Laserfiche WebLink
i <br /> APPLICATION FOR CONSTRUCTION PERMIT <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT � <br /> BUILDING DEPARTMENT H�NTING SYSTEM: �GAS ❑ELECTRIC f� /y��,,,� � <br /> 259-8810 <br /> X DEMIOUTION COMBINATION x BUILDING MECHANICAL PLUAABING <br /> ��E MIII�ADDRESS aTv ziP .�C SIGN <br /> ./.��. �-.r .-. . ._.. � � PNONE <br /> MAILADDRE55 v �,lc� ��� `��// <br /> CITY 21P PHpqE <br /> �� i�o1 H«,,,,tf f�K,#- zs� 3�// <br /> �NCHITECTORDESIGNER M�IL�DDRE55 ��n. Z�P <br /> /�\��.� PHONE <br /> S/ <br /> fiENERALCONTqACTOR MAIIADDRE55 LITV ZIP <br /> PHONE STATELILENSE• <br /> w �..�r <br /> MECHNIILA�Cq�TqAC M�ILADDRE55 CITY ZIP <br /> PMp�E ST�TE LICEN$E f <br /> �����Tp'�C M�IL/�DDRESS CITY ZIP PIqNE <br /> STATE LICENSE� <br /> QASS OF Wi7RK <br /> Ci NEW 'i�.i ADDITION �G ALTERATION X REPAIR JC DEMOLITION I i WpODSTOVE/FRPL INSERT ❑ BUILDING RELOCATION <br /> �- � �' � coHr�cr�sor�u�orHorre <br /> r rn�or,wonK •� � � <br /> DESSCN9F M'ORK AND Sq1�qE F TAGE INVOLVED <br /> PRDPOSED USE OF BUIlOMO <br /> I HEREBV CERTIFV THAT i HAVE READ AND EXAMINED THIS <br /> ����R�PT��P�EpTV 151�pWN BELOW pp ATLIGN FOUq CppIES� ` PROV SAONS OF UWKN�D ORDI ANCES GOVERNING TFII$R7ypE pp <br /> �ot �� � WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTINO OF A PERMIT DOES NOT PRESUME TO OIVE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br /> OTHER STATE OR LOCAL LAW REODUTiNO CONgTpUC71pry pp 7HE <br /> PERFORMANCE OF CONSTAUCTION.THAT I AM AUTHORIZED BV THE <br /> OWNER OF THIS PROPERTY TO PEHFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> �.�� _ �_ a -i- y 3 <br /> _ � e��,,,,� �„� , <br /> , <br /> c..�.' �m��,KE�� <br /> v�u�w�o �au►Nc�� <br /> : MC• TY�E OF RkiURE FEE NO TYPE OF EOUIPMENT � <br /> . WATER CLOSET(TOILEn � C—AMNDL(3 UNITS—H.p. <br /> �TM�B ' FO D AIH SYSTEMS—B.T.U. M E.A. � <br /> IAVATORY(WASH BASIN) � � UNIT H RS--B.T.U. M � <br /> R ' CLOTMES D RS <br /> KI HEN SINK d DISP ' VENTILATION FA � <br /> DI HER � MNpE F100D � <br /> ' �J1UND TRAY ' WATER HEATER , <br /> CLOTHE3 HER � WOOD STOVE � <br /> � �R��� ' METAL FIREPLACE 8 CHIMNE � <br /> � DRINKIN(3 FOUNT ; FIREPUCE INSERT � <br /> FLOOR DRAIN � HEAT PUMP � <br /> BACKFLOW PqEVENTERS ' OAS PIPING � <br /> � ROOF DRAIN9—RAINLEADER � EXHAUST FAN +'— <br /> SINK(SERVICE—BAR,ETC.) � � <br /> � <br /> I <br /> ' <br /> SUB TOTAL S ; SUB TOTAL S ' <br /> PERMIT S � PERMIT S ' <br /> TOTAL FEE S TOTAL FEE S � <br /> FOR OFFlCE USE ONLY: <br /> F�T��K � RE�RSETB�GK ,.._�dETBACN PLANCMECN6'MBER FEE I 6 <br /> REGEIPTNO. <br /> — /� <br /> USE 201IE LOT�RE� V�GANi 51TE �ES VALUAiION E <br /> C- <br /> BUILDING � <br /> 1YPEOFCONfS.�LLOWABIE 7YPEOFCOMSi1C1Ull oCnMAy;r xaabMiuxcuMrts ' <br /> tnouv p�UMBING � <br /> � <br /> 5����+ NO.OFSTORIES B�SEMENT . <br /> MECHANICAL � <br /> � <br /> OCCUPANCYLWD FIRESPRNKLERSREOD NEIGHTLIMITATION ADDITIONALPUNCHECK i <br /> � <br /> PE�SONFORSPRMKLERS SPRINKLER � <br /> S1ATE LUILDING SURCHARGE � <br /> INtAKEBY PLANSAPPROVEDBY CITYOFEYEREIT PUBLICWORNS � <br /> LOCAL SALES � <br /> TAX COOEIS S1OS TOTAL � <br /> - � <br />