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l« � � <br />APPLICATIV.�1 FOR CONSTRUC7 �ON PERMIT <br />CITY OF EVERETT • BUILDING DIVISION � <br />3200 CEDAR STREET • EVERETT, WA 9B20t • 259-8810 <br />f I DEMOLITION f I COMBINATION I i BUILDIN(i I I MECHANICAL �� PLUMBING I i SION <br />PROJECT ADDRESS <br />625 101e[ Place S.E. <br />OMHFR M�RRNN1F55 f.ltt TiP PHOH( <br />Millbrook Asaoc. 10120 7th Avenue S.E. Everet[ 98208 <br />IFN�NI MMI �MM1f55 fAIV lIP PNMIE <br />�IICNITfGTqifIF51ONF11 M�p�O1MF55 LIiV !iP Pm1HF <br />O[NEfIN C(N1IMCi(%1 Mllll �dMif55 � i�v )m P�NMlF gfQE I ICFN9F � <br />Rose Woodward Conet. 8606 Caecadia Everett 98208 337-4003 <br />MFQUNIC�I COqIR�Cf(M M�II �OfN�F55 CITV llf PIIONF SUtF IICFNSE � <br />PIIIIARIN4CONIR�CT(M MIII�t%ME55 ❑fv !IP PINNIE SUIEIH:FN9E� <br />Robineon P1bR.Lnc. 607 SE Ev Mall Way N26 Evere[t 98208 355-(i171 ROBINP*272C2 <br />�scaiae waa iNn sai�aF vooTwe x�vaveo <br />PROP09F0 U9E Oi IIIIII IMNO <br />4-olex <br />ior niocK <br />r�x i o Mraeen <br />CONBTMICTION I O�N IENDER. �0011ESS. TElEP110NE MIMBF.R <br />TVPE OF FURURE OR I I EM <br />CLOSETITOILETI <br />K{TCHEN SIt�K <br />UIUNORV TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKINO FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />SINK ISERVICE — BAR, ET <br />IVIO COPIESI <br />E <br />FOR OFFICE USE ONLY: <br />fRONT SFTpM1N REM 5FTR11f.tl 90E SFiP�fN <br />USEIONF It111111F11 <br />IIEINIT llMit�TION NO Of I1WFllINO <br />IINIIS <br />pp{;IIp1N(n KK� fN cumif 5 LV:CIIPINI IO�U <br />nnam <br />RREAIMMRF.01� �P�90N <br />vu�svmN�iFr�nFnn nr�c� <br />�rrv or nwsi ri erus �rrnovrn er <br />---- — n.ie ------- <br />HEATIN(3 SYSTEM: I i GAS i I ELECTRIC � I _ <br />conucr rrnsor+er�u r���r r+o <br />I HERE6Y CEFTIFV TNAT I HAVE READ AND E%AMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND CORFECI ALL <br />PROVISIONS OF LAWS AND ORDINANCES OOVERNING THIS TVPE OF <br />WORK WILL BE COMPLIED JJITH WHETHEH SPECIFIED HEREIN C�'1 <br />NOT. THE �RANTING OF A PERMIT DOES NOT PRE5UME TO OIVE <br />AUTHORITV TO VIOLATE OH CANCEL THE PROVISION OF ANV <br />OTHEH STATE OR LOCAL LAW REOULATINO CONSTRUCiION OR THE <br />PERFORMANCE OF CONSTRUCTION. THAT I AM AUTHORIZED BV THE <br />OWNER OF THIS PROPERTV TO PEHFORM THE WORN FOR WHICH <br />APPLICATION IS MAOE ANU I COMPLV WITH THE STATE <br />CONTRACTORS LAW 1827 RCW ANO 298.200 WAC. <br />- z /�/� <br />X -�— <br />SIfiN unF o�te <br />f,IIY PUSINF551 M,fNSC NO <br />FEE N0. TVPE OF EGUIPMENT FEE <br />A/C — AMNDLO UNIT3 — H.P. <br />' FOPCED AIR SYSTEMS — N7L M E.A. <br />, HEAT PUMP <br />� UN��f HEATERS — B T.U. M <br />� CIOTHES DRVERS <br />� VENTILATION FAN <br />� RAN�E HOOD <br />i WATER HEATER <br />� WOODSTOVE <br />i MEtAL FIREPLACE (WOOD BUHNING) <br />� FIREPLACE INSERT (WOOD BURNING) <br />; OAS FiREPLACE <br />� OAS RAN(iE <br />FAN <br />SUB TOTAL S <br />PERMIT E � <br />TOTALFEE f ! <br />ri eucuecK Nurmrn I rFr �� ��t; I nrcrmr No <br />��i]. ,i <br />Wf.�NI511F rCCO ���� <br />i�YFS �'.NU p1111bMC '� <br />S�tF Of AI IXi� I <br />PI��MN�N�i <br />PASFMFNI MFCIUNIC�I --�� �"' � � "_ ._. <br />rFs � Hn _-----_ __—" _ _ <br />�INIIIIIIN�I fM �N I llf fM f <br />___ omrn �60 Heada)� � �[/ <br />� <br />s rmr eun nn.r. svnr,�unar <br />�CITY OF EVERETT �� ����� w������° <br />LOCAL SALES <br />TAX CODE IS �105 7o7AL <br />