJ <br /> CONTRACTPRICEOFWORK "yUL�� , � / � � � � `' `� � � <br /> D RIBE WORKANDSOUAPE FOOTAGE INVQIVEED GJQX L���� (/(�p�, <br /> l ��� �.. <br /> rnoaoseouseoFeuaoiNc — I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> '� � , APPLICATION AND KNOW THE SAME .�BE TRUE AND CORRECT.ALL <br /> LEOALOESCRIPTI N'1FPROPERTY�SHO se�ow RATTACMFOl1flCOPIES� PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIfIED HEREIN OR <br /> �oT BLOLK oF NOT. THE GRANTING OF A PERMIT DOES NOT PRES1IME TO GIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHEii 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 /> PPL�CATION IS MADE AND I COMPLY WITH THE STATE <br /> CO CTORS LAW 1 . CW AND 296.200 WAC. <br /> I '3 E �Y�l� � `�� < <br /> PRQIECT AODRESS icNmm�e oetE <br /> LIIV BUSME55 UCENSE NO <br /> PLUMBINfi MECHANICAL <br /> N0. TYPE OF flXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) A/C—A/HNDLG 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 ' CLOTHESDRYERS ' <br /> KITCHEN SINK&DISP ; VENTILATION FAN � <br /> DISHWASHER � RANGE HOOD � <br /> LAUNDRYTRAY ' WATER HEATER ' <br /> CLOTHES WASHER � WOOD STOVE � <br /> URINAL ' METAL FIREPLACE 8 CHIMNEY ' <br /> DRINKING FOUNTAIN � FIFEPLACE INSERT � <br /> FLOOR DRAIN � HEAT PUMP ' <br /> EACKFLOW PREVENTERS � GAS PIPING � <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN � <br /> SINK(SERVICE—BAR,ETC.) � — � <br /> � <br /> � � <br /> � � — <br /> SUB TOTAL $ ; SUB TOTAL 5 � i _ <br /> PERMIT $ � PERMIT $ �S � __ <br /> TOTAL FEE $ ' TOTAL FEE $ �`__ <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBACK REAR SETBACN SIDE SETBACN PLAN CHECK NUMBER FEE RECf:IPT NO. <br /> ///��� <br /> USE ZONE LOT AREA VACPNT SITE FEES VALUATION FEE <br /> BUILDING <br /> TVPE OF CONiS.AILOWABLf TYPE OF CON51.ALTUPL oIX1UPSHGY No Of uHRUHCUNns � <br /> c�ouv � PLUMBING � <br /> ---+— <br /> SIZE OF BIOG. NO.OF STORIES BASEMENT MECHANICAL � <br /> OCCUPANCV LJRO FIRE SPRNNLEPS REO'D NEIGMT LIMITATION ADDITIONAL PLAN CHECK �_ <br /> i <br /> SPRINKLER i <br /> �— <br /> RERSON FOfl SPRINNLERS <br /> STATE BUILDING SURCHARGE � <br /> i <br /> INTAKEBY PLPNSAPPROVEOBY CITYOFEVEHEIT PUBLICWORKS i <br /> LOCAL SALES � <br /> TAX CODE IS 3105 TaTA� � <br />