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5929 EVERGREEN WAY CLARK DENTAL 2018-01-02 MF Import
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5929 EVERGREEN WAY CLARK DENTAL 2018-01-02 MF Import
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Last modified
2/2/2022 2:29:27 PM
Creation date
2/9/2017 10:02:29 PM
Metadata
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Address Document
Street Name
EVERGREEN WAY
Street Number
5929
Tenant Name
CLARK DENTAL
Imported From Microfiche
Yes
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APPLICATI& FOR CONSTRUCTON PERMIT�/C//���� T <br />CITY OF EVERETT E BUILDING DIVISION \ J <br />3200 CEDAR STREET • EVERETT. WA 98201 . (425) 257-8810 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING MECHANICAL Cl PLUMBING ❑ SIGN <br />PROJECTADDRESS: .sgll &VEFGREEN VY <br />6WN[I1 Yb b.ESS GF'f PP PMDN! <br />RIcH k, Rog wo Mill F1tg ggeew wv 6U&FIT 78703 <br />IENWI 4N AXXXESS MTV m PNONf <br />•IILNTE(iE O11 DE$idrtR 4 IDOPf55 VII III IYN}( <br />"WrImL CMNTRb10T MAX APp1E55 CNY Im %PYR STATE ICENSFF <br />WE EN 4MO TnSC10P MFn Ef SS pTY Im %KNf SIFIF IC[MSE• <br />F1Fk1T I\L0.aF1VA1_ 44345151901aL AIL- A6f_kTJD 9B052 yes-�es•9uti A 4TMl 3��'% <br />%INpIM CONIPIf.IDP MAE b S5 PTT DP nNyR S1Nf IC[NSf <br />cdF11T.c1 PI.`L 2wd�Pi r. 0 <br />HEATING SYSTEM: ❑ GAS ELECTRIC ❑ <br />EESC F W.YYt ANO SW-Z FW EEIWI D <br />1 <br />MAW IgF150441P PNDr.S Np <br />�92 <br />I HEREBY CEA7IFY THAT 1 HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORPECT ALL <br />PROVISIONS OF LAWS AND ORDIN.•NCES GOVERNING THIS TYPE OF <br />WORK Will BE COMPLIED PATH WHETHER SPECIFIED HEREIN OR <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONI RACTORS LAW 1627 RCW AND 296200 WAC <br />,;-`,15,1 �F/ /� /, <br />l <br />all33 // % -1 �1 <br />OI ; <br />ZTv AUSIIASS IF.FNSE NO <br />omros[o lnE d mn dNn �N <br />LEa4 EESC IN NM% -TV 14TDFIM MIMN w pTKNTwD C ESI <br />LOT m(XA d <br />pi asF SFL 0 R <br />Pwl:[l TAXI FH A <br />(7l0ddOS/ pOCo OO;J� <br />Cd5rf111CrION 1a IfNCEP ESS TEIf%IdT[ NI1FImR <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR REM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />AIC—AfHNDLG UNITS <br />BATHTUB <br />FORCED AIR SYSTEMS <br />_ <br />LAVATORY (WASH BASIN) <br />HEAT PUMP <br />SHOWER <br />UNIT HEATERS <br />KITCHEN SINK A DISP <br />CLOTHES DRYERS <br />DISHWASHER <br />RANGE HOOD <br />LAUNDRY TRAY <br />WATER HEATER <br />CLOTHES WASHER <br />WOOD STOVE <br />URINAL <br />METAL FIREPLACE (WOOD BURNING) <br />DRINKING FOUNTAIN <br />FIREPLACE INSERT (WOOD BURNING) <br />FLOOR DRAIN <br />GAS FIREPLACE <br />BACKFLOW PREVENTERS <br />GAS RANGE <br />SINK (SERVICE — BAR. ETC.) <br />GAS PIPING <br />EXHAUST FAN <br />+_ <br />SUBTOTAL S <br />SUBTOTAL $ <br />PERMIT $ <br />PERMIT Sao <br />r <br />TOTAL FEE S <br />TOTAL FEE 5 <br />FOR OFFICE USE ONLY: <br />FIYWI SFTAACm <br />Wb SEEM. <br />VIE[SE 1W. <br />M. CriECN NUWTP <br />III <br />PFCfR'IIq <br />MSf IONF <br />11(ICNI IiN1AlKY1 <br />QCCtFAK,� Fln •u <br />INE 51AnIwlfP M oD <br />I Wf 4APM PLOD <br />I'mm Cd l <br />for APTA <br />v4ANr VIE <br />DIES D MI <br />FEES <br />VALUATION <br />FEE <br />— <br />--------------- <br />PrE1RNf. <br />_ <br />ND d frM 111NG <br />chili <br />SIff d m0W i <br />%�,y <br />yI I.xFM AI <br />ADVIl1N4 %AN CrYC• <br />UfflinNNr 1()NU <br />AAV EENI <br />O.es O N9 <br />IRAV(YI <br />OINEP <br />RF N[(Ey <br />J4f SMIDNG TNiCTM1Y.f <br />—. <br />%AMSFPmov/DaI <br />u51! <br />CITYOFEVERETTLOCAL SALES <br />TAX CODE IS 3105 <br />-- <br />TOTAL <br />- <br />
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