Laserfiche WebLink
pPPLiCATIQ ' FOR CONSTRUCT("�N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> HEATING SYSTEM: J GAS U ELECTRIC 'J � <br /> BUILDING DEPARTMENT <br /> 259-8810 <br /> L� DEMOLITION I '. COMBINATION I ' BUILDING f 7 MECHANICAL ❑PLUMBING ; SIGN <br /> OYMER MNL 4D�BE55 CRY 21P PHONE <br /> `��2rncS 3Z1� SNo2E �V`z �f2fii b' Zo3 3 - � �o _ <br /> D � IAAtLAODRE$5 CIiY IP PHONE <br /> TGNRNT <br /> ARCHITEGTOFDESIGNER �.�/��/DDFESS CITV 2iP PHONE <br /> GENE/Rj�/,ONTRALTOR <br /> 'IAILPDORESS GIT1' 2m PIIONC STATELICE1i5[• <br /> `_ /���� ��iy Zip PHONE STATE LICENSC <br /> MECMANICPLCONTRACTOR MAILADORESS <br /> PLUMBING GJNTRACTOR <br /> MAILAODRESS CITV 21P PHONE STATEIICENSE� <br /> CONTRPLT PPICE OF WORK <br /> OESCRIBEWOR✓�A� JSO��REFOOT/GE�NVOIE� ^ CONiAGTPERSOYAIJDPHDNENO q'`�£ _����_Q�,(IT <br /> �_ D ' U�- 1 <br /> �'�4.SI,4M.� `n"�'R , <br /> ���� _ Lx�¢y.�' �o oJ£ 2t — <br /> NI�. � S � 4iylC.Q �v I HEREBY CEF-IFY THAT I HAVE READ AND EXAMINED THIS <br /> PROPOSED USE OFBWLDING APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> PROVISIONS OF LAWS AND ORDINANCES GOVLFNING THIS NPE OF <br /> LEGAL�ESCRIPTIOYOFPROPERTV�SHOWNBELOIYORATTACHiWOGOPI[5) WORK WILL BE COMPLETED WITH WHETHER SPEGFIED HEREIN OR <br /> NOT. THF CiRANTING OF A PERMIT 6UES NOT PRESUME TO GIVE <br /> ipT BLOCH oF AUTHORITY TO VIOIATE OH f ANCEL THG PROVISIONS OF ANY <br /> OTHER STATE OR I.00AL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSIHUCTIOIJ.THAT I AM AU?HORV_ED RV THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICN <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> enncE�inx i.o.NUMeer+ CONTRACTORS LAW 18.27 RCW AND 296200 WAC. <br /> CONSTRUCTION LOAN LENUER.ADDRESS.7ELEPHONE NlIMBER �I \� �_ '� O-I <br /> l\ I �} <br /> � � O�IC <br /> PROJECT ADDRESS sicrvnnnc <br /> 3z�s � �� — �,,.a�s,��ss�,«„«,�� <br /> PLUMBING MECMANICAL <br /> N0. TYPE OF FI%TURE OR ITEM FEE NO. TVPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) A�C—A�HNDLG UNITS—H�P� -- <br /> BATHTUB FORCED AIR SYSTEMS—B.T.U. M E.A. _ <br /> LAVATORY(WASH BASIPJ) UNIT HEATERS—B.T.U. M __ <br /> SHOWER CLOTHESDRYERS <br /> KITCHEN SINK 8 DISP VENTILATION FAN <br /> DISHWASHER RANGE HOOD <br /> LAUNDRYTRAV WATER HEATER <br /> CI.OTHES WASHER _ WOOD STOVE ---r— <br /> URINAL METAL FIREPLACE(N'C10�BURNING) <br /> DRINKING FOUNTAIN FIREPLACE INSERT ' <br /> FLOOR DRAIN HEAT PUMP � <br /> BACKFLOW PREVENTERS GAS PIPING <br /> ROOF DRAINS—RAINLEADERS EXHAUST FAN <br /> SINK(SERVICE—BAfi,ETC.) <br /> i <br /> SUBTOTAL 5 <br /> SUB TOTAL 5 pERMIT 5 � <br /> PERMIT S — 70TAL FEE $ �— <br /> TOTAL FEE 5 <br /> FOR OFFICE USE ONLY: FEE RECEIPT NO. <br /> FRONTSETBALK PE�RSETBr1C6 51�[SET9�CK P����CHiC�! JpM�ER <br /> /T � <br /> WEZONE LOTAREA VACANTSITE / 1 ^/' <br /> FEES VALUATION FEE <br /> . _ YES � � N� pUILDING I OU _�� <br /> 71:�OF CONSi. NO OF Si0RIE5 occurebc+ uo o`nv.lm'+G uart5 � <br /> , s=our PLUMBING � <br /> SIZEOFtiiDG FIRESPRINKLERSREO'D BASEMENi MECHANICAL <br /> YES NO <br /> FiREn�AaMRWD N[IGNTunnintiorv �DDI110NALPLANCHECK <br /> OCCUPANCVLO�D — <br /> 01HER � <br /> REPSON �TATE BUILDING SURCHARGE � <br /> INiANEDY PLRNSAPPRW[DI1V CITYOFEVEREIT PU�LICWORKS � <br /> LOCAL SALES -- ���J <br /> oA,E TAX CODE IS 3105 TO1AL =� <br />