Laserfiche WebLink
APPLICATIOI_ FOfR CG�'ri�TRUCTI' N PERMIT � <br /> TO BE COMPLET[D IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATiNG SYSTEM: GAS ❑ELECTAIC ❑ <br /> 259-8810 � <br /> ❑ DEMOLITION _] COMBINATION CJ BUILDING Cz�'IUECHANICAL ❑PLUMBING ❑ SIGN <br /> O ER Mo" ADDflE59 QTV ZIP PMONE <br /> E �•Q/V 2102 LAfe6 HTS �R �VERE77" 9&20$ 337-o91s <br /> TEN/WT MFILA�DRE�S CITV 21P PMONE <br /> ARCHITECTOAOESIGNER MqILA�DRESS Cltt ZIP PHONE . <br /> GENERALCONTRACTOR MRILADORE55 CITY ZIP PHONE ST�TELIGEN6:/ <br /> MECHANICAL CONTfiACIOfl MAIL PD�RE55 CITV IIP PHONE SiRE 4CENSE� I <br /> E�. P cn reeh 5���� Sh�e�e.-� Ul1�e .1 L S � <br /> rwrmm�uc(�lTMGTOR MAILAD�RE55 CITY ZIP PHONE SiATELICEN5E1 <br /> V <br /> O T AC RI � ORN - <br /> DESC BEWORKANDSOURREFOOTAGEINVOWEO CONTACiPEN50NANOPHONENO. <br /> Fu NwT <br /> — I NEREBY CERTIFY THAT I HAVE READ A��O E%AMINED THIS <br /> PPOPOSED USE Of BUILDING APPI_ICATION AND KNOW THE SAME TO BE TRUE ANO CORRECT.ALL <br /> PROVISIONS OF LAWS AND�RDINANCES GOVERN{NG THIS TYPE 0� <br /> LEGALDESGRI�'IONOFPROPEFTY�SMOWNBELOWOflATiACHTWOCOPIES� WORK WILL BE COMPLETED WfM WHETHF.R SPECIFIED HEAEIN OR <br /> LOT-- BLOGK oF NOT. THE GRANTING OF A PF.FMIT DOES NOT PRESUME TO GIVE <br /> AUTHORITY TO VICLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LGCAL LAW REGULATING CONSTFUCTION OR THE <br /> — PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORI2ED BY THF <br /> OWNER OF THIS PiiOPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> . rnace�rnx i.o.NUMeea � CONTRACTORS LAW�827 RCW AND 296. U W C. <br /> GONSTPUCTION LOAN lENOER,ADDflE55,TELEPHONE NUMBER <br /> PROJECT ADDRESS ar�+.une * � ie '����'— <br /> CRYUUSMLSSlCEN5E1q <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTUAE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATEF CLOSET(TOILET) i A/C—lVHNDLG UNITS—H.P. v�— <br /> BATHTUB ; / FORCED AIR SYSTEMS—B.T.U. UM E.A. <br /> LAVATORY(WA,�',H BASIN) � UNIT HEATERS—B.T.U. M <br /> SHOWER � CLOTHES DRYERS <br /> _ KITCHEN SINK 8 DISP ; VENTILATION FAN <br /> DISHWASHER � RANGE HOOD <br /> LAUNDRY TRAY WATER HEATER � <br /> CLOTHES WASHER WOODSTOVE <br /> URINAL ' METAL FIREPL4CE(WOOD BURNING) <br /> DRINKING FOUNTAIN � FIREPLAGE INSERT <br /> FLOOR DRA;N HEAT PUMP <br /> BACKFLOW PREVENTERS ; GAS PIPING <br /> ROOF DRAINS—RAINLEA�ERS � EXHAUST FAN � <br /> SINK(SERVICE—BAfi,ETC.) <br /> � <br /> —�-- <br /> SUB TOTAL S ; SUB TOTAL $ <br /> PERMIT $ � PEFMIT S <br /> TOTAL FEE S TOIAI FEE $ � <br /> FOR OFrICE USE nfvLY: <br /> FAONTSE79ACK flEAPSETBACH SIOESET�FCN PLANCNEC NUMBEP �EE RECEIYTNO. <br /> 57d� <br /> I15EZONE LOTAREA vncnnisrte FEES VALUATION FEE <br /> ❑ 1'ES ❑ NO BUILDING <br /> TYPEOFLONSi NO.OPSTOPIES atc»ncr xaovqvnlixGuwrs — i <br /> cuuuo pLUM81NG <br /> i <br /> SIZEOFBLOG. FIFESPRINNLERSREO'D BASEMENf MECHANICAL � <br /> ❑ YES ❑ NO , <br /> OGCUPMlGYIOAD FIREAIAPMREO�U � HEGHTLIMITATION ADDITIONALPLANCHECK � <br /> OTHER � <br /> REASON —'i— <br /> STATE BUILDIN�SURCHARGE <br /> INTAKEBV PLANSAPPRJVEOBY GITYOFEVERE7T PUBLICWORNS ' <br /> LOCALSALES �— <br /> onTe TAX CODE IS 3105 TJTAL <br />