Laserfiche WebLink
� <br />APPL�vATI� FOR CONSTRUCT�N PERMIT � <br />TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br />BUILDING DEPARTMENT � <br />259-8810 <br />❑ DEMOLITION ❑ COMBINATION <br />TENANT <br />ARCHITECT OR DESIGNER <br />MAII <br />2� <br />MAIL AUDRESS <br />HEATING SYSTEM: � <br />❑ BUILDING <br />CI7/ <br />CITV <br />CITY <br />❑ ELECTRIC f] <br />IgMECHANICAL <br />ZIP PMONE <br />ZIP <br />• �'j,�r�15� 'r'7f�tl NCi"✓h��l� �i <br />S SI � 1- cm . ziv <br />�A��ty�i.lj�1'p�ri�.�sJ w.f <br />CONTRACT PRICE OF WCRK <br />DESCflIBE WORK AND SOUpqE FOOi�GE INVOLVED <br />PROPOSED USE OF BUILDING <br />LEGQ UESCRIPTiON OF PROPERTV (SHOWN BELOW OR ATTACH 7VJ0 COPIES) <br />LOT BLGCN OF <br />Lot � b� S'7Rta1�� n� N� �� <br />?APCEL �AX I.D. Nl1MBEF <br />CONSTRUCTION LOAN LENDER. ADDRESS. TELEPHONE NUMBER <br />' d'!U/ <br />; PLUMBING <br />; NO. TYPE OF flXTURE <br />� WATER CLOSET (TOILET) <br />; BATHTUB <br />� LAVATORY (WASH BASI�';) <br />" SHOWER <br />� <br />� KITCHEN SINK & DISP <br />1 - DISHWASHER <br />� LAUNDRYTRAY <br />� CLOTHES WASHER — <br />URINAL <br />. DRINKING FOUNTAIN <br />' FLOOR DRAIN <br />' BACKFLOW PREVENTERS <br />Fi00F DRAtNS—RAWLEA[ <br />u� � ��: <br />OR REM <br />PERMIT <br />TOTAL F <br />FOR OFFICE USE ONLY: <br />� FRONTSETBACN REARSETBACN <br />USEZONE LOi�REA <br />SIDE <br />CONTACT PERSON AND PHONE NO. <br />PNONE <br />PHONE <br />PHONE <br />❑ PLUMBING ❑ SIGN <br />uba -b • RacEPco'�`7« <br />PHONE STRTE LICENSE / <br />> 5 -59Y i ca. , <br />PHONE SiATELICENSEM <br />I HEREBY CERTI'rY 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 TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT �OES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE Ofl CANCEL THE PROVISIONS OF ANY <br />OTHER STATE OR LOCAL U+W REGULATING CONSTiiUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED 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 l ,1827J�CW AND 296200 WAC. <br />� <br />A/C—A/HNDLG UNIT�H.P. <br />FORCED AIR SYSTEMS—B.T.U. <br />UNIT HEATERS--B.T.U. M <br />CLOTHES DRYE9S <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METAL FIREPLACE (WOOD BUF <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />PLANCHECNNUMBER I FEE <br />❑ YES � NO BUILDING <br />TYPEOFLONST. NO.OFS70FiE5 acurlucr xoa.rx[uiqeuxrts <br />REASON <br />INTAKE BV <br />�aWP PLUMBING <br />FIRE SPflINKLEflS RE�'D BASEMENT MECHANICAL <br />❑ YES ❑ NO <br />FIFEALAqMREOD HEIGHTIIMITATION ADDITIONALPLANCHECK <br />OTHER <br />STATE BUILDING SURCHARGE <br />PU1NS APPflOVEO BY CITY OF EYEREIT PUBLIC WORKS <br />LOCAL SALES <br />DATE TAX CODE IS 3105 TOTAL <br />PERMIT $ <br />TOTAL FEE $ <br />FEE <br />YX <br />n <br />� <br />uy <br />H <br />