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APPLICA�'14.�1 �OFd CONSTRUC7 .�N PERMIT <br /> CITY OF EVERETT • BUILDING DIVISION <br /> 3200 CEDAR STREET • EVERETT, WA 98201 •259-8810 <br /> 11 DEMOLITION f 1 COMBINATION I 1 BUILDING rl MECHANICAL I I PLUMBING fl SIGN <br /> PROJECT ADDRESS <br /> 11005 16th Avenue S.E. <br /> OWNER MAILADDRE55 CIiY ZIP PHONE <br /> Engineers Investment Co. 1830q 17th P ace NW Seatt1e 9817� <br /> TENANT �d11LADURE55 CIiV ZIP PHONE <br /> ARCHITECTOROE9GNF.R MAILAOORESS CIN ZIP PNONF <br /> GENEFi�LCONTIIACTOF MFIL�D�FlE55 CIIY IIP PHON[ STATELICENSEx <br /> Wehmeyer Associa.tes 3�+5 N.W. 189th St. Seatt1e 98177 969-1124 <br /> MECHANICALCONTR4C'i0R MAILADDRESS CITY ZIP PHONE STA7ELICENSE� <br /> PWMBIYGCONiRFCTOR M4ILAODFESS CITY 21P PIIONE STATEUCENSEM <br /> Robinson P1b . Inc. 60� SE Ew Ma11 Wa �26 Everett 98208 355-6171 ROBINPjE272C2 <br /> CONTRACT PRICE OF WORK <br /> $9000.00 HEATING SYSTEM: I l GAS I l ELECTRIC ❑ <br /> DESCRIBE WORK AND SOUARE FOOTAGE INVOLVED CONTAQ PERSON ANO PHONE N0. <br /> sprinkler svstem - 1�Qi �pfirl �� <br /> I <br /> I HEREBY CERTIFY TNAT I HAVE READ AND EXAMINED THIS <br /> PROFOSED VSE OF�UILOINfi APPLICATION AND KNUW THE SAME TO 8E TFUE AND CORHECT.ALL <br /> apartment PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br /> WORK WILL BE COMPLIEU WITH WHETHER SPECIFIED HEREIN OR <br /> LEGFLDESCRIPTIONOFPROPERTYISHOWN9ELOWORATfACHiWOCOPiES� NOT. THE GRANTING OF A PERMI7 DOES NOT PRESUME TO GIVE <br /> �or o�ocK oF AUTHORITY TO VIOLATE OR CANCEL THE PROVISIOId OF ANY <br /> OTHER S1ATE OR LOCAL LAW REGULATING CONSTRUCTION OR'fFiE <br /> PERFORMANCE OF CONSTRUCTION.THAT I AM AUTHORIZED BY THE <br /> OWNER OF THIS PHOPERTY TO PERFORPA THE WORK FOR W�IICH <br /> APPLICATION IS MADE AND I COMPLY WITH THE STATE <br /> PARCELTAX I.D.NUM9ER CONTRACTORS LAW 1827 RCW AND 296.200 WAC. <br /> � � <br /> __ � �� /) /� / <br /> CONSiPUCiION�OpN LENOLR,A�DRESS.TELEPHONE NUNBER X ��"/�� ��/ �,� /(��' (r///��� <br /> SIGNATURE �t DATE <br /> CITY BUSINESS LICENSE NO. <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF FIXTURE OR ITEM FEE <br /> WATER CLOSET(TOILET) � A/C—A/HNDLG UNITS—H.P. � <br /> BATIiTUB � FORCEDAIRSYSTEMS—B.T.U. M E.A. � <br /> LAVATORY(WASH BASIN) � HEAT PUMP � <br /> SHOWER � UNIT HEATERS—B.T.U. M ' <br /> KITCHEN SINK 8 DISP ; CLOTHES ORYERS � <br /> DISHWASHER � VENTILATION FAN ' <br /> LAUNURY TRAV � RANGr HOOD i <br /> CLOTHES VJASHER WATEF HEATER � <br /> �— <br /> URINAL WOOD STOVE ' <br /> DRINKING FOUNTAIN � METAL FIREPLACE(WOOD BUFlNING) � <br /> FLOOR DRAIN � FIRE?LACE INSERT(WOOD BURNING) � <br /> BAGKFLOW PREVENTEFS � GAS FIREPLACE � <br /> SINK(SERVICE—BAR, ETC.) � GAS RANGE <br /> � GAS PIPING I <br /> i EXHAUSTFAN � <br /> � � <br /> SUB TOTAL S � SUB TOTAL S i <br /> PERMIT S i PERMIT S � <br /> TOTALFEE 3 � TOTALFEE S ' <br /> FOR OFFICE USE ONLY: <br /> Pii0NT5EiDACK RE�(iSETBACN SI�ESETOACH PLANCIECK�' MCE F[E �/�f RFCEIPTNO. <br /> 2 "- <br /> usezorue iornr�en vncnr+rsite FEES VALUATION FEE <br /> nves n No ouaoiNc ' � <br /> ! <br /> HEIGHTLIMRATION NOOFUW@LLING SIZEOFOL�G/CL � <br /> UNITS P�l1MBING � <br /> OGGUPANCV 1!0 OFSiO�IES OGGUPANT IOAD BASEIdENT MECN4NICAL i <br /> GROUP <br /> flYCS Il NO i <br /> FIREALAPMREOD RE�SON A�DITIONALPLANGNEGH i <br /> oT�+EnSprink1er 128 He ds ;00 <br /> FIRESPRINNLERREO'D PEASON � <br /> STATE 0 W I�ING SURCNMGE i <br /> - T� <br /> TYPEOPCONST. PLl�NSAPP �oav CITYOFEVEAETT vuoucwonKs ' <br /> LOCAL SALES <br /> on.e� 0 —�l S TAX CODE IS 3105 TOiAL / _ ` �nn <br />