Laserfiche WebLink
APPLICATIOrI FOR CONSTRUCT1�.iN PERMIT <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT � <br />BUILDING DEPARTMENT hEATING SYSTEM: �'GAS O ELECTRIC ❑ <br />259-8810 ' <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />ONMER W1ILMDRESS CITV ZIP P110NE <br />7bf�+- GAR[So.✓ �ir t S2�-'�4t. sw E� 9�103 35� �a.s�1 <br />TENMIT MAILAODRE+S C17V ZIP PHONE <br />�fiCHITECTqiDESIGNER MAILADORE55 <br />CITv 21P PHONE <br />GENEflALCONTRACTOR MAILADOPESS CITY ZIP PXONE ST�iELICENSE� <br />MECHANIC�LCONTIiACTOq MAILADDPESS C1TV ZIP PMONE STATEt�CENSE/ <br />6�i_ S�S//EYli,s7.1�L /!✓/E, ,I�9R//.rEr/.t�✓Gts!'. Ei; 9?l3a r 25=�.7//ri _FUB16S32/�Ei <br />PLUMBINOCONTMCTOii MAILADUflESS CITY 21P PHONE STATELICENSEI <br />CONTiUCT PRICE OF VYONK <br />�z 6�s —=' <br />DESCf11BE M/ORK ANO 3tw.'�flE FODT. <br />USE OF BUILDMlG <br />LEGAL DESCRIPTION OF PROPEHTY (SHOWN BELOW Ofl ATTACN TWO COPIES� <br />LOT BLOCK OF <br />PAflCEL TN( I.D. NUAIBEfl <br />CONSTRUCTIONLOANLENDEfl.A00RE5S,TELEVMONENI <br />PRQIECTADDRESS <br />�//z Si � GR-' • S, cli_ <br />PLUNBINO <br />N0. TVPE OF FlXTUNE OR ITEM <br />WATER CLOSET (TOILE� <br />BATHTUB <br />UVATORY (WASH BASIN) <br />SHOWER <br />� KITCHEN SINK 8 DISP <br />DISHWASHER <br />" UIUNDRY TRAV <br />CLOTHES WASHER <br />URINAL <br />� �, DRINKING FOUNTAIN <br />FLOOR DRAItJ <br />� : BACKFLOW PREVENTERS <br />FOR OFFICE USE ONLY: <br />FRONTSETB�CK NEAR: <br />USE ZONE <br />TYPE Of �ON$T. <br />SIZE OF BLDG. <br />OCCUPANCYIOAD <br />PERMIT <br />TOTALFEE <br />fIRE SPRINKLEflS REO'D <br />FIflE <br />PUNS �PPflOVED BY <br />OA7E <br />CONTACT PEHSON AND PMONE <br />I HEFEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO 6E TRUE AND CORRECT. ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CON�TAUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WOfiK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW 1827 flCW AND 296200 WAC. <br />Y �>'��.� ��� � ��- qs� <br />Sp�1�q� pATE <br />TYPE OF E�UIPMENT FEE <br />JDLCa UNIT�Ii.P. ,� ��.s _—�— <br />UNIT HEATERS—B.T.U. M <br />CLOTHES DRYERS <br />RANGEHOOD <br />WATER HEATE <br />METAL <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SIDESETBACK PUwcnt n <br />I <br />v�curr s�Te F <br />❑ YES ❑ NO BUILDING <br />OCL�MXCY Iq.OiDWEL4MGUX1i5 <br />�� PLUMBING <br />BASEMENT <br />❑ YES ❑ NO <br />MEIGHT LIMITATION <br />CITY OF EYENETf <br />LOCALSALES <br />TAX CODE IS 3105 <br />MECHANICAL _ <br />AODITIONAL PLAN CHECK <br />OTHER <br />STATE BUILDING 5;.� �CNARGE <br />PUBLIC WORKS <br />TOTAL <br />SUB TOTAL <br />PERM�T <br />TOTALfEE <br />FEE � RECEIPTNO. <br />H <br />�N <br />A <br />� <br />�u <br />X <br />� <br />q <br />r <br />