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APPLICATIO'� FOR CONSTRUCTI'�N PERMI� � <br />TO BE COMPLETED IN BLACK INK-PLEASE PRINT <br />BUILDING DEPARTMENT <br />259-8810 <br />❑ DEMOLITION ❑ COMBINATION <br />MRIL <br />MAIL <br />CONTR�CT PRICE OF WONK <br />��� <br />naccniaF WORK AND SOl1A <br />ADORESS <br />INVOLVED <br />HEATING SYSTEM: ❑ GAS ❑ ELECTRIC 'J _ <br />,__ <br />!�'BUILDING 'Ll MECHANICAL <br />CItY ZIP PHONE <br />,�.�,F�., � �, ^°� 4RS�o5 '�'� <br />C�TV Z�P <br />PROPOSED IISE OF BUILDING <br />LEG�LDESGHI RiY15HONTlBELOWOR4iTRGNiWOCOPIESI <br />LOT BLOGK OF <br />PARCELTA%ID.NUMBEP <br />WNSTRUG� <br />NI/MBER <br />FEE <br />FOR OFFICE USE ONLY: <br />fRONTSET9ALN REARSETBACK <br />USE20NE LOTAPEA <br />7YPEO�CONST. NO.OFSTORIES <br />SREOFBLDG� FlPESPRINNLEIi5FE0'� <br />___.._......,�n.n FIREALA <br />onre <br />3'DE <br />CONTACi PERSON AN� PIIONE NO <br />!�i?LUMBING f �� SIGN <br />i <br />� <br />0 <br />i HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALl <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING nF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANV <br />PERFORMANCEOOF�CONS RUCTION. THAT I AM AUTHORI ED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 7827 RCW AND 296200 WAC. <br />1 \ 1 � �ll\�l � � �� `-(?��.� <br />D tE <br />SIGN�iUP[ _ <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—B.T.U. M <br />HEAT <br />FAN <br />�AGRNT SIIE <br />,- VES i J NO BUIIOINfi <br />[WN��KL+ NOO�DWILL�NGu�Y6 <br />�na� p�UMBING <br />BnSEMENt MECHANICAL <br />i 1 YES � . NO �— <br />NEiGMT uMITAnoN ADDITIONAL PLAN CHEGK <br />OTHER <br />STATE BWLDING SURCHARGE <br />CI OCAL SA ES PU�LIC WOfiKS <br />TAX CODEIS 3105 TOT^� <br />NO. <br />v <br />� <br />� <br />