Laserfiche WebLink
��;�: <br /> r <br /> APPLICA�IC � FOR COWSTRUCT�-1N PERMIT ���� --- <br /> - TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> -------- <br /> - ---- -- <br /> � HEATWG SYSTEM: U GAS U ELECTRIC �J ___- ___ __ —___ <br /> _I <br /> BUILDING DEPARTMENT — <br /> 259-8810 <br /> , Li DEMOLITION I � COMBINATION BUILDING XMECHANICAL I PLUMBING I SIGN <br /> OLVN^ER Q / MMLADORF.55 CIiY �./� 1',.' PHONF <br /> .. c��C�.�1".d_.a�Lerr �t0o(o�2.���r S�E.E�<rL�1,G1i�Af'za,� 3s3-6'5�7� <br /> r HavT �.�na nooabss crtv zia aHone <br /> ARCHIIEri��pE51GNER IdAILADURE55 CitV Z? PMO4E <br /> �--I GJrERALCORTiL.CTOR M'iIAD�RE55 C�iY ZIP PHONE STATEUCENSEa <br /> ��� <br /> A�� n1LC I+IGPLGONTRAGTOR IAAILA�DRE55 CILY ZIP PHO\'F. ST�TELICENSE> <br /> >H v~i ��;_:,".,, <br /> xy PLUl.IBiNGCONTRACIOR MAItA�OPE55 C��t�� bP �'�!011E SThTEUCENSEa <br /> y z t�-i <br /> �! f] cor�ranc*raicE o�wcaK <br /> �� H'.V �(�'��.7� � <br /> � ~� �ESCRiBEWORH/NOSOUAREPOOTAGEINVOWE� W�IiACTPEP50NANDPHONEIIp. I <br /> HN H I <br /> xp Gowv��.f E/K Fwatc �ti fo Cr�ts --— � <br /> � HC <br /> � �g i HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS �', <br /> y'�� ("� PROPOS[DUSE OF OURDiNG n APFLICATION AND KNOIN TH[SAME TO BE TRUE AND CORREGT.ALL ! <br /> ,SFK+ PROVISICP:S OF LA:VS A'dD OFiDI1JANCES GOVERN�NG THIS TYPE OF ' <br /> 9 H� i.Ean�oESCaionor+oFrucPer+rv�;no•:r�o[ic'rvoaaTrncHTwocaaies WGRK VJILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR I <br /> t� NOT THE GRANTING OF A PERh1R DOES NOT PRESUME TO GIVE '� <br /> �"i H �or °�ocr. --- cr� AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF AN� i <br /> g �' <br /> �--� OTHE9 STATE OR LOCAL LAVJ REGULATING CONSTRUCTIGN OR'rIE <br /> C� C7� — PERFOR�.1ANCE OF CONSTRUCTION.THAT I AM AUTHORIZED F�'THE <br /> ��+ OWNER OF THIS PROPERTV TO PERFORM THE WORK FOh: WHICR <br /> Lz1 -- APPLICATION IS h1ADE AND I COtdPLY WITH THE STATE �, <br /> y �� PnecE�*Rx i o r�u�noea COIlTRACTORS LANJ 1827 RCW AND 29520�WAC. �� <br /> ' cowsmucnou�onc�eu�ee.nooeess.*e�erHouenur.ieer� ��/ �/ / �. _ ' <br /> —__.__—_—___— _ �JtL S:F.��-/-„�� — 1'� <br /> �-i-% �_ <br /> PflOJECT A FiESS _� /� � — _ _____ _ �_ c�i� . <br /> •,�, � Ey� ��, � <br /> PLUMBING �dECHANICAL . <br /> �"}��t�`.,; N0. TVPE OF FIXTl1RE OR�TEM PEE NO. TVPE OF EOUIPMENT FEE <br /> ;� _ VJATER CLOSET(TOILET� _ —__ -__�__ _ _�.�-A�NNOLG UNIiS-H.P. — <br /> BAiHTUB � FOFCED AIR SVSTEMS-B.T.U. M EA. <br /> - LAVATORYIWASHBASINI UNI7HEATERS_B.TU. M <br /> . SHOWER CLOTHES ORYERS <br /> r� _ KITCHEN SINK&DISP � VENTILI.TION FAN <br /> �—__ --- <br /> �� DISHWASHER RANCE HOOD <br /> LAUNDRY TRA� ' � WATER HEATER <br /> _�_—_ —_— <br /> CLOTHES WASHER WOODSTOVE .�_ <br /> �� URINAL _ _. METAL FIREPLACE�WOOG BUHNING) i <br />� GFINKWG FOUNTAIN _ _ FIflEPLACE INSERT ___T_ <br /> FLOOR ORAIN � hIEAT PUMP __ <br /> � BACKFLOW PREVENTERS GAS PIPING <br /> � � [XHAUSTFAN <br /> �'� ROOFDRAINS-RAWLEADERS . ___ _ — , <br /> SINK(SERVICE-BAR,ETGI __ _. _ __ ��, <br /> �1�� - -- _ ---- <br /> _ --- - - ------;- <br /> '� SUB TOTAL S SU�TOTAL S <br /> �'� PERMIT $ �� —�-_ �_. .. -_-_..__. PGRMIT S —_— _ <br /> — —_—_—____ . ._�—.___ .._ -� <br /> TOTALFFE 5 TOTALFEE S � <br /> - FOR OFFICE USE ONLY: <br /> --- ,-- _ __ _ <br /> FRONTSEipAGN REFRSEi��GH �� IDLtif_IpACn � 1'LAI:O�'CCKh'J '!lLH !EE N[CEIPTNO <br /> ��'�y/:i_ <br /> � i.� <br /> usezoue w�nne:. vnr,n�rtsn[ FEES VALUATION FEE <br /> --�- <br /> . YES . NO Oui�uwG � <br /> � ____.- _ __—..- _._. __.___ __ ' _ <br /> tVPEOfGONSi ��OOFSiOPIES ncrur.sr � ..uorsrv.�s -- - � <br /> uso�,� pW67f3MG <br /> SRFOFOLOG. FIHteMMH�riLCltOft[C'� OASEMENT ry�ECHANICAL <br /> � �. VES : �. NO --- ----- <br /> OCLUPAIlCYLOAD FlREALAR61RE0� HEIGHiLIIAR�TICN �D�ITIONALPLANCHECH <br /> OTHEF <br /> —_ —_—'__— ___—_ --r— <br /> fiEA50N <br />' STATF BWLOWG SURCIInHGE <br /> ir�rnKeov � ���nr�snrreov�onv CITYOFEVEREII' pUourWORKS '� <br /> LOCAL SI1LE5 <br /> �,,,F_ � TAX COOE IS 3105 TaT^� ,;__ <br />