Laserfiche WebLink
- - ' J _ F. 1 <br /> APPL�CATION FOR CONSTRUCTI�.N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—P4EASE PRINT <br /> BUILDING DEPARTMENT HEATING SVSTEM: � GAS U ELECTRIC O_ _ — � <br /> 259•8810 <br /> ❑ OEMOLITION LJ COMBINATION n BUILDING i�MECHANICAL �I PLUMBING i1 SIQN <br /> pyyry� MA0.ADDMESS 17Y 2rt` q�q�7P1! <br /> �� D1TTGE �`I�� '�C�� � �✓� ���QJ <br /> IEN�NT M�ILADDME85 C�tt lIP PHONt <br /> ARC11rtfCTfIRDESqNEP A4KIDDNE55 CRV 11a nqN[ <br /> AfMEMLC�INTNAG70R N�II�DdIE$S GITY LM NWNE STATlLICENSC� <br /> J yCCVMNM,4CONTM{;TOR MARMDNF&4 ITV ZN ST�TlUCEN6F� <br /> � flQ�l� ��s11�u.Jq"(�d�f`-��L"fD �I�I�" Ya�Thl A�& NE�8�1�51 AQCOlL1���lII�E' <br /> PLl1MEM04�1M11UK%10p MNLIID�NE6p C�N [Y, ` �,�a/ i'MOML ST�TELKlNSE• � <br /> }����1C�w� <br /> cnwm�ciwuuofw.xec�h�•� pp j �,,,� ���/�/ �ir�— <br /> � W 4�pu� �y <br /> pEqCRI�C WORN�MO SOUAIiE FOOTMIE M1VOlVkU C0YI11Ci PFRSON�NO PNCM!NU <br /> � _('i'v,r� }0 �a C��� r�s �Z6•K�51 <br /> � i HEREBY CERTtFY TH1T I MAVE REAO AND E%AMINEO THIS <br /> � rnon�e.nusc w eui�unu+ ��� APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL � <br /> i � PROVISIONS OF UWS AN�ORDINANCES GOVERNINp THIS 7YPE OF <br /> � teaµoescmrtronoF Pnorenir tsNa,vn etwwnn nrucN iwc+coPms WORK WILL BE COMPLET_D WITH WHETNER SPECIPIED HEREIN OR <br /> NOT. THE GHANTINO OF A �ERMIT DOES NOT PRESUME TO(iIVE <br /> ���-- a�ocn � - ov —_ � AUTHORITY TO VIOLATE OR CANCEL TME PROVISIONS OF ANV <br /> UTHER STATE OR LOCAL lAW NEGl1LATINO CONSTRUCTION OR THE <br /> '- PERFORMANCE OF CONSTRUCTIpN.THAT I AM AUTMORIIED 8Y THE <br /> � � � OW�1ER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICN <br /> � ' � APPLICATION IS MADE AND I C01.1FLY WITH TME STATE <br /> v.nctt ruc i.o.eamFn CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> �qM{fq�ICTqNLWNIFNOCR.ADUI2SST � '��I��nF�r ' , _ \ <br /> ,` 1' i _ l�� �,G A\ <br /> PRO�lCT AD011ESS � K !c�'�� �� ' V <br /> u���tr'ro.ti'.�ic�nvFn1 <br /> ��a� MECMAMCAL <br /> N0. TYiE OF fl1ITURi OR ITlM [ N0. iYPE OF EQUIPMENf FEE <br /> WATER CLOSET(TdLET) � PJC -NHNDLO UNITS—H.P. , <br /> �TMTUB _ FORCED AIR SV$TEM�B.T.U. M E.A. <br /> UVATpRV(WASH BASIN) UNIT HEATERS- B.T.U. M <br /> SFqWER CLOTNES DRYERS �; <br /> � NITCHEN SINK 6 DISP VENTILATION FqN <br /> DISHWASHER � RANDEHOOD '�— <br /> UUNDqV TRAV WATER HEATtR � <br /> CLOTHES WA5MER WOOD STOVE � ` <br /> _ URINAL ' METAL FIREPUCE�WOOD BURNING) 1 <br /> DRINKINa FOU�TAIN �� ; FIFEPLACE INSERT � � <br /> FLOOR DRAIN ' . . � HEAT PUMP ' - T— <br /> BACKFLOW PREVENTER5 �� OAS PIPING , <br /> ROOF OR�INS-•RAINLEAOERS EXHAUST FAN � <br /> K�SE ICE—BAfl,ETC.) � � � ' , <br /> ' - - r <br /> � <br /> • I <br /> _ <br /> SU TOTAL S ; SUBTOTAL 'i <br /> PER IT � S ' PERMIT S � <br /> TOTAL FEF S TOTAL FEE S — <br /> FOR OFFICE USE ONLY: <br /> •FOMT6FT9��K REAP9lTMCK SIDCGETp�CM eIPNCNtI:KYLMlER �EE flECEIViNcI <br /> ��RfMME �I1FF yAGA4T$Ift FEE$ VALUAiION FEE <br /> r VES I �I NO pUIL01NG <br /> IYI'[01fAWST O RTONiES am�suY� w'vmuw�a�wwx�it — — � <br /> ���� PI UMBING _.. .— i <br /> SRE01lL06. FIHFS INKLlIISACOT P� NI MECHANIC4L �l�� <br /> ��res i.. r�d _� <br /> OCGUMNCYLWD PinhMA Rf:O'D NFlf..Mlt, ON � AD�ITIONAI PIANCMECK <br /> � -�� <br /> _ OIN6R i <br /> Rt�50M . __ <br /> 'T <br /> � STATE tlUILD�NG SURCHARCE <br /> - S <br /> �NT�NElY CIANSAPPqpypDBY CITYOFEVEREIT PUBIICWOHKS � <br /> LOCAL SALES ' <br /> DATF TAX CODE IS 9105 ror►� <br />