Laserfiche WebLink
APPLICATIQ""f FOR CONSTRUCT'�N PERMIT � <br /> TO�E COAAPIETED IN BLACK INK�LEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ � <br /> 259-8810 <br /> ❑ DE�AOLITION ❑ COMBINATION 1 ] BUILDING L'MECHANICAL ❑PLUFIBINfi �1.SKiN <br /> OMRIEN M�ILADOflE55 �pryE <br /> ���I�S ISIa(. y2gs ! 3��11'F�/aZ�. �-,d, �saeS <br /> ' iE I.UILADDRE55 CITV ZI��� PIqNE <br /> 2 �� ,�' � Z <br /> �RCNITECT Op pESIGNE MAIL MDAE55 CITY 21P PIIONE �� <br /> ; GENEMLCONTMCTOR MAIL�DDRE55 LITY ZIP � �� P ST�TEIICENSE• ' ' <br /> i � Ors'�. S�r�.�//��As Z6 Z S/�llBw�'•rI Nanr Du'�M,rii+.�,� L�l �gu6 C.l�S�o�i o 9yA1.E I <br /> t MECIMNIGILC iTR R MAILADORE55 CITY ZIP—���qryE ST�TEIICENSE� , <br /> � <br /> , PLUABRq CONTRACTOR MAIL 1100RE55 CITY ZIP PMpNE ST�iE LICENSE/ <br /> i <br /> � CONTRACT PRICE OF WpMc <br /> 9reej° �9i9 = <br /> DE lEWdF(ANDSOU FOOTIIGEMVOLVED CONT CTGERSON�NDPNpqE w `� <br /> � <br /> � 1 <br /> �cia i HEREBV CERTIFY tHAT I HAVE READ AND EXAMINED THIS <br /> � <br /> wbPa u� aF euwrtq r10� APPLICATION AND KNOW THE SAME TO BE TqUE AND COHRECT.ALL <br /> \ f PROVISIONS OF UWS AND ORDINANCES OOVERNMq 7HI3 TYPE OF <br /> � �2uoe irrapoF ROPEHTY�5110MMBELPMOR�TT�GI7WOCOPIES� WORK WILL BE CAMPLETED WITH WHETHER SPECIFIED HEREIN OR r � <br /> � NOT. THE CiRANTINO OF A PERMIT DOES NOT PqESUME TO f31VE <br /> ��T �� � AUTHORITV TO VIOLATE OR CANCEL THE PROVISION$ OF ANV <br /> OTHER STATE OR LOCAL LAW REGULATINO CONSTRUCTION OR THE <br /> ' �� PERFORMANCE OF CONSTAUC?ION.THAT 1 AM AUTFIORI2E0 BY 7HE � <br /> , OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WMICH <br /> �� APPUCATION IS MADE ANO I COMPLY WITM TME STATE � <br /> � ,,.` ._ � v L TN(I.D. R ' CpryTRACTORS UW 1827 RCW AND 296.200 WAC. ti <br /> � ', .. TION LMN LENOER. .TElEP110NE N1AAlER <br /> ' , �i�26^ �y <br /> . �°xc'i'q�s v�e� �E �.h y <br /> (��Q LT'lU911Et6liC[NSE NO <br /> � �� ��A�AL � <br /> N0. T/PE OF RRTURE OR iTEM FEE N0. TYPE OF EOINPMEMT .� <br /> {��"*'�� • � WATERCLOSET�TqLET� � NC—AMNDLOUNITS—H.P. , � <br /> - - BATMTUB ; FORCED AIR SYSTEMS—B.LU. M E.A. � f <br /> LAVATORV(WASH BASIN) � UNIT MI�ATERS—B.LU. M ; p <br /> $HOWER � CLOTMES DRYERS � ' <br /> � KITCHEN SINK d DISP I VENTILATION FAN ; �, <br /> OISHWASHER � RAN(iE NOOD � <br /> � LAUNDRY TRAY ; WATER HEATER � � <br /> I CLOTHES WASHER � WQOD STOVE ; - <br /> � URINAL ' METAL FIREPUCE(WOOD BURNING) � , <br /> � � ��' DRINKIN(i FWNTAIN � PIREPLACE INSERT ; <br /> FLOOR DRAIN � HEAT PUMP ' � <br /> BACKFLOIN PREVENTERS ; OAS PIPING ' <br /> ROOF DMINS—RAINIEADERS � E%HAUST FAN � <br /> SINK(SERVICE—BAH,ETC.) ; � <br /> � <br /> ' � � <br /> � � � <br /> j � � <br /> I SUB TOTAL S � SUB TOTAL S <br /> � PERMIT S � PERMIT S � <br /> ,� TOTALFEE S ' TOTALFEE S ' ' <br /> FOR OFFlCE USE ONLY: �v I� C��-� c o/{ <br /> � ' FRONTSETBACK REARSF.7&1CK SIDESETB�CI� PUWCNE UMBER FEE RECEIPiNO. <br /> � Q �� <br /> usezor+e LOTAREA v�curtsi� fEES VALUAiION FEE �' ! <br /> � ❑ YES ❑ NO � _ � <br /> BU�IDING � .� - <br /> lYPEOFLONST ND.OFSTORiES acuvuKr xoamv[uixcuyrts '� <br /> i <br /> GB00o piUM81NG � <br /> SIZEOFBLOG. FIRESPRINNLERSREO'D BASEMENT �� ? <br /> MECHANICAL � �. 1 <br /> ❑ YES ❑ NO , � ' <br /> OCCUPANCY LOAD FIRE ALARM REO'0 HEIGMT LIMITATIO� ADOITIONAI PUN CHECK � � ; <br /> �A.�1 MF�� i + <br /> GIpL OTHER ' - <br /> REASON � ��.�I <br /> � STATE BUILDING SURCH�RGE i ,� <br /> INT�KE BY PUNS.APPROVED BY CITY OF EVEREIT PUBLIC WORNS � . � �I <br /> �M �oc�s��es <br /> o�.e � TAX CODE 18 9105 ror�� <br /> . � i <br />