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APPLICATIOI. FOR CONSTRUCTI�'�7�1 PERMIT �•�t'«.�� <br />ma t �N�n��, TO BE COMPLETED IN INK—P�EASE PRINT � <br />uTv or <br />everett - ---- _ _ __ � <br />BUILDING DEPAPTMENT I_HEA7ING SVSTFM J GAS J ELECTRIC J__ __ <br />259 8810 <br />DEMOLITION COMBINATION __ BUILOING MECHANICAL PLUMBING SIGN <br />OWNER M�II �DORE55 �I1V )ip p�����t <br />November Ptr 22702 66 Ave W Mtlk Terrace 98043 775-5297 <br />iFN�Nt MM1110�PE55 QTY Tlp pHpryE <br />�RCNITEGiORpESIGNER PAil�ppRF55 Li1V )iP p�E <br />GENERAI RNI1R�(TOR MMl �ODRE55 Cliv piP PHONF UCENSE � <br />Ross Woodward Const. 8606 Cascadia Everett 98208 337-9003 ROSSWC*102K1 <br />MFCN�NIC4l CONiMC10R M�il �DORESS Cil I 11P PHOqE IICENSE � <br />PLUMBiN(iCONfR1C10R M�Il�00RE55 LiIY IiP PNONE IICENSE/ <br />Robinson Plbg 607 S� Gv Mall Way Everett 98208 355-6171 ROBINP*272C2 Level 2 <br />ClAS50F WORN <br />NEW ADOITION ALTERATION FEPAIR DEMOLITION WOGDSTOVEiFFPL INSERT BUILDING FELOCATION <br />CONULi PER$py �ND PHONE NO <br />Of SCRIflE WORM �NO SOl1ARE FOOi�6E INVOLVED <br />Install sprinkler system - 11 <br />rqnoosEo USE or Buaonuc <br />1 FG�I DESCqIPTpN Of PROPERTY ISNOWN PELOW OR �TT�CN <br />��� BIOCN OF <br />PRq1ELt�DDRESS <br />505 103rd Flace S.E <br />NO. <br />NITCHFN SINK 8 DISP <br />LAUNDiiV TRAV <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN _ <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />qOOF DRAINS�-RAINLEADE <br />SINK (SERVIC6-BAR. ETC.) <br />FOR OFFICE USE ONLY: <br />LR(kl15FiPni.K � qE�RSEIBACN <br />U5E 1(N1F <br />fY%OV f.MlfS A�.�pWABI( <br />Si7 OF� <br />tII.�Nyvl(ln(� <br />__ :-�, . _—_ <br />ni nson von sanw.i tas <br />CO'uq'7Jc�itl [ <br />iNf�MF AY <br />IAT <br />0 <br />I HEREBV CERTIFV THAT 1 HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE THUE AND CORRECT. ALL <br />PflOVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TVPE OF <br />WORH WILL BE COMPLETED WITH WHEiHER SPECIFIED HEREIN OR <br />NOT. THE GRANtING OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTHORITV TO VIOLATE OR CANCEL THE PqOVISIONS Of ANV <br />OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. TFIAT I AM AUTHORIZED BV THE <br />OWNER OF THIS PqOPERTV TO PERFOFM THE WORK FOR WHICH <br />APPLICATION IS MADE AND 1 COMPLV WITH THE STATE <br />CONTRACTORS LAW 18 27 RCW AND 296.200 WAC. <br />SiGN�iUREOfGONiR�f,10ROR�UiHOR1ZE0�0ENT O�TE <br />x ����� <br />APPIIC�N15GtV AUSiNFSS uCFNtiE NO �NOpUSWESSN�Mf. <br />TVPE OF EOUIPMENT FEE <br />A/C—A�HNDLG UNITS—H P <br />FORCED AIR SYSTEMS—B.T.U. M E.A. <br />UNIT HEATERS—B?.U. M <br />CLOIHESDRVERS �— <br />VENTILATION FAN <br />RANGE HOOD <br />WATER HEATER <br />WOOD STOVE <br />ME?AL FIqEPLACE 8 CHIMNEV � <br />FIREPLACE INSERT <br />..�........_ -- —r—. <br />GAS PIPING <br />E%HAUSTFAN <br />SUB TOTAL E <br />PEFlMIT j <br />TOTAL FEE $ ;�� <br />SIDESEtB�CM PIANCHFLM� <br />.j L- ' <br />wCeNt SiTE FE <br />Nn �lOR�ES — <br />f IFE snqNq f R5 RE00 <br />Yt�i> <br />�.�Mti��xciir��s <br />��MN I I <br />NL <br />BUILDING <br />PLUMBING <br />MECMANICAL . .Li .t� .,_ ,C G� <br />y <br />ADDITIONRL PUN CHECN <br />C��'l�� �'r �Z.?/ STATEBUILDINGSURf.HRRGE <br />PUNSRPPqpVEDBv CIiY OF EVERETT P�JBI IC WORK$ <br />LOCAL SALES <br />o�%la 1A.1 TAX COOE IS 3105 T0T11L <br />� <br />$ <br />S <br />RFCFIPI NO <br />Gb'oy y <br />FEE <br />—T— <br />_'—__�n � <br />—1" _ <br />�o <br />—T— <br />— yT— <br />