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ti' � <br /> Pa APPLICATION rOR �ONSTRUCTIQ`�'I PERMIT �"«�'�t <br /> rne e�e�o�ren TO BE COMPLETED IN INK—PLEASE PRINT � I <br /> CIN OF � <br /> r�� H evQ rett HEATING SYSTEM: ❑GAS ❑ELECTRIC ❑ �, <br /> [�j �;� BUILDING DEPARTMENT � � <br /> � '3 259-8810 <br /> a y y � DEMOLITION COMBINATION BUILDING MECHANICAL ;7 PLUMBING SIGN <br /> H �yC � pWryER MNLApDPE55 GITV ZIP PHONE <br /> H z h+ Jonatltan Snyder J'D ,L�, v x // .�� c��-�� %s 1 7 S ,;y,f'�- (ic Y 7 <br /> K y � 1P�/Nt MRIIRDDRESS dtt ZiP PHONE <br /> � H � - <br /> �/J CF' �BCMITECTOROESIGNER MAILADORESS CITY ZIP PMONE <br /> �i " <br /> GENERnLCONiRACTOR MAILAODPE55 CItV 2�P PNONE UCENSE• <br /> o�d Leghorn �nt. P.O. Box 1188 Mukilteo 98275 745-3577 <br /> N�g M1I[CNANiCALCONTRRCiOR AIAILADDFESS �!n' ZIP PNONE � LICENSE• <br /> nV n <br /> PWIA�INGLONTRACTON MAILA�DPE55 CITV I�P PMONE LIGENSE� <br /> [�y�y Robinson Plbq. 607 SE �v Ma1.:=���y Everett 96208 355-ti171 ROBINP*272C2 <br /> H F] L1A550FVlORK <br /> gy �,-_I NEW ADDITION . - ALTERATION . �� REPAIR DEMOLITION . � WOODSTOVE/FRPL WSERT � �. BUILOING RELOCATION <br /> f-I <br /> n�C^ y GONTACTPERSONAN�PHONENO <br /> •' r[�J CONTPACTYPICEOFWORK ZEJ7S.00 <br /> y� DESCfiIpE WORN AND SOUARE FOOTAGE INVOLVED <br /> _y� y S rinkler s stem-28 heads <br /> PFOPOSEDUSEOFBUIIDING I HEREBY CERTIFV THAT I HAVE READ AND EXAM'NED THIS <br /> SI'R APPLICATION AND KNOW THE SAM11E TO BE TRUE AND CORRECT.ALL <br /> L[GRLOESCPIPTIONOFPROPEflttISHOWN BEIOW ORRTTACH FOUR WPIES� PROVISIONS JF LAWS AND OROINANCES GOVF.RNING THIS T1'PE OF <br /> WORK WILL BE COMPLETED WITH WHETHER SPECIFIED HERtIN OR <br /> �or etocK oc NOT. THE GRANTING OF A PERMIT DOES N0T PRESUME TO GNE <br /> AUTHORITY TO VIOLATE OR CANCEL THE PROVI310NS OF ANY <br /> OTHER STATE OR LOCAL LAW REGULATING CONSTRIICTION OR THE <br /> -- PERFORM1IANCE 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 /> CONTFACTORS LAW 1827 RCW AND 296.200 WAC. <br /> SIGNATURE OF CONiRACTOR Oi1 AUTNOR2ED AGENt ORTE S�-�/j�� <br /> ^ Y <br /> PIiOJECT AOONESS � '4�" ' ��� <br /> APPIIGp iS ITVOl15�NES5UCENSENO.PNOBUF'NESSNAME <br /> '�� 4829 Glenwood Avenue <br /> PLUMBING MECHANICAL <br /> 1 ' NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> � WATcR CLOSET(TOILET) A/C—NHNDLG UNITS—H.P. <br /> ��1 BATHTUB FORCF.D AIR SYSTEMS—O.T.U. M E.A. i <br /> LAVATORY(WASH BASIN) UNIT HEATEiiS—B.T.U. M �_ <br /> i ' SHOWER CLOTHES ORYERS <br /> � NITCHEN SINK 8 DISP VENTILl,TIO�J FAN <br /> 1 � DISHWASHER 1 RANGE HOOD <br /> LAUNDRY TRAV � WATER HEATER <br /> ' CLOTHES WASHEH � WOODSTOVE <br /> URINAL ' METAL FIREPLACE 8 CHIMNEY <br /> '�1 DRINKING FOUNTAIN FIREPLACE INSERT <br /> t � FLOOR ORAIN _ HEAT PUMP ' _ <br /> � BACKFLOW PqEVENTERS GAS PIPING � <br /> ROOF ORAINS—RAINLEADERS � EXHAUST FAN <br /> 1 SINK(SERVICE—BAR,ETC.) � <br /> / <br /> '�' SUBTOTAL 5 SU3TOTAL 5 <br /> PERMIT S PERMIT 5 <br /> — � TOTALFEE 5 TOTALFEE $ <br /> FOR OFFICE USE ONLY: <br /> FIlONT$ETURC1t RERRSETBAGK $�O[`[t��CK PIANCM[CMNt1ldpER FEE �.p �ECEIPTNO. <br /> v� ���/? ��C� � ` .F/.� <br /> US[ZON[ LOTAREA �ACANTSITE FEES VALUATION FEE <br /> DUILDING <br /> 1VPEOftONiS.AIlOWABIF iYPfO�LONSiAtfWL OC:uvuKv r.D0�Uti0.u'�cuxns <br /> tAwv p�UMBING <br /> SREOFB�CG. NO.OFSTONiES BRSEMENT MECHANICAL <br /> OCCUPANCVLO�D FIRESPiiNKLERSRF.OD HEiGHTIIMIT�TION �LPLANCHECK � <br /> OTH ?�ue•-i(L�i- �O� 00 <br /> PEASON iOR SPRINNLERS �-�-- <br /> STATE BUILDING SURCHARGE <br /> ihLAkCpi PV.NSAPPROVEDDY CITYOFEVERETT PUBLICWORK$ <br /> LOCAL SALES 'T— <br /> E, � Z J TAX COOE IS 3105 T�Tp� l�,9; p p <br />