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pppLIG..TION FOR CONSTR�CTION <br /> PERMIT <br /> ,•,..,�,, <br /> fbe Eve�9rrn� <br /> iiVC� � <br /> everett <br /> �UILDWG DEPARTMENT <br /> y ���+tJ � 259�Beto TO BE COMPLETEO IN INK— PLEASE PRINT <br /> O S :C rn�ii�ooaEss ��rr ii> v«u�a — <br /> cm++�a <br /> ,lohn Robinett 1001 P!. Broadway Everett 9II201 252-25 _ <br /> yy y _ urv —z�r vHor+E <br /> �['� � � "[tiANt MPII POORC55 <br /> y ~ MMLAD�P[55 G11Y ZiP PNOME <br /> �(i y A� pq[HREGTOHOESIONEA <br /> y y�E f.WLM�PESB GTv Zio PMOHE LICEXeE• <br /> GENEMLCANTNI�LTOR <br /> D.G. 8randvold 53C17 139th Avenue S.E. Snohomish 98290 568-9342 <br /> Z � �{Y ZIP VNpNE IIRNSEI <br /> MECNhNIGILONTRAGipR MML�'JDPE3$ <br /> O� d <br /> OTY 2�P PMOMC 16EN5E� <br /> � � C �n�UMB�N6CANiRFGTOA M�IL�DOPESS ' <br /> �• � Robinson Plumbina,Inc 607 SE Everett Mall Way E'.prett 98208 355-6171 ROBINP*272C2 <br /> F"� cuss Dr wonk <br /> Z M <br /> � y �] NEW ❑ AODITION ❑ ALTERAiION ❑ REPRIR ❑ DEMOLITION ❑ WOODSTOVE/FRPLINSEtiT BU�LD�N6REIOCATION <br /> �pry}��t p[q50H�NO PNONE Np <br /> �..� y i�rypHTIMPFWEMEMORINICCF�rO�AAEMDUELONLY <br /> �jvy5 yN CANTRAGIPRIGEOlWOAK DL04�.�0 <br /> ll rJV� OESCRI9EWOAN�NDSOt1�REi00TKsE�NYOLVEO <br /> �c� � plumbing <br /> vaOPOSE�USE O/BNLDiNO �NEREBY CERTIFV THAT I HAVE READ AND E%AMINED THiS APPUCATION AND <br /> 1j CA KNOW THE SANE TO BE TPUE AND CORRECt.ALL PROV�S�ONS OF LAWS AND <br /> y � N office OROINANCESGOVERNINGTHISIYPLOFWORKINILLBECO�APLETEDH'ITH <br /> L[GALDESLN�Pf�ONOfPROVEA1Y15HOWMBELOWOA�TTkHFO11NGOAES) WNETHERSPE�IFIEDHEREINORNOT.THEGRANTINGOPAPEAIdITDO[SNOT <br /> PRESU�.�E TO�iIVE AUTHORITY TO VIOLATE OR CANGLL THE VROVISIONS OF <br /> . — B�� pf pNYOTHER5IAT[ORLOCALLAWR[�ULATINGCONSTRUC710NORTHEPER- <br /> 7N�ISPROPERN OP[RFORMIHEWOFK'FORWMOHAPPLC TEON�SEJIhD[ <br /> AND I COMPLV WITH iHE STATE CONTRACTORS LAW 1827 RCW AND <br /> --� 286200 WAG. <br /> SIGNATUREOF�ONiRnCTStiOGnUL�Oa'1E�A�iEN1 UA1E <br /> _ X � ��� <br /> 7-�0- � y <br /> �ry�r���Q ApDHE55 aPP�iGSNiS 1 V BO9�+E55 U,lNSE NO�NO�115iNES5 N>ME <br /> 1831 Colb AvEnue <br /> MECHANICAL <br /> PLUMBING FEE <br /> /` Np, TYPE OF FI%NRE OR ITEM FEE NO. TYPE OF EOUIPMENT <br /> I ��l 2 WqTERCLOSETITOILETI 10 00 NG—WHN�lGUN1TS—HP. — — <br /> BATHTUB FORCED AIR SVSTEMS—B.T.U. M EA <br /> j z LAVAIORVIWASHBASIN� UNITHEAT[RS—BT.U. M <br /> 1 I _ SHOWEP � CLOTHESDAYEBS -- <br /> �_ � KITCHEN SINKB DISP. VENTILATION FAN — <br /> _I DISHWASMER RANGE NOOD <br /> WATER NEATER u— <br /> �, LAUNDRV TRAV µ/ppD STOVE — <br /> CLOTHES WASHER <br /> � METAL FIR[PLACEB CHIMNEY <br /> URINAL <br /> FIREPLACEINSERT — <br /> I �_� DFiNKING FOUNTAM _ <br /> NEAT PUMP <br /> FLOOR DPAIN <br /> BACKFIOW PREVENTEPS GAS PIPING <br /> ROOF DRAINS—RAIWLEADEF3 E%NAUST FAN <br /> Iw <br /> +1 ' SWH�SERVICE—BAR.EiQ) — _ <br /> � <br /> i + --_ <br /> �1� fi 5� <br /> � SUBTOTAL S Z5 OO SUBTOTAL S _ <br /> � PERMIT S PERIdIT S �5 OO _ <br /> 1 TOTALFEc 5 ZS QO TOTALFEE 5 z� 5n <br /> ��1�' FqpN15ETB�CK OCPRSEiBACK SI�ESCiBPCN <br /> PUHCXELMNUMBER fEE NECEIFfNO. <br /> � wcer�is�*E FEE8 VALUATION FEE <br /> VSEZOxE ��T�A� ❑YES ❑NO <br /> BUILDING — <br /> TYFEOFCONST. OCCUPRMGYOMJUP NOOFf1'NELLINOUNIIS <br /> pL�owABLE/PGTUAL PW MBINO <br /> s¢eove�oa. noo�sTonres esYT. a��o"� MECHANICAL <br /> ❑N <br /> HEIONTLIMITIRION OTHER <br /> FIPEBPFINNLFRSREOl11REU CI VES ❑NO S?AT[9UILDINO SURCHARGE <br /> STATEENERGVSURCHARGE <br /> /.PMIC6TION�GGBV �UNS�PPR9Y PUBLICWORKS <br /> TOTAL <br />