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_:. � ;_. �:....:..,�,,,.�� <br /> - ,�; <br /> tMEMryn�n �.�PLICATION FO�-��� . ���,�„ �f; ` <br /> ceverett CONPERM�TTION � �, <br /> BUILDING DEPARTMENT r <br /> 259•87a5 TO BE COMPLETED IN INK- PLEASE PRINT ; <br /> BDEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANI:AL ❑ PLUMBING ❑StGN ti <br /> ;�. <br /> OWNER M�ILADpRE55 CITY ZIP PIIONE F' <br /> WaehinRton Natural Gas , P. O. Uox 1186, Everett , 98206 355-3331 ", <br /> •PCHITFGTORDESIGNER MAILA�ONE55 CIT� 21P PNpIIE <br /> DNA � <br /> OENEMLGONTH�GTOP M,111 ApppESS CIIV 21P PI�ON[ LILENSE x � <br /> Cobra Coretruction Co. , P.O. Box 1299, Everett , 98206 258-3667COB1tACC240BZ �; <br /> MECH�NIC�LCONiAAGTOq M�ILAp0AE55 CItY ZIP PIIONE LICENSE• � <br /> DNA �; <br /> PWMBINOCON7pACTON M�IIADDRESS CiiY _IP PIIONE IILENSE• '� <br /> nxn '`� <br /> GL�55 OF WORN y <br /> i <br /> ❑ NEW ❑ AODITION ❑ ALTERATION ❑ REPAIR {� DEMOLITION ❑ WOO�STOVE/FRPL.INSERT ❑ BUILDING RELOCATION <br /> V�LUATION OF WOBN�COST OG M�TENI�LS PLUS L�BORI dj <br /> $3 , 968. 00 �' <br /> OESCqiBE WORK Y <br /> Demolish houae, garage & foundation, complete, & haul from the site. ; <br /> i <br /> USE OF BUIL01N0 j� <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP• � <br /> Sinitle—familv Dwellin — NonHistorical pI.ICATIONANDKNOWTHESAMETOBETRUEANDCORRECT.ALL t <br /> LEO�LDESCRiPTIONOFPROPEPttISNOWNB[LOWORATT�CNFOURCOPIESI PROVISIONSOFLAWSANDORDINANCESGOVERNINGTHISTYPE 4 <br /> OF WORK WILL BE COMPLETED W�TH WHETHER SPECIFIED I�ERE• n <br /> ior_eioc�_or INORNOT.THEGRANTINGOFAPERMITDOESNOTPRESUMETO �i <br /> GIVE AUTHORITV TO VIOLATE OR CANCEL THE PROVISIONS OK <br /> SEE ATTACHED EXHIBIT "A" ANYOTHERSTATEORLOCALLAWREGULATINGCONSTRUCTION � <br /> OR E PERFORMANCE OF CONSTRUCTION. �' <br /> 51 11T REOFCONTRAGfORORAUT110R12EDAGENT DATE �� <br /> X 5�2��88 '• <br /> PNOJECT�DOPE55 APPI ,1HTSGtYBU51NE55LiCf. �t' <br /> 10029-1at Drive, S . E. , Everett 98208 O11 � <br /> `� <br /> PLUMBIN� ECMANI i�' <br /> NO. TYPE OF FI%TURE FEE NO. TYPE OF EOUIPMENT FEE <br /> WATERG:OSET�TOILEn AIRCOND. UNITS-M.P.EA. _ 1: <br /> BATNiUB REFRIGERATION UNITS-H.P.EA. <br /> �AWTOHY�WASH BASIN� BOILERS--H.P.EA. <br /> SHOWER pAS FIRED AC.UNITS-TONNAGE EA � <br /> NITGHFN SINK 8 OISP. FORCEO AIR SVSTEMS-B.T.O. M EA. � <br /> OISHWASHER WA��MEATERS-B.T.U. M <br /> LAUNDRYTRAV UNITHEATERS-B.T.O. M fl' <br /> CLOTHES WASHER EVAPORATIVECOOLERS <br /> WATER HEATER CLOTMES DRYERS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTA�N RANGE HOOD <br /> FIOOR DRAIN Alq HANDLING UNIT- QF.M. <br /> VAC::9M BREAKERS STOVE r <br /> i <br /> FOOF DRAINS-RAINLEADERS METAL FIREPLACE A CHIMNEV <br /> SINK SERViCE-6AR,ETC. WOODSTOVE/FIREPLACEINSERT <br /> I" <br /> - J. <br /> l <br /> _ �: <br /> 9UB TOT�L 9UB TOTAL 3 <br /> __ PEflMIT f PERMIT { � <br /> _, TOTAI FEE 5 TOT:L FEE f <br /> THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL �. <br /> FqUNiSETBACN REARSETB�CH SIpESETBACN PL�NCHECNNl1AlUER PUNCIIELKFGE <br /> FEE PECE�Pi NO <br /> OSE 20NE �OT�PEA V�C�Ni SIIE <br /> DYES pN0 FEE6 V�LUATIOH FEE <br /> TYPEOFLONST. OCGUPANCYGROUP NO.OFDWELUNGUNITS <br /> 5¢E Oi O100 NO Of STONES MAX OCC LO�O DUILDING S . <br /> PLUMBING <br /> _ 1 <br /> MECIIANICAL <br /> FIRE SPRINKLERS REUUIPED ❑ YES ❑ NO <br /> OTMER <br /> PENALTY <br /> RPf�ICATIDNACC.OY P�ANSp1ELNE0BY �PPR.FORISSU�NCEBY - � <br /> TOT�L <br /> ic <br /> �, <br /> i' <br />