Laserfiche WebLink
APPLICATIC I FOR CONSTRUCY )N PERMIT <br />TO BE COMPLETED IN BLACK INK —PLEASE PRINT - <br />BUILDING DEPARTMENT L HEATING SYSTEM: k{ GAS UELECTRIC U _ <br />2598810 <br />DEMOLITION COMBINATION ❑ BUILDING I MECHANICAL I'OLUMBING SIGN <br />fNMfH MAC ADCPI <br />,UA 18�1 19N'DR. fIlLIA1411e�11A., q?'n ago.lys_� <br />ifKAxi ADUAEAs rm !I IyIpIX <br />W,rNMLCOlwlm MAA IEdIFu cIrv_� 71A NdE BfAif LCEN:I• <br />MfCIWNLN LOlIxAC'M <br />I <br />COIITR/Lr 0110E OF WdM <br />0lFtY1BE 1YdF1 AMp ADIMNE F(IDI/yM�'F MVSVED .�1_ , <br />CbRfir Of11H0N i1M RQNE NO <br />h <br />_4510 <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATKM AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL <br />PROVISIONS 0- LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HEPEIN 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 CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT 1 AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND 1 COMPLY WITH THE STATE <br />CONTRACTORS LAW I8.27 RCW AND 29620D WAC. <br />9�3I "9 3 <br />PIfDIosfD1IIL MWkam <br />5 FA <br />LFaM UfICMPIXwoI FKonAry ISIIDrm IfLOW MArtxHIWOfCP(II L <br />LOT aou OF <br />h (,qY�7� 11n1 <br />SdIS E.�-1f 4— <br />h <br />•11LFLiM ALAtlFB <br />D <br />L0118iMK110K�lENOFN. M[MIF64, RlEFHP1F KUNIfN <br />( 11 <br />.I^'I <br />n.tiwnir,w.� <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />No. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />NC-AMNDLG UNITS-H.P. <br />_ <br />BATHTUB <br />FORCED AIR SYSTEMS-B.T.U. M E.A. <br />LAVATORY (WASH BASIN) <br />UNIT HEATERS-8 T.U. M <br />SHOWER <br />_ <br />CLOTHES DRYERS <br />_ <br />KITCHEN SINK A DISP <br />VENTILATION FAN <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT <br />FLOOR DRAIN <br />HEAT PUMP <br />BACKFLOW PREVENTERS <br />GAS PIPING <br />ROOF DRMNS-MINLEAOERS <br />EXHAUST FAN <br />SINK (SERVICE -BAR. ETC I <br />T <br />SUBTOTAL { <br />SUBTOTAL E <br />PERMR E <br />PERMIT S <br />TOTAL FEE III <br />I <br />I TOTAL FEE $ <br />FOR OFFICE USE ONLY! <br />rmNT IFr0ACA <br />Alm [kI�K11 / <br />MINE , <br />RWLNFCkm,%* 7/ <br />'FE <br />NfCfV r�a <br />LorlNf'Gl(A�/� <br />VADMf✓tm <br />(1 YES f' NO <br />FEES)/ <br />VALUATION <br />FEE <br />W0.dNG <br />IKUMBINu <br />O <br />THE O(TMI <br />uF <br />IUD gITdI(6 <br />GTWLI I. AeeAluEvllF <br />7Z, <br />9uf of �I <br />_W��75S 35 r <br />OCCIIAM: LMD <br />AZe <br />FF! MIMIE� RFOD <br />FFII AIAAY KfoO <br />B1EfYENr / <br />[1 YES NT //NO <br />~1 LANTArj <br />MECHANICAL9D <br />.11, INAI PLANCHECK <br />.T <br />OTHER <br />�{� <br />AEAFOH <br />STATE BUADRXI SURCHARGE <br />MTAIE AF {{ <br />�I <br />W A �3 <br />FLAMF oBr CITY OF ERRETT <br />LOCAL SALES <br />arf TAX CODE IS 3105 <br />PIIBI K: "AS <br />TWAL <br />73 7 LID <br />