Laserfiche WebLink
�^ APPLICATIOC FOR CONSTRUCTI; N PEi�MIT � <br />' �� I <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />��ING DEPARTMENT �HEATING SVSTEM: U GAS U ELECTRIC J_ —1 <br />259 8810 <br />�. ' DEMOLITION fl COMBINATON '.�� BUILDING f I MECHANICAL X; PLUMBING il SIGN <br />n1YNEP MRR AGOfiES$ CIiV ZIP PNCNE <br />LIiY <br />1`IIONE <br />✓�r9/f7� <br />qRU�RECipqDESiGNEfl MAILAUOPESS CIiY 2iP PMONE <br />GVIEMLWIIiMCiOfl 4AIL/A,00l1E55 CILV ZIP PXONE S1AiELICFNSE• <br />rii}(s'�lPdi�rL P.✓%/' <br />i'.COIANKRLCON1FALiOfl MNLAD0f1i55 GIR' ZIP FHON[ SiAiEL6EN5E• <br />1'W'�AOWGCONiMGiOfI M1IFILADDflESi GTY ZIP PI�ONE $ihIE110EN5[� <br />COIIiRACT PIiICf Of W�{iN � <br />��OcO rX <br />ocs�n�ee �wnv nNo sawFe roorncc ivvave[ <br />�/U�!/[i�L i/•� I <br />fIlOPGSEJ USE OF BOILOIIIG <br />,Q�/v Q�Yc° <br />tFWLPESCPI?il NOFPflJPEFiY15NOWNBEL01 <br />lUi BLOLN OF <br />�n •w�nnrf�� <br />Nu�cE� �.io r+uueEA <br />cC45ifluC110N LOAN LEtI�[II. ADDAE55. iEIEPN( <br />FOR OFFICE USE ONLY: <br />PEASON <br />I HEREBV CERTIFY THHT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TROE AN� CORRECT. PLL <br />PPOVISIONS OF LqWS AND ORDINANCES GOVERNING THIS NPE OF <br />cov:esi WORH WILL BL COMPLETED WITH WHETHER SPEGFIE� HEREIN OR <br />NOT. THE GRANTING OF A PERh71T OOES N0T PRESUME TO 31VE <br />AUTHORIT'/ TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br />OTHLR STATE OR LOCAL LAW REGULATING CONSTFUCTION OP TME <br />PERFOR�7ANCE OF CONSTRUCTION. THAT I AM AUTHORIZEO BV THE <br />OWNER OF THIS PF70PERTV TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLV WITH iHE STATE <br />CONTRACTORS LAW 1827 RCW AND 296240 WAC. <br />❑ YES C NO <br />7 YES f7 NO <br />imnxcov runsnrvew�our CITYOFEVENETf <br />LOCAL SALES <br />o+�e TIIX COOE IS 3105 <br />GAS <br />9UIL�ING <br />PLUMBING <br />MECHFNICRL <br />FODITIONAL PLAN CHECK <br />OTMER <br />STATE BUILUiNG SURCHARGE <br />PO�LIC WORRS <br />TOTAL <br />FEE <br />M <br />