Laserfiche WebLink
APPLICATIO ; FOR CONS1fF�UCT. )N �ERMIT �� <br /> TO BE COMPLETED I� BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: :J GAS '�..J ELECTRIC �J <br /> 259-8810 —" <br /> DEMOLITION COMBINATION BUILDING XMECHANICAL PLUMBING SIGN <br /> O NER MAILAODRE55 /-' I 1 , � LiP , �' Pf10NE � <br /> �4� �-bmPS �=2�1D �`����� ��i ;���r' r �E l�'� , ,'%� - =����� <br /> TR.'FNT IdAIL ApDRE55 CITY ZIP PHONE / <br /> ARCHITECTOROESiGNER MlILAODRESS CITV ZIP PHONE <br /> G{NE��pNiRqCTOR } �AILq00RE5S CITV 21P PHONE STATcLICENSEM <br /> JJ �y /�� 'I �� <br /> M NA ALCON TOfi MAIL�DpRE55 C�TV 21P P ONE SiA ICENSEe <br /> � 5 ��en�R. Qo , � 7�1�i Qe�c. 7v7-�63� /, �'c�c�/s3cr-( <br /> PWM�INGCONTRhCTOR M�ILAD R� CITV ZIP PHONE �T.",?[IICC�liEM <br /> CLA55 Of WORK <br /> �NEW � ADDITION ALTERATION REPAIR DEMOLITION � WOODSTOVE/FRPL INSEFT �UILDING REIOCATION <br /> LONTACTPER50 AN�PHONENO. <br /> CONTR�CTPRICEOFWOPK ��U ��J� �f <br /> DESCRieE WORKANG SOUAqE FOpTAGE INVOLVED <br /> � l 1 <br /> =�s��tc.<- �,,„��.e,ie- I�i�n: SUsrp-� 75' 7 ' / 6 3 <br /> C. <br /> PRJPOSEDl15EOFBUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW 7HE SAME TO BE TFUE AND CORRECT.ALL <br /> iecn�o�scamriouoFaaoaearvwHownee�ow��,r�HFou,a/c�o�e�,n�' NOL TH�E GRANTOI GPOF A PERIMITyDOESFNOTPPRESUMEETO GIOVE <br /> LOT_�� pLOCK pF v` <br /> AUTHOFITY TO VIOLATE OR CANCEL THE �ROVISIONS OF ANY <br /> OTHFR STATE OR LOCAL LAW REGULATING CON57RUCTION OR THE <br /> PERFORNANCE OF CONSTFUCTION.THAT I AM AUTHORIZED BY THE <br /> _ OWNER OF THIS PROPERTY TO PERFOqM THE WORK FOR WHICH <br /> . � � APPLICATION IS MADE AND I COIdPLY WITH THE STATE <br /> CONTRACTORS LAIW 7827 RCW AND 296.200 WAC. <br /> PqOJECTAppHE55] (^/ //�� X p�� �// �/SY <br /> 3SJI K,\OM� f���`Q aiC.IN1�l�! _` ORi[ <br /> �l <br /> cirv ou..mtss uctvsr�.o <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM F[E NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) ,. "� NC—A/HNDLG UNITS—H.P. <br /> __ BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. <br /> _ LAVATORY(WASH BASIN) i ��NIT HGATERS—B.T.U. M <br /> SHOVJER CLOTHES DRYERS <br /> KITCHEIJ SMK 8 DISP i VENTILATION FAN <br /> DISHWASNER � '� RANGEHOOD <br /> _ LAUNDRyTRAY i WATERHEATER <br /> CLOTHES WASHER WOOD STOVE — <br /> _ URINAL METAL FIFEPLACE 8 CHIMNEY i <br /> __ DRINKING FOUNTAIN _ FIREPLACE INSERT <br /> _ FLOOR DRAIN HEAT?UMP � <br /> BACKFI.OW PREVENTERS 'Z GAS PIPING <br /> ROOF L`RAINS—RAINLEADERS FXHAU5T FAN - <br /> SINIC(SERV'CE—BAR,ET0.) � <br /> — � <br /> — , <br /> � <br /> SUfi TOTAL S ' SUB TOTAL g � /�� <br /> PERAAIT S �— PERMIT 5 <br /> _L_ TOTAL.FEE 3 TOTAL FEE $ r•;� <br /> FO^ OFFIJE USE ONLY: ' <br /> �qpNi�:ET��CK — REARSETBACK SIpESEiBACK PL4NCHECKNUGBEH FEE R[CEIPTNO. <br /> use Zor�e ioT r,nen VACANT SRE FEES VALUATION FEE <br /> T <br /> eui�oiN� <br /> 1v�E0FC01li5.ALlOWABLE 1YPEGFLOHSfACiUAL octnpAxcr NOorowEumGmnS <br /> ceour PLUMBING <br /> SREUFBIDG. NOAF570RIE5 BASEMENi � --- <br /> MECHANICAL <br /> GCCUPANCVLppD � FIRESPRNKLEqSPEO'D HEIG4iI.I1dIiATION �D�ITiONALPLANCHFCK i - <br /> I <br /> —� SF`HM4LER ' <br /> HCASON FOR SPFIN'*LERS _ __ <br /> T <br /> STAT�BUILDMG SURCHARGE <br /> �•:-����'i+�.—�---i-- �,-�nNsnaaRoveoov GTYOFNERETT pue��cwoaHs --- — <br /> i LOC.4LSALES <br /> � TAX CODE IS 3105 T�TAL <br />