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.910// <br /> APPLICATII..� FOR CONSTRUCI .ON PERM14 <br /> CITY OF EVERETT• BUILDING DIVISION � <br /> 3200 CEDAR STREET• EVERETT, WA 98201 • 259�8810 <br /> f 1 DEMOLITION f I COM8INATIOiV I I BUILDING I 1 MECHANICAL I 1 PLUMBING (I SIGN <br /> PROJECT ADDRESS <br /> 4618 Basewood Drive f <br /> owr�ER Mu��nonrss cirv nr rHo�+E <br /> IEN�Ni YRILADO�F.SS CILY )II• PIIONE <br /> �RCIIRECTORDESIGNEf1 M�IL�U�RESS Cliv ]IP P110NE <br /> 6ENEMLCONiR�CiOR MML�D�f1E55 CITY 71P PMONE StA1EUGENSE� <br /> �olin Construction P.O. Box y�l Mukilteo 98275 353-7076 <br /> MECIIANICMCONTR�CTOR MNLAD�RF.SS C17Y ZIP PIIONE STR7ELICENSE� <br /> PWMBINOCONTRACTO!i MnILA0DRE55 CITV ZIP PMONE Si�iFUCENSE/ <br /> Robineon Plumbi.ng,Inc. 607 SE Ew MallWay N26. 98208 355-6�.71 ROBINP*272C2 <br /> CONIRAC7 PRICE OF W01iR — <br /> $1725.00 NEATING SYSTEM: f l GAS I-1 ELECTRIC ❑ <br /> DESCRIBE WONN�NO SOUARF.F0pT�6E INVOIVED COVTRCi PEii50N�NO PNONE NO <br /> S�rinkler sys*am _ <br /> I HEF�EBV CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br /> PROPOSED USE OF BUILOINO APPLIC'ATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> SFR PROVIS�ONS OF LAWS AND ORJINANCES GOVERNIN6 THIS TYPE OF <br /> WORK VlIIL PE COMPLIED WITH WHETHER SPECIFIED HEHEIN OR <br /> LEQ�LDESCRIPTIQYOFPROPEHTY�SNOYM9ELOWOR�TfACH1WOGOPIES� NOT. THE GRANTINO OF A PERMIT DOES NOT PRESUME TO dIVE <br /> ior etocK oc AU7HORIl'V TO VIOLAT'c OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATINO CONSTPUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WH�CH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PMCEL TA%I.D.NUMBER CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> CONSTPUGTION LO�N LENDER.1100RE59.TElEP110NE NIIMBER x �ti �- 7- � <br /> 9GN�TU pRE <br /> CITY 9USINESS IICENSE NO <br /> PLUMBINO MECHANICAL <br /> NO. TVPE OF FlXTURE OR ITEM FEE NO. TYPE OF FU(TURE OR ITEM FEE <br /> WATER CLOSET(TOILF� � A/C—AMNDLa UNITS—H.P. � <br /> BATHTUB ' FORCEDAIHSVSTEMS—B.T.U. M E.A. ' <br /> � <br /> LAVATORV(WASH BASIN) � HEAT PUMP � <br /> SHOWER � UNIT HEATERS—0 T.U. M � <br /> KITCHEN SINK 8 DISP ; CLOTHES DRYERS ; <br /> OISHWASHER � VENTILATION FAN � <br /> LAUNDRYTRAV ; RANGEF100D ' <br /> CLOTHES WASHER WATER HEATEfi � <br /> URINAL � WOOD STOVE � <br /> _ ORINKINO FOUNTAIN i METAL FIREPLACE(WOOD BURNING) i <br /> FLOOR DRAIN � FIREPLACE INSERT(WOOD BURNING) � <br /> BACKFLOW PREVENTERS ; GAS fIREPLACE ; <br /> SINK(SEFVICE—BAR, ETC.) � OAS RANGE � <br /> GAS PiPINO ' <br /> � EXHAUST FAN i <br /> � i <br /> i � — <br /> SUB TOTAL E ' SUB TOTAL S ' <br /> PERMIT S � PERMIT S � <br /> TOTALFEE S � TOTALFEE S ' <br /> FOR OFFICE USE ONLY: <br /> FRONT SETBACK RE�R SEiBACK SIDE SETB�LK PUN CNF NIIMOf.P FEE RECEIPT NO. <br /> 7 (c1�0 „?l� //02 3 J� <br /> usezone toteRe� yALANi51TE FEES VALUATION FEE <br /> mes n r+o emiomc —� <br /> NEIOHTL�MIT�TION NO OFOWElUNO 5'ZEOFBIDGrtI � <br /> I/NITS <br /> PLUMBiNa � <br /> OCGQUPANCY Iq O�SIONES OCCUPANTlO�D B�'EMENI MECH�NIC�L <br /> f7YEE f1NO - -�— <br /> FIRE�URM REO'D REAS(k! AUDIIION�L PLAN CHEGK � <br /> urr,ea SPRINKLER (15 he de) 20 �00 <br /> FlRE SPRINI(LEO PEO'D REASON � <br /> SGTE BUILDING SURCMARGE j <br /> i <br /> T'PEOFCONST PUNS�PPRO�E�P.Y CRYOFEVERETT PUPIICWORNS I <br /> JM LOCAL SALES — �— <br /> uArF � q TAX CODE IS 3105 TOTAL 20 '00 <br />