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APPLICA'Tll.�l FOR CONSTRUCI .ON P�RMIT <br /> CITY OF EVERETT • �UILDING DIVISION � <br /> 3200 CEDAR STREET• F.VERETT, WA 98201 • 259-£5810 <br /> OEMOUTION COMBINATION BUILDING � MECHANICAL � ' PLUMBING i � SIGN <br /> PFOJECT ADDRESS <br /> a e W <br /> ovn�en M��i .nn�,r�. r,ir� r�r m�,,•�r <br /> Goldmark Enterpriees 915 Stitch Road Lake Stevena 98258 334-9656 <br /> 1RI�N1 qeil nf�0��f5S nh )ir ��nONF <br /> APCIIRfCTOROF5IGNER Aull <Pf���fb5 Clir )In PIIONF <br /> OFNERRLCO4IPwCf(Nt MMLROPl�(cF Ci�v ;u' PI�OHE SUtE11CFN5F.i <br /> Goldmark b:iterprisea 91; Stitch Road Lake Stevens 98258 334-9656 <br /> ME[NANICAI CONiR�CTO� 4Ail�O��E55 CItV JiP pllONf ST1TF IICENSE� <br /> PlU4PINCCONII1ACiDR M4iLPODnE55 CJIv 71v PIIONk SGiELICFNSE� <br /> Robineon P1bg.,Inc. 607 SE Ev Ma11 Wa;� N26 Everet;t 98208 355-bi71 ROBINP*272C2 <br /> covm.cr rnir.e or vronn <br /> $2520.00 HEATING SYSTEM: i �GAS iIEIECTRIC �l <br /> oescniec woa��ao sou�ne voornce iNvaveo cor+rncr rrnsoN nNn r��oNe No <br /> Sprinkler <br /> I IIEREBV CERTIFV THAT I HAVE READ AND E%AMINED THIS <br /> AFPLICATION AND KNOW THE SAME TO BE TRUE AND CORfiECT.ALL <br /> PqWOSEO USE OF PIIRDINO PROVISIONS OF LAWS AND ORDINANCFS GOVERNING THIS TVPE OF <br /> WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR <br /> LEO�LOESCRIPTIONOFPROPERtt�SNOVMflEIOWpUTGCNTWOCOVIESI NOT. THE GRANTINCi OF A PERMIT DOES NOT PRESUME TO DIVE <br /> �oi n�ceK or AUTHORITV TO VIO. ATE OR C�NCEL THE PROVISION OF ANV <br /> OTHER STATE OR LOGAL LAW REGULATINO CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION.THAT 1 AM AUTHORIZED BV THE <br /> - OWNER OF THIS PROPERTY TO PERFOFM THE WORK FOR WHICH <br /> A'PLICATION IS MADE AND I CUMPLV WITH THE STATE <br /> PMCEL TAX 10 M1MAF.R CON7qqCTORS LAW 1827 RCW AND 296200 WAC. <br /> WNSTRIIL�ION LO�N LENOER �O�f1E55 TF.IEPNONE NUMpFR x�L���/�L�, �� 7/�jj/� <br /> sicr�e�une ` � <br /> CitV BUSME55 LICFNSE NO <br /> P4UMBIN6 MECHANICAL _ <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF FIXTURE OR ITEM FEE <br /> WATER CLOSET(101LE') � A/C—ARiNOL�UNITS—H.P. � <br /> BATHTUB ; FORCED AIR SVSTEMS—B.T.U. M E.A, � <br /> LAVATOFV(WASH BASIN) � HEATPUMF i <br /> SHOWER � UNIT HEATERS—B TU. M <br /> KITCHEN SINK 8 DISP ; CLOTHES DRVERS i <br /> �ISHWASHER �_ � VENTILATION FAN � <br /> LAUNDRY TiiAV � RAfJC;E HOOD i <br /> — T <br /> CIOTNES WASHER WATER HEATER � <br /> UAINAL WO00 STOVE <br /> ORINKING FOUNTAIN i METhL FlFEPLACE(WOOD BURNING) i <br /> -�— <br /> FLOOF DFAIN FIRE°LACE INSERT(WOOD BURNING) � <br /> B/'�CKFLOW PREVENTERS � GASFIREPLACF i _ <br /> SINK(SERVICE—BAR,ETC.) � GAS RANGE <br /> ' GAS PIPING <br /> i E%HAUSTFAN � <br /> ' �— <br /> SUB TOTAL E ' SUP TOTAL E T <br /> PERMIT S PFRMIT S � <br /> TOTAL FEE E � TOTAL FEE 5 ' <br /> FOR OFFICE USE ONLY: <br /> (lIONTSF1PI1f.K i1f4115PTpACN Si0G5FTBACN PI�NCIIFf.NNUMpf ffF PFCFIPiNO <br /> � � <br /> uselor+e ioienee we�Nrsitr FEES VAWATION FEE <br /> �ivFs n No nunnn+A <br /> HEIGNT UMII�iION NO 0(OWIf1.LING Si7E Of ALOG41 <br /> UNR5 p111M01NG <br /> OCGUP�NCV NO 0�SfORiES f%:CIIP�NI IO�U P�SEMENI MECIUNICAI <br /> O�i011P <br /> IIYES II NO -- — i <br /> 1 <br /> FIRF.AUiiMREOD f1f�50N �0[NtION�LP1�Nf.HfCK <br /> OIIIFR <br /> FlPESPRINNLERRE00 RF�SON � <br /> I Si�IF flUll�Mb SIIRf.IUfl(iC i <br />�, trre ov r.oNsr ri nNe�rnnovrn nr CITV OF EVERETT nuni�c vnmxs � <br />� ��M LOCAL SALES —' <br /> ua�E ^l �y �.fj TAX CODE IS 3105 70TAL I <br />� <br />