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`�:. , ��. <br /> .k;�. APPLI '`' TION FOR CONST�CTION <br /> :� PERMIT <br /> ENrymn everett <br /> OF , , � <br /> everett . . . : . <br /> ,+'BUILDINO DEPARTMENT <br /> 26B•BB10 TO BE COMPLETED IN INK—PLEASE PRINT <br /> EP MI1IL�DDPESS CIiY ZIP PHONE <br /> National IrvPctmants Coro 14200 N E 12th P1 6ellevue, Wa.98007 643-3576 <br /> TEN�NT MAIL��URE59 CITY 21P MONE <br /> MCNITECTOflDE91CJ1ER MAIL�DORE59 GITY ZIP PMONE <br /> OENEMLCANTR/�CfOR MNLAODRE53 CIIY ZIP VNONE 4CENSE• <br /> _Natiflndl invP�tmPnfi� Corn 74200 N F. 17th P1 , Ba1lev�e,WA 98007 643�576 <br /> MEpUNIC1ILCONTR/�CTOR M�ILA�pPE59 GtY ZIP FNONE 4CENBE• <br /> PLUMlINOCANTIULfOR M�ILAODRESS CITY ZIP PN�NE LICENSE• <br /> Robinson Plumbin9, Inc. 60i S.E. Everett Mall Way, E�erett, WA 98208 355-6171 ROBINP*272C2 <br /> CW/OF NORM <br /> � NEW ❑ ADDIiION ❑ ALTERATION ❑ REPAIR ❑ OEMOLITION ❑ WOODSTOVFJFRPLINSERT ❑ BUIIDINORELOCATON _ <br /> TENNIT IMPpOVEMENT OP INTERIDR NEMOOEL ONLY CAl1I�GT PERSON�ND PHONE N0. <br /> ca,rn.crrn�cEo�WOHK $62635.00 <br /> pEkq�gE Wppl(I1N080U�AEFOOTMEINVOWEO <br /> lumbin <br /> PIqP08ED UBE Oi BUILOINO I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION AND <br /> mo te 1 KNOW THE SAME TO BE TRUE AND CORRECT.ALL I'ROVISIONS OF LAWS AND <br /> LEO/�L OEBCRIPTION OF VPOPERtt�SHOWN BELOW OP ATT�LH FOUR COP�ESI ORDINANCES GOVERNING THIS 71'PE OF WORK W7LL BE COMPLETED WITH <br /> W HETHER SPECIFIED HEREIN OR KOT.THE G9ANTING OFA PERMIT DOE9 NOT <br /> PRESUME TO GIVE AUTHORIN TO VIOLATE OR CANCEL THE PROVISIONS OF <br /> loi B�OCK oF ANYOTHERSTATEORLOCALLAWREGULATINGCON5TRUCTIONOR7HEPER• <br /> FORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE OWNER OF I <br /> TH�S PPOPERiV TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE <br /> AND I COMPLY WIiH THE STATE CANTRACTORS LAW 1027 RCW AND <br /> 298.200 WAG <br /> SIONAiUPEOFCONiR�CT0110RAUiHORIZEDApENi DATE <br /> X � /O - 9-r'� <br /> AIOJECTMORE99 I '�� APPLIC� T C Y USINESS4CENSENO. BU91NE59N�ME <br /> �Broadway North <br /> PLUMl�N6 MECHANIGIL <br /> Np, TYPE�DF FI%T11RE OR ITEM FEE Nd. TYPE OF EOUIPMENT FEE <br /> 3 WATERCIOSET(TOILETI 65 00 A/C—A/HNDLGUNITS—H.P. <br /> BATMTUB FORCED AIR SYSTEMS—B.T.U. M EA <br /> LAVATORY(WASHBASIN) UNITHEATERS—B.T.U. M <br /> $HOWER CLOTHES DRVERS <br /> KITCHEN SINK 8 DISP. VENTILATION FAN <br /> DISHWASHER RANGEHO00 <br /> UUNDRYTRAY 2 WATER HEATEFl �3 <br /> CLOTHES WASHER WOOD STOVE <br /> URINAL METAL FIFiEPLACE 6 CHIMNEY <br /> ORINKINO FOUNTAIN FIREPLACEINSERT <br /> FLOOR DHAIN HEAT PUMP <br /> BACKFLOW PPEVENTERS 6A5 PIPING <br /> ROOF DFAINS—FiAINLEADERS ExHAUST FAN <br /> SINK�SERVICE—BAR,ETC.) <br /> SUBTOTAL s 890 00 SUBTOTAL S � <br /> PERMIT S PERMIT E ; <br /> TOTAL FEE S 7"OTAL FEE S 2 O i <br /> FRONTB:TBIIGR PEARBETB\CK SIOESETBRCK PIwNCNECKNUMBER FEE RECEIPfNO. ii <br /> U6EiONE tornri�� VAG�NTSITE FEES VALUATION FEE <br /> O YE9 O NO <br /> BUILDING <br /> 7ypEpfCON9T. OCCUPANG�OfiOUP NO.OFLM'ELL1NOlINIfB <br /> �uOweB�v�ciu�� PLUMBING <br /> lREOF9LOQ NO.OFBiORIE3 esMr. occ�oeo MECHANICAL � <br /> OY <br /> ON � <br /> HEIOHTLIMIT�TIAN OTHER <br /> FIREBPRINRIERSRE0U1PE0 OYEB ONO STATEBUII�INGSUFCHARGE � <br /> STATEENERGYSURCHARGE <br /> APPLIGQIONACGBY PlAN9APPRDY PUBLICWORKS <br /> TOTAL <br /> �..r......- -.—�..--�""��m1 •r. .r. . ...�._........... . n.�,. . �,.N..MMa/n...w.w.� <br /> . .--r... . .. . . . . . �l. . 1�. ��wt — - I <br />