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I L.L, I U, L%,Li%-I I f1LUU LA - I Iu: z063483136 APR 23, 1996 5:02PI•I 4639 P.05 <br />APPLICATICA FOR CONSTRUCT: ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION <br />3200 CEDAR STREET • EVERETT, WA 98201 •259•8810 OF <br />I DEMOLITION C) COIABINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIT <br />PROJECT ADDRESS:L�910 PINEHURST--EVERETT,-WA 9820 <br />waln MAIL A00RLSS CItY lip PHONE <br />COBLENTZ, CHRIS 1910 PINEHURST EVERETT 98203 355-1036 <br />I riAUT—•" MAIL Abbnl Rc CITY--.._.liF MIONE <br />I <br />t:MTECTOAD(SIONFA MAIL ADDRI SS CITY 71P PNONF <br />'.l i/CMICpITnlCIOR MAIL .SS CITY - - p1` FIIONF. SIATE LICENSEr .. <br />.. ..— ...0 nJJV _liV GRG [ <br />'t ('HANICAl CONMAIL AOORF SS CITY •' ?IF, Ellp¢ STATE IKEN E <br />'iIiMOINOCp/mACTOR MAIL ADORII 59 DItY pIgNE S1ATElK;FNSEA <br />� !,NIIMCt PRICE bI WORK -- <br />$1800. 00 I mo` HEATING SYSTEM: X190AS ❑ ELECTRIC <br />��:•;CgbE RORKIND SOUAIK fO01A0E INV01,1'!O I 1 CONTACt rinSON Am ►NONE NO. " <br />._ BATUB00M RXTTF-NTTON �S ZEKE FARNSWORTH <br />1-800-599-7RG9 ^^_.. <br />I HEREOY CERTIFY THAT 1 HAVE READ AND EXAMINED Till <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT A I <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE C- <br />WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OI <br />NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO OPP <br />AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF AN <br />OTHER STATE OR LOCAL LAW REGULATINO CONSTRUOTION OR TID <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BY 1II1 <br />OWNER OF THIS PROPERTY TO PERFORM THE WORK FOR WHWI <br />APPLICATION IS MADE AND 1 COMPLY WITH THE STA" 1 <br />CONI RACT O S 1^ 18.27 ROW AND 2 WAC. <br />/ <br />SIONATUNF 030077 OAT <br />irouobeE or IKALallo <br />RESIDENTIAL <br />'•ALDCBC/KPTICN Or PAMIFITY IDIOM IWI OWOR ATTACH TWOCONESI <br />16 61 7 BLOCK —oF <br />I PLAT THEREOF RECORDED IN VOLUME 8 OF PLATS <br />PAGE 3 EXCEPT THE WEST 10 FEET OF SOUTH 30 <br />K:EL TAX LO NULMER LOT 17 <br />4390-693-058-0003 <br />SIMICTONIOANLINNFLADDRESS.ITELEPHONENUMIUR <br />_ <br />CITYWOINESSLICENSEIID. — - <br />UBMING <br />MlCNANICAL <br />K0. <br />TYPB OP nRTunE OK ITtM <br />FEE <br />NO. <br />TYPI OF IMU1PMENT <br />FEE <br />/ <br />WATER CLOSET (TOILET) <br />I <br />A/C _ AMNDLG UNITS <br />' <br />/ <br />BATHTUB <br />LAVA70RY (WASH BASIN) <br />' <br />4. <br />FORCED AIR SYSTEMS <br />- <br />; <br />HEAT PUMP <br />---------- - <br />$HOWEp <br />' <br />UNIT HEATERS <br />CLOTHES DRYERS <br />�} <br />KITC EN SINK 6 DISP� <br />DI MBHER <br />LAUNIORY TRAY <br />CLOTHES WASHER _ <br />I <br />RANGE HOOD <br />I WATER I IEATER : <br />WOOD STOVE <br />4 . <br />_ <br />URINAL <br />GRIN ING FOUNTAIN� <br />1 <br />y <br />METAL FIREPLACE (WOOD BURNIN ___._ <br />FIREPLACE R48ERT WOOD BURNING) <br />I <br />Fl00IT DRAIN <br />GAS FIREPLACE <br />_ <br />BACKI'LOW PREVENTERS <br />; <br />GAS RANGE <br />_ <br />SINK (SERVICE - BAR, ETC.) <br />1 <br />GAS PIPING <br />FAN <br />; <br />_EXHAUST <br />SUS TOTAL $ <br />' <br />SUS TOTAL S <br />PERMIT S <br />I•� <br />PERMIT fr <br />_ <br />TOTAL FEE $ <br />r <br />' <br />- - TOTAL FEE f <br />i <br />"1)R OFFICE USE ONLY: <br />,. "IT SETTIACK <br />REAR SETBACK <br />SIDE SETBACK <br />MAN T.IIECK NU✓°III^T <br />' <br />NTLIMITATpy <br />2oV <br />t, IPANCY ID ps10ARE <br />; <br />K <br />�►2-.� L <br />I 1•I1INKIER REO.0 <br />ri UnillEa'u'� <br />101 A MA <br />C% <br />VACANT SITE <br />OYES M NO <br />•. FEES — <br />PMLnaO <br />;,DIfDaU SIZE OFBLOMI <br />tK111R <br />OCCIMANT lOAb BASEMENT <br />o,EE 9�No <br />-- <br />PLUAIRINO <br />4EpIN11CA1 <br />----- <br />AMI IONAl. MAN C11t CK <br />onrtn <br />� <br />IICARON <br />11EAK17N <br />—^—..—_ <br />ATAiE 0Uq IKNO SVNCHMIO! <br />Or CONST <br />PI ANS APPROVED by <br />J14- <br />GATE 8 6 <br />CITY OF EVERETT <br />LOCAL SALES <br />TAX CODE 19 3`105_j <br />POST K; WUIIX!. <br />---- -- <br />TOTAL -_ <br />rEF -ice 1 REOEIpt <br />D <br />