Laserfiche WebLink
APPLICATIC� 1 �OR CON�TRUC���N PERMIT � <br /> �G� TO 9E COMPLETED!N BLACK INK—PLEASE PRIPIT <br /> HEATINCa SYSTEM: GAS ❑ELECTRIC ❑ � <br /> BUILDING DEPARTMENT <br /> 259•8810 <br /> ( 1 DEMOLITION Cl COMBINATlON �Q BUILDING I I MECHANICAI. � I PLUMBING ! SIGN <br /> OWNER MAILADORESS GITY ZIP PHONE <br /> Shqran Z�� 1119 E-4oy-f /�ve� �ve�e�, CrJ�k . 98ao1 as9 - 3i�q <br /> TENANT MAIL ADDFiE55 CITV ZIP PHONE <br /> ARCHITECTOR�ESIGNER MAIIADDflE55 CITY ZIP PNONE <br /> f`'�ike i�lickerson� �7.�� Ccl� #Go7� �vere�W�4. `1'B�ol a59- IS�O <br /> GENEiULCONTRACTOR MA0.AD BESR QTY 21P PHONE STFTEIICENSE� <br /> �is C sT �Pr�nr �••� IYS?�^�� w c,c' Go��, ,�,w �D S�RNr�DWa �flv�C_S�47b.) <br /> M HRNICALCONTpACTOR MAIIA�DflE55 ��T�' Z�P ��NPNE� .L SiATEUCENSE/��/^� <br /> Q�- 3� �( <br /> PLUMBINGCONTRACYOF ' MA�LA9pRE55 CITV ZIP PHONE STRIELICENSE� <br /> CUSSOFWOflK� <br /> (1 NEW I I ADDITION ALTERATION L i REPAIR I I DEMOLITION I I WOODSTOVE/FRPL iNSERT I I BUILDING RELOCATION <br /> CONTACT PEfiSON AN�PHONE NO. <br /> CONiRACTPPICEOFWOPK / �� �Q✓+ S ��� ��� <br /> DESCRIBEWOflKAND50URREF00TAy�"IN�'(ILVED !/)� g !j//jl � <br /> (2emocte� Seean�( �;oor es 'de e ar M� �e lJ��c%erson J59-1560 <br /> PROPOSEUUSEOFBUILDING I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br /> �j APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECI�.ALL <br /> (CB S�de r��� nROVISIONS OF LhWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> IEGALDESCRIPTIONOFPROPEFTV�SHOWNBELOWORATfACHFO RCOPIES pK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> toT e�ocn oF NOT. THE GRANTING OF A PE9MIT DOES NOT PRESUME TO GIVE <br /> AUTHORITV TO `.�IOLATE OR C.4":CEL THE PROJISIONS OF HNY <br /> SGPi bra�,✓�n gs OTHER STATF OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTflUCTION.THAT I AM AUTHORIZED BY THE <br /> ^,/�� / l � ^' , 7 C'�� OWNER OF THIS PAOPERTY TO PERFORM THE WORK FOR WHICH <br /> �(/ /�/ Cf.l-( / J APPLICATION IS M COMPLY WITH THE STATE <br /> Z/ - CONTRACTORS LAW .27 RCW AND 96200 WAC. <br /> ,LG�� _, <br /> `</��G -�2% pD� -�009 ��� � ,,�G- 1�-gv <br /> SiGNATUFE <br /> 7RQIECTAODRESS /, I� / / �_L ^✓� - <br /> r-ro T n LITYBJSINESSIICEN5EN0 <br /> PLUMBING MEGHANICAI <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) � AIC—A/HNDLG UNITS—�I.P. � <br /> BATHTUB ' FORCED AIR SYSTEM3—�T.U. M E.A. ' <br /> LAVATORY(WASH BASINj � UNIT HEATERS—B.7.U. M � <br /> SHOWER ' CLOTHESDRYERS <br /> KITCHEN SINK&DISP ' VENTILATION FAN � <br /> DISViWASHER � RANGE HOOD � <br /> LAUNDRYTRAY ; WATERHEATER <br /> , WOOD STOVE ' <br /> CLOTHES WASHER i METAL FIREr'LACE 8 CHIMNEY ' <br /> URINAL ; <br /> DRINKING FOUNTAIN � FIREPLACE INSERT <br /> FLOOR DRAIN ' HEAT PUMP ' i <br /> � <br /> ' GAS PIPING <br /> BACKFLOW PREVE4TERS � �— <br /> ROOF ORAINS—RAINLEADERS � EXHAUST FAN ' <br /> SINK(SERVICE—BAR,ETC.) � ' <br /> i <br /> � <br /> , � <br /> — � <br /> - � <br /> � <br /> SUB TqYO,L $ ' <br /> SUB TOTAL $ � 1�� " pERMIT S � <br /> PERMIT S ' , <br /> TOTAL FEE $ ; TOTAL FFE $ � <br /> FOR OFFICE USE ONLY: °'��J��/D �-�' ,�-� <br /> PLANCHECKNUMBER FEE nn HECEIPTNO <br /> FRONT SETBACK PEAR SETBALK SIDE SETBpCN/ � f� � /J.�C 1 <br /> / �J� / � _ � 7�hI <br /> ��� FEES VALUATION FEE <br /> USEZON LOTAREA VPCANTSITE JJ[ �f <br /> �' 2 BUILDING � 4'�� ` /�L ' D <br /> A'oEOfCONTS.�LLOv• :lE ttPEOFLONST.AtTUAL [CCqW��r i9atVx[uix�uxns p�UMBING ?�� <br /> -� �� J l�-3 �� <br /> SIZEOFBLDG. NO.OFSTOFilES BASEMENT MECHFNICAL � <br /> i <br /> Sf ,0 2- � —� _ <br /> ADDITIONAL PLAM CHECK <br /> OCCUPANCY LOAD FIRE SPflNNLERS REOV NEIGHT IIMIT�� � <br /> n�p Z SPFiINNLEfl � <br /> REASOr�iFORPRINNLERS STATEBUILDWG9UFCHARGE �- �� <br /> INTANEBY PIAN�AVPR �E�BY CITYOFEYEREIT PUBLICWORKS ~— <br /> J � TAX COD IS 31OS TOTAL L/ i Q <br /> 3 2n1RH <br />