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APPLICATII.N FOR CaNSTRUCI.ON PERMI'� <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259-8810 <br />I� DEMOLITION i I COMt31NATION i i BUILDING �l MECHANICAL I PLUMBING f'� SIGN <br />PROJECT ADDRESS � / / <br />114 W. Intercity Avenue �'rt �-+ <br />owNen n.nanouness <br />nr� 7ir ri�or�E <br />Slank 6 B1ank Properties P.O. Box 2266 Everett 98203 355-4725 <br />'E"rNt unn.nonnFss arv zir� ���ouF <br />ARCHITFCTORpESIGNER MAILADORE55 CiTY ZIP PHONE <br />GENEP4LWNTRnCi04i IAqILn�pRE55 (;nY 7iP PHONF ST�TELICENSE• <br />Blank 6 Blank Properties P.O. Box 2266 Everett 98203 355-4725 <br />MECM4�VCALCONTRACTOR MAILAD�RE55 QTV 21P PIIONE STATEIICENSE+ <br />PWMBI`lGWNTqACTOR ldqILA�ORE55 CITY IIP P!IONE SiNELICF�SE• <br />Robinson Plbg., Inc. 607 SE Everett Ma11 Wa �i26 Everett 98208 355-6171 ROBINP*:72C2 <br />CONTRqCt PRICE OF WORK <br />$1100.00 HEATING SYSTEM: I_1 GAS I� ELECTRIC rl <br />OESCPIBE WORK ANO SOUARE FOOTAGE INVOLVED CONiACT PERSON A4p PHONF. NO. <br />SFR <br />LtGnL �ESCRIPTION OF PROPEFTV (SMOWN BEL01 <br />LOT BLOCK OF. <br />rnxi.o.NurreEa <br />CONSTRUCTION LOAN LENDER, A�DFEiS. TELEPMONE NUMBEP <br />NO. TYPE OF FIXTURE OR ITEM <br />WA7ER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISP <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />SINK (SERVICE — BAR, ETC <br />SUB TOTAL S <br />PERMIT 5 <br />TOTAL FEE 5 <br />FOR OFFICE USE ONLY: <br />rnorvrsErancK nFnn setoncK <br />U�E ZONE <br />HEIGNT LIMITATION <br />OCCUPANCV NO O: Si0RIE5 <br />GROIIP <br />FIRE AIARM PEOD <br />FlRE SPRINKLER REO'D <br />TYPE OF CONST <br />LOTAREA <br />NO OF �WELLING <br />UNITS <br />REh50V <br />DATE <br />SI�E SETORCK <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATIGN AND KNOW THE SAME TO BE TRUE AND CORRECL ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br />NOT. Th{E GRANTING OF A PERMI� DOES NOT PRESUME TO GIVE <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br />OTHER STATE OR LOCHL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTqUCTION. THAT I AM AUTHORIZED BY THE <br />OWNER OF THIS PROPERTY TO PEFFOFM THE WORK FOR WHICH <br />APPLICATION IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW iB27 RCW AND 296.200 WAC. <br />g-�.LQJ _(l�i�l�^�-f' ��ln i S <br />si�Nkru�e ��T� <br />CIiY �USINESS LICENSE NO. <br />MECHANICAL <br />FEE NO. TYPE OF FI%TURE OR ITEM <br />� A/C—A/HNDLGUNITS—H.P. <br />� FORCED AIR SVSTEMS — B.T.U. ' <br />i HEAT PUMP <br />� UNIT HEATERS — B.T.U. M <br />i CLOTHES DFiYERS <br />V�CAN� <br />flYES fl ND <br />512F OF 9LOG!TI. <br />❑YES fl NO <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE IS 3105 <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOOD STOVE <br />METALFIREPLACE <br />FIREPLACE INSER� <br />GAS FIREPLACE <br />GAS RANGE <br />GAS PIPING <br />EXHAUSTFAN <br />PLAN CIIECK <br />�11IL01NG <br />PLUMOING <br />MECHANIC�L <br />ADDITIONAL PLRN GHECN <br />on+en �13 Heads) <br />STATE DUII�ING SURCHARGE <br />rU�tIC woRKS <br />TOTAL <br />SUB iOTAL 5 <br />PERMIT 5 <br />TOTAL FEE 5 <br />FEE RECEIPTNO. <br />� L� <br />FEE <br />