Laserfiche WebLink
Q►PP�.i�A'T�tl J �'OR CO�ISTRUCT: >N PER6V19T �� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PflINT <br /> BUILDINGDEPARTMENT HEATWGSYS7EM: ❑GAS ❑ELECTRIC V � <br /> 259-8810 — <br /> DEMOUTION i=i COMBINATION f� BUILDING f ECHANICAL � I' <br /> ��'�'+-R M1IAILADDRE55 � PLUMBING iJ SIGN i <br /> � / C/IiY ZIP PHONE I <br /> /.A�rN�Gy[F x�E'�'STEF ui'/ ,c[ 1a2�� t1J I <br /> TENANT IdAiLA��RdSS �T- 3�2��� 1, <br /> ��TY Z�P PNONE ' <br /> AHCHITFCTOqDF.51GNEP IdAILqOpRE55 ��ry Z�P I <br /> PHONE <br /> GENERALCONTR�CTOF R1pILpDDRE55 CI7Y ZIP PMOfJE <br /> SiATE UCENSE a i <br /> GECHANICALCONiPACTOq lAAI�ADDRESS CITY Z�p � - �� <br /> PHONE 3tATtlLICENSEe <br /> �`e/IJ�E�.I �{�` - 7rinlG 1:7� C'�,�-3T.U�T�8 EtlT �,�q. �87oi ?53-33�// _-�zil�No9nec. <br /> PWL!81NGCONTRpCiOR MAILAD�FESS CITV 21P FHONE <br /> STATE LiSENSE n <br /> 1 <br /> COrJiqpCT PRICE OF WOFK <br /> � <br /> [)ESCFIBE WOP.K AND SOUAqE FOpTqGE INVOLVEU CONTACT PERSON AND PMONE?O. <br /> r�,oNoSeouseoFeu��oiNc I HERE6Y CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> /� APPIICATION AND KNOW THE SAME TO BE TRUE AMD CORRECT.ALL <br /> �-r� ' PROVISIONS OF LAWS AND ORDINANCES GOVERPIING THIS TYPE OF <br /> i.er,n�oescqi�rior�oFaHoveaTv�sHowrvae�owonnnnc��rnocaPiesl WOHK WILL BE COMPLETED W�TH WHETHEF SPECIFIED HEP.EIN OR <br /> ior .— a�_ctiK oF NOT. THE GRAN1lNG OF A PERMIT DOES NOT PRESUME TO GIVE <br /> AUTHCRITY TO VIOLATE OR CANCEL Th� PROVISIUNS OF ANY <br /> _ OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION ON THc <br /> — PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZE�BY THE <br /> OWNER OF THIS pROPERTY TO PERFORM THE WORK FOR WHICH <br /> r�.uvice�inxi.o.ruuMoea APPLIC ION IS MADE AND I COMPLY WITH THE STATE <br /> Svy7 _ �.7 Dn�_��o�» CONTR ORS LAW 18.27 RCW AND 296200 WAC. <br /> '�."�STRUCTIONLOANLENDEP,ADpRESS.TELEPHOMENUMOER <br /> i)A- �L.S:/��?�i <br /> PROJECT ADDRESS , �i, �� "/d"l>> <br /> onrc <br /> G �I11i5�hC59LiCG15LN0 —' <br /> PLUMBING PAECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TVPE OF EQUIPMENT FEE <br /> _ WATER CLOSET(TOILET) A/C—A�HNDLG UNITS—H.P. <br /> � BATHTUB FORCED AIR SYSTEMS—B.iU. M E.A. <br /> LAVATORY(WA.SH BASIN) UNIT HEATEAS—B.T.U. M <br /> SHOWER CLOTHES DRYERS � <br /> _ KITCHEN SINK&DISP - VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> LAUNDRY TRAY / WATER HEATER i� <br /> CLOTHES WASHER WOOD STOVE <br /> _ URINAL ; METAL FIREPLACE(WOOD BURNING) —�— <br /> _ DRINKING FOUNTAIN FIREPLACE INSERT <br /> FLOOR DRA!N yEAT PUMP '— <br /> _ BACKFIOW PREVENTEFS L GAS PIPING — <br /> ROOF DRAINS—RAINLEADERS � EXHAUS7 FAN <br /> __ SINK(SERVICE—BAR,ETC.) _ <br /> _ � _ <br /> T <br /> ___ SUB TOTAL 5 ' SUB TOTAL $ p� <br /> __ PERMIT $ PERMIT § � <br /> TOTAL FEE S TOTAL FEE $ J � <br /> FOR OFFICE USE ONLY: <br /> pr,���;JiS[TEACK REARSETBALK SIDESETB�CK PLANCHEC NUTApER F[E qECEIPTNO. � <br /> �OS3(o <br /> us�'on[ �o7nRen VACANTSITE FEES VALUATION FEE <br /> _ ❑ YES ❑ NO BUILDING <br /> �- [1-GONSi NO-OFSTORIES OCcurr^cx 600fov:uuNto:ns I <br /> �no�P PWMBING i <br /> ..il:�.GF 2LOG FIqE SPRINKLERS REO'D BASEMENT �--r—' <br /> ❑ YES I � NO MECHANICAL �� � <br /> CC!\:PANCVLOAO FIREALARh1REOD HEIGHTLIMIiAT10N AD�ITIONALPLANCHECK <br /> r,=,tsoN �1HER <br /> �— <br /> STATE BUILDING SURCHARGE <br /> ;;Lv:[f3v PLANSAPPqOVE�eY CITYOFEVEREII' FUBLICWORK$ <br /> lOCALSALES <br /> r,�ar TAX CODE IS 3105 TOTAL <br />� ,. ,,.,......r ,., _ ,� . ,_... _. . .._n.,,.._.a..,.. _ <br /> t <br />