Laserfiche WebLink
APPLICATIQ ] FOR CONSTRUCT )N P�RMIT �� <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> BUILDING DEPARTMENT HEATING SYSTEM: iJ GAS U ELEC7RIC U_ � <br /> 259�8810 <br /> I 1 DEMOLITION f i COMBINATION '. � BUILDING '� !MErHANICAL I-;PLUMBING �. I SIGN <br /> o�'"re u�aMoacSs arv n� r�wrve <br /> h�4 rr %ho!/n�on �.'���:�_L1U/ 2�S- /��� <br /> rervu�*.� uu�noon[s an zin cHcr�e <br /> ANb111ECi0fl0[SiGNER IA�AAPDPEuS GI1Y ZIP V�qHE <br /> GENEFAGON1PPLi0R M/AILAOOPE55 LIiV 11� PMON[ SIAIELICENS[• <br /> '!�. C C'Y[.C/l✓-. 251. �)$-U <br /> MECIUNqµ+FI1FFGiOP �IhNA�DNE55 L�1V ZIP PIKKlE GiR1FlICFN54• <br /> PWMBiNGCCN1F1Gt011 M�ILA0011ESS CIiY ZiP FNONE Sil.l[UCENSE/ <br /> PrE..� t,�, %z A.�� n 5���,� . l�zY� ses.. . zJ �.eT-sP/- izs�n <br /> cw+ie�r,r vni_e ov waeK <br /> � '`'j UU ..> _ <br /> oEscnieEwonx�r�osai�nFrnarnccwvavco coxr�crvcnwr��o �d��z s�� �/Z�7 <br /> /'/ �. c — <br /> I HEREBY CERTIFV THAi' I HAVE READ AND EXAMINED THIS <br /> ar+oPoSEouse W ourt�m�c/ APPLICATION AIJD KNOW THE SAME TO 9E iRUE AND CORRECT.ALL <br /> n.,�/ /e � PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPEOF <br /> iee+�oesrniorrorio r4 nocCn r�seowrvee�owonnruartwowPiesi WORK WhL�E COMPLETED WITH WHETHF.H SPECIFIED HEREIN OR <br /> NOT TME GFANTING OF A PEFMI(ODES NOT PFESUME TO GIVE <br /> �or e�otrc Oc -- AUTHORITV i0 VIOLATE OF CANCEL iNE PFOVISIONS OF ANY <br /> OTHER S1ATE OR LOCAL LAW flEGULATING CONSTRUCTION OR 1HE <br /> - PEBFORMANCE OF CONSTRUCTION.TMAT I AM AUTHORRE�BY 1ML <br /> OWNER Of THIS PROP[RTV TO PERFORM THE WORK FOR WHICH <br /> — APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> vnncurex io rvuMeea CONTRACTOHS LAW 1027 flCW,WD 296200 WAC <br /> CCNSIPJLt10�ILO�NLRIDEP.A��RE55JElEPMONEIINA(IFP <br /> — x %���-� Ltic�c �-2-5�— <br /> PROJECTADDPESS ^ti f-/j �� ' _ <br /> � L mn no��.�- — _ <br /> PLUMBING MECHANICAL <br /> NO. 1YPE OF FI%TUNE OH ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> 2 WATEFCLOSET�TOILET) a'C—��HNDLGl1NITS—H.P <br /> ? BATHTpB FORCEDAIFSYSTEMS—B.TU. IA EA. <br /> 'Z LAb'ATORV�WASFI6ASIN) UNITHEATEflS—BT.U. M <br /> SHOWER CLOTMESORYERS _ <br /> Z KITCHEN SINK fl DISP VENiILAiION FAN _ <br /> DISHWASNER FANGE HO00 <br /> LAONDRYiHAY '7 WAiEPHEATER <br /> CLOiHES WASHER WOO�STOV[ <br /> UfiINAI h1ETAL FIREPLACE(WOOD BURNING) <br /> ORINKING FOUNiAM FlHEPLACEINSEflT <br /> PLOOROFAIN MEATPUMP _ <br /> BACKFIOW PAEVENTERS GAS PIPING <br /> ROOF DRAINS—RAINLEAOERS E%H�UST PAN <br /> SVIK�SERVICE—BAR,ETC.) _ <br /> —�— <br /> � SUBTOTAL 5 (r3 , SUBiO�AL 5 �. <br /> PERMIi S ]p PERMIT S _ <br /> TOTAL FEE S �3 � TOTAL FEE 5 <br /> FOR OFFICE USE ONLY: <br /> lPONiSEtB<CN PEPFSELBhGR SI�ESLIOACN �lA4CHEC8NlIM0EP iEE FEL[�PLf10 <br /> ���� � <br /> usenirie wtnaen vacnvrsrte FEES VALUpTION FEE <br /> ' YES �. NO BUILDING <br /> iYGfO{COHS� lpOFSiOWES ttn��Y. 4UIXVM:WVWnS ' <br /> 1 <br /> �""" PLUMBING <br /> SREO:BLDG RN[S�FiNxL[FSFCO� Be5E4EN1 MECNANICAL � <br /> -�. YES �.:i NO — <br /> CCCUPANGYl0A0 iIPFAUPMfiEOO NLIGHLIIMIiI.ilq! AI)OITiONRLPLINCH[CK <br /> _ OTHCR <br /> IIE�SON —� <br /> STATE OWLOiNG SUFLHAPGE <br /> 141/.G[BT �LANSRPPPOVCOBV �'ITMQFEVEflETT pU�LICWORNS <br /> LOCRL SALES <br /> o.re TAX COUE IS 3105 TOTA� ' � <br />