Laserfiche WebLink
APPLICATIO� FOR CONSTRUCT["`N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDIhG DEPARTMENT HEATING SYSTEM: GAS ❑ELECTRIC ❑ _ <br /> 259-8810 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING _I MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNER � MAIL ADDFESS CIN ZIP PNONE <br /> J ERIC �io�Kli�.S 13Z3 UAK�S l�d �U£-6��� 2SZ-�'f4$7 <br /> TENANT MAIIADDRE55 GITV ZIP PMONE <br /> ARCHITECTOPDESIGNER MAILADDNE55 CITV 21P PHONE <br /> GENEHAL CONTRRCTOfl MAIL ADDRESS CITV ZIP PHONE STATE LICENSE t <br /> MECHANICAL CONTRACTOR MAIL ADORE55 � \ dTV ZIP� PHONE STATE UCENSE t <br /> "TA�K H7ts �S/syz^1F.Ju1ct�D�,�1d�c�F�,a1y u�A�A�/cc�' U�9g�.T2 �f8bl-8� 7'dayslH��clE <br /> PLUMBINGCONTRAGTOR MAILADDRESS CITY ZIP PMCNE STAIELICENSEt <br /> CONTRACT PRICE OF WORK <br /> 2 SbD <br /> DESCRIBE WORN AND SOURRE FOOTRGE INVOLVED CONTACT PERSON AN PHO NO. p <br /> _ �O ? <br /> �� � <br /> -- i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSED E OF BUIIDIN APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF IAWS AND ORDIN.4NCES GOVERNING THIS TVPE OF <br /> LEGRLDESCHIPT�ONOFPflOPERTV�SHOWNBELOWOPATfFCNTWOCOPIES� WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br /> ior e�ocK oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTFUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTV TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND � COMPLY WITH THE STATE <br /> PAHCEI TA%I.D.NUM6ER CONTRACTORS LAW 18.27 RCW AND 296200 WAC. � <br /> CONSTRUCTIIXJ LOAN iENDEP.ADDPESS,TELEPHONE NUMBER p <br /> X �� O ��O��i <br /> PROJECTADD SS s ���� 77 7� oae - <br /> CItYBOSME SIICGN5EN0 <br /> PLUMBIN6 MECHANICAL <br /> NO. TYPE OP Fll(TURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) � P✓C—NHNDLG UN�TS—H.P. � <br /> � <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.�J. M E.A. � <br /> LAVATORY(WASH BASIN) � UNIT HEATERS—B.T.U. M ; <br /> SHOWER ' CLCTHES DRYERS � <br /> KITCHEN SINK&DISP � VENTILATION FAN ; <br /> DISHWASHER � RANGE HOOD � <br /> LAUNDRY TRAY ; WAT[R HEATER ' <br /> CLOTHES N�ASHER � WOOD STOVE � <br /> URINAL ; METAL FIREPLACE(WOOD BURNING) � <br /> DRINKIN3 FOUNTAIN � FIREPLACE INSERT ; <br /> FLOOR DRAIN � HEAT PUMP <br /> BACKFLOW PREVENTERS ; GAS PIPING ; <br /> ROOF DRAINS--RAINLEADERS � E%4AUST FAN � <br /> —� <br /> SINK(SERVICE—BAR,ETC.) ; S ' <br /> _ ; <br /> — - � � <br /> SUB TOTAL S ; SUB TOTAL $ ; <br /> PERMIT S � PERMIT $ � <br /> TOTALFEE $ ; TOTALFEE $ ' <br /> FOR OfFICE USE ONLY: <br /> FRONT SETBACK dEAR SETBACK SIDE SETBACK PLAN CHEC��E FEf RECEIPT NO. <br /> O <br /> USE20NE LOTAREA VACANTSIfE FEES VALUATION FEE <br /> Ci YES ❑ NO BUILDING � <br /> TYPEOFLON57. NO.OFSTORiES acuv�ea xoaDwEuixcuxrts <br /> i <br /> GXWP PLUMBING � <br /> SIZE OF BLDG. FIRE SPRINKLERS REO'D BASEMENT MECHANICAL s� � <br /> ❑ `fES C' NO , <br /> OCCUFANCVLOAO FIREPIARMREOD HEIGHTUMITATION ADDITIONALPLANCHECK � <br /> i <br /> OTHER ' <br /> — � <br /> REASON <br /> � STATE BUILDING SURCHARGE i � <br /> INTAKEBV PUNSAPPRGVEDBY CITYOFEVEREIT PUBLICWORNS � <br /> LOCALSALES � <br />