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APPLICATIC�1 �OR CONSTRUCT��N PERMIT � <br /> TO BE COMPLETED IN BLACK INK—PLEASE PRINT <br /> ( HEATING SYSTEM: ❑GAS CI ELECTRIC ❑ <br /> BUILDING DEPARTMENT <br /> 259-8810 X SPRINKLER <br /> DEMOUTION COMBINATION BUILDING MECHANICAI. PLUMBING SIGN <br /> OWNER MAILAD�RESS CITY ZIP PHONE <br /> Randy Carlstrom 121 W. Winesap Road Bothell 98012 <br /> 7ENANT MAIL PDDfiE55 CITY ZIP PHONE <br /> AP:HITECTORDESIGNER MAILAODRE55 CITV 21P PMONE <br /> GENER�LCONTRACTOR MAILADDRE55 C�N ZIP PHCNE STATELICENSEM <br /> Tutmarc Assoc. , Inc. 4909 119th P1. N.E. Kirkland 98033 827-6561 # TUTMAC*214 MZ <br /> MECHANICAL WNTPACTOR MAIL AUDRESS QTY ZIP P1 OVE STATE LICENSE R <br /> PLUMBING CONTRACTOR MRIL ADDRESS CITV ZIP PNOIJE STATE LICENSE+1 <br /> Robinson Plbg , Inc 607 SE Ev Mall Way #26, Everett 98208 355-6171 ROBINP*272C2 <br /> CLA55OF WORK <br /> X NEW �. ' ADDITION � � ALTERATION �� REPAIR . . DEMOLITION I �. WOODSTOVE/PRPL INSERT i I BUILDING RELOCATION <br /> CONTACT PERSJN AND PMONE NO. <br /> LONTR�CiPRICEOFWOflK $6695. 00 <br /> DESCRIpE WORK AND SOUARE fOOTAGE INVOIVED <br /> sprinkler installation % � <br /> PROPOSEDUSEOFBUIL�ING i HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> SFR APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> LEGAL DESCRIP710N OP PPOPENTV(SHOWN BELOW OR ATTACM FOURCOPIES) PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WOFK WILL BE COMPLETED WITH WHETHER SPECIFIED HEREIN OR <br /> �or o�ocK oF 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 /> PERFOflMANCE 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 /> CONTRACTORS LAW 1827 RCW AND 296200 WAC. <br /> z �.z,.r //�� �- 5/- 7- 93 <br /> $IG AtOPE OA1E <br /> PRQIECT AODPE55 <br /> 1609 �ngland Avenue ��r•o�s��Ess���E�sE�� <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILET) � AIC—A/HNDLG UNITS—H.P. ' <br /> BATHTUB ; FORCED AIR SYSTEMS—B.T.U. M E.A. ' <br /> LAVATORY(WASH BASIN) i UNIT HEATERS—B.T.U. M � <br /> SHOWER ' CLOTHES DRYERS ' <br /> KITCHEN SINK 8 DISP � VENTILATION FAN � <br /> DISHWASHER � RANGE HOOD � <br /> LAUNDRY TRAY ' WATER HEATER <br /> CLOTHES WASHER � WOOD STOVE ' <br /> — � METAL FIREPLACE 8 CHIMNEY ' <br /> URINAL � <br /> DRINKING FOUNTAIN � FIREPLACE INSERT � <br /> FLOOR DRAIN � HEAT PUMP � <br /> BACKFLOW PREVENTERS ; GAS PIPING � <br /> ROOF DRAINS—RAINLEADERS � EXHAUST FAN ' <br /> SINK(SERVICE—BAR,ETC.) � � <br /> � <br /> � ' <br /> � ' <br /> SUB TOTAL $ ; SUB TOTAL S ' <br /> PERMIT 5 � PER � <br /> TOTALFEE $ ' TOTALFEE 5 ' <br /> FOR OFFICE USE ONLY: 2��� - <br /> PLAN CHECK NUAIBER FEE CEIPT NO. <br /> fRONT SETBAGK REAR SETBFCN SIDE SETBACN � � O /�' , <br /> �� <br /> uSEzoNe iornaen VACANTSITE FEES VALUATION FEE _ <br /> BUILDING <br /> 7YPE OF CON15.ALIOWABIE TVPE OF CONST.ACiOAL a6ao�D�Y ���Of DNulinL UmiiS � <br /> PLUMBING <br /> SRE OF BLD(i. NO.OF STORIES BASEMENT MECHANICAL � <br /> i <br /> ADDITIONAL PLAN CHECK � <br /> OCCUPANCVLOAD FIRESPRNKLERSREO'D MEIGHTLIMITATION � <br /> SPRINKLER � O Heads ) �-�'_�� <br /> REASON FOR SPRINNLEPS i <br /> STATE BUILDWG SUFCHARGE <br /> WTAKEOV PLANSAPPROVEDOY CITYOFFVERETT PUBLICWORKS � <br /> LOCAL SALES .,�o__ <br /> TAX CODEIS 3105 rora� <br /> �� 3 -� .@�LI�Z� e� <br /> � c�F�j � � -z� �� �' <br />