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62053 <br /> APPLICATIC� , FOR CONSTRUCT_ �N PERMIT <br /> CITY OF EVERETT•BUILDING DIVISION � <br /> , 3200 CEDAR STREET•EVERETT; WA 98201 •259•8810 <br /> ❑ DEMOLlTION ❑ COM8INATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> PRWECTADDRESS: 10407 3rd Avenue S.E. <br /> OYMER MAIL�WIiE55 dtt <br /> Nadia Gusakov 10411 3rd Avenue S.E. Everett 98208 z347-0716 P�E <br /> TEWWT YNll1D011E55 G1Y � . <br /> 71P PIIONE <br /> ARfJ11RCTORDE5IGMER MAll11DDRE55 Cltt /i� <br /> PM(1NE <br /> QENEMICONTMCTOR MULIIDDRE55 LiIY ]il' PiIONE SfATEIICENSE� <br /> Nadia Gusakov 10411 3rd Avenue S.E. Everett 98208 347-0716 <br /> MEG/MlIOµCONTR�CTOR MulApppE55 Clry 7i� <br /> PIICNE STUE IICENSE� <br /> PlUAC1kGCONTFACTOR MOLAOOR[SS CITY ""--� ' ----- <br /> Robinson P1bg. ,Inc. 607 SE Ev Mall Way �k26 Everett j98208 355-6171 ROBINP*272C2N�I <br /> conrw�cr rmce oF vronK <br /> 2200.00 HEATING SYSTEM: ❑GAS ❑ E�ECTRIC ❑ <br /> �SCpOE M011KANO$pU�qE FOpT�{iE INVOLVED GONfICT i`C�SON�ND 1'NpNE Np <br /> SFR Sprinkler <br /> 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> riwrosco use or euadra APPLICA710N AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> PROVISIONS OF UWS AND OROINANCES GOVERNING THIS TYPE OF <br /> �eaKoescnwnwaanoaenn�s�rovmee�owon�n,wNrvroe�s� �RK WILL BE COMPLIED WITH WHETHER SPECIFIEO HEREIf OR <br /> NOT. THE aRANTINO OF A PERMIT DpES NO7 PRESUME TO 61VE <br /> ��T °L� � AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY <br /> OTHER STATE OR LOCAL LAW qE6UU7iN0 CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCiION.THAT I AM AUTHORIZED BY THE <br /> OWNER QF THIS PROPERTY TO PERFORM THE WORK FOR WHICH <br /> APPLICATION IS MADE AND I COMPLV WITH THE STATE <br /> ��T'���o�M�p CONTRACTORS LAW 1/82�7 RCW AND 298200 WAC. <br /> fAMSTMUC110N IOAN LENIIER.�Dp1E55.IELERIONE NUAI9ER x _1 /11 .1 II / ^(A // I I(�p�� <br /> af�V�VIV ,!C J V\J/ <br /> SION�TUfIF. D�TE � <br /> QTY p11SINE5S ltCENS[NO <br /> � �V��� MECHANICAL <br /> � M�• TYPE OF FlKTURE OR ITEM <br /> � FEE NO. TYPEOFEOUIPAAEIIT FEE <br /> � WATER CLOSET(TOILET) � NC—M►{NDIa UNrtS � <br /> BATHTUB � FORCEDAIRSYSTEMS � <br /> LAVATORV(WASH BASIN) � HEAT PUMP � <br /> SHOWER � UNIT NEATERS , <br /> KITCHEN SINK 8 DISP � CLOTHES DRVERS � <br /> DISHWASHER � RANGE HOOD , <br /> LAUNORY TRAV ; WAIER HEATER � <br /> CLOTHES WASHER � WOODSTOVE <br /> URINAL � MEfAL FIREPLACE(WOOD BURNING� ' <br /> DRINKING FOUNTAIN i FIREPLACE INSERT(WOOD BURNING) ' <br /> FLOOR DRAIN ' <br /> � GAS FIREPLACE , <br /> BACKFLOW PREVENiEHS ; GASRANGE � <br /> SINK(SERVICE—BAR,ETC.) � GAS PIPING � <br /> _ EXHAUSTFAN � <br /> � <br /> � <br /> � � <br /> � <br /> � � <br /> � <br /> SUB TOTAL f ; SUB TOTAL f 1 . <br /> PERMIT S i PERMIT S —� <br /> TOTAL FEE f � TOTAL FEE S � <br /> FOR OFFICE USE ONLY: <br /> FRONTSE79AC1( pE�RSETB�LK SIDESfTB�LR 1`l�NC11ECRNUH6fR fEF REC[IPiNO <br /> 37�oD <br /> usEZp+E LOTAREA V�CANi51TE FEES VALUATION FEE <br /> ❑YES ❑NO pUil0lNf. � <br /> HEIONTLIMIUTION NOOFOWELUNG SIZEOFBIOGRI � <br /> UNIfS — <br /> P1I16�OV10 i <br /> Q�V��NCV NO O�SIMnFS OCCUPANfLO�D 9�SEM[NT I <br /> MFCN�NIf.M <br /> ❑YES ❑NO � <br /> PIRESPRINKLEqREO'D PF�SON �p0�11(IN1lP1ANC��ff.K <br /> —�T— <br /> om��eads) 2(YAO <br /> FINEAUtiMREO'D RE�SOY <br /> i <br /> SU1G OOIIDING$IIqC1U116E <br /> TYPEOfCONST n�nNS�npnOVEDBv CITYOFEVERETT IIIOIICWpfINS <br /> ��M LOCALSALES — ___7—_ <br /> o.re �Z �(l TAX CODE IS 3105 ToiAL 2000 <br />