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- , _ <br />. � <br />APPLICATIO�. FOR CONSTRUCT�.�N PERMIT <br />CITY OF EVERETT • BUILDING DIVISION �C� <br />3200 CEDAR STREET • EVERETT, WA 98201 • 259•8010 <br />(TenanC Improvement) <br />O DEMOLITION ❑ COMBINATION � BUILDING p MECNANICAI ❑ PLUMBING ❑ SIGN <br />PROJECT ADDRES5: 1818 121et StreeC S.E. Evcrettt WA 9821:8 _. <br />OYMEB M�IL�Wf1E55 CIfY 7�� PnOH[ <br />The Everett Clinic 3901 Hovt Ave. Everett WA 96201 206 339-5460 <br />--5- —�-- <br />tcNu+r YMI �Od1E55 �an nr rimN� <br />The Everett Clinic 1818 121et St. Everett HA 98208 (206) 304-1104 <br />11f1L1111CGt011UE51GHE11 M�ilAMlf1E55 cirv iii• mmrir <br />Architect�rnl ficrks. Inc. 11335 N.E. 122nd W�y Suite 140 Rirklcnd 98034 (206)823-2244 <br />OENEOMCONip�Gidl M�IL�UWIES� GIY :i� PnONF SI�iF11CCN5E� <br />To be sclected � <br />MECNMlIC�LCONTRA�}pq MML�A�° ES�/ (tITY )iP PIIONE ST�fELICENSE� <br />To be selected • 1�'//17/4// <br />To <br />DESCRIBE MVfIR ANp $qJAIIE fOOTkE <br />c�rv <br />rnoro:.�o use ov euiara <br />Office (Nedical) existinR uec <br />iea� oesr.mPrwN o� rnortnn is��own eEiow on �n�cx iwo corics� <br />l0T BIOCN p� <br />see <br />orrsn <br />N/A <br />LUMI <br />NO. <br />� <br />V <br />� <br />e <br />� <br />� <br />� <br />0 <br />e <br />attnchmen[ labeled - A <br />�cnmen� inpelea — a <br />LOI�N IENDEII, �ODnE55. TEIEi'IqNE NUMBER <br />WATER ClO5E1 <br />BATHTUB <br />LAVATOHY (Y�A: <br />aHOWER <br />TCHEN SINK I <br />DI WASHER <br />UU Y TRAY <br />CLOTHE WASf <br />URINAL <br />DRINKINO FO <br />FLOOR DRAIN <br />BACNFIOW PRE <br />StAIE <br />HEATING SYSTEM: � GAS ❑ ELECTRIC ❑ <br />CONUCi PfO50N �YO P110NF NO <br />.r,.af (!lnrk _ !�(1f.1 n�z_��ii <br />I HEREBY CEflTIFY TNAT I HAVE READ AND E%AMINED THIS <br />APPIICATION AND KNOW THE SAME TO BE TRUE ANO CORRECT ALL <br />PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF <br />WORK WIIL DE COMPLIED WITH WHETHER SPECIFIED HEf1EIN OH <br />NOT. THE ORANTIN6 OF A PERMIT DOES NOT PRESUME TO GIVE <br />AUTIIORITY TO VIOLATE OR CANCEL THE PqOVISION OF ANY <br />O7HER STA7E OR LOCAL LAW REOULATIN� CONSTRI;.^,TION OR THE <br />PEAFOFMANCE OF CONSTRUCiION. THAT I AM AUTHORIZED BY THE <br />OWNER OF TH�S PHOPERTY TO PERFORM TNE WORN FOR WHICH <br />APPLICATI01� IS MADE AND I COMPLY WITH THE STATE <br />CONTRACTORS LAW IB.27 RCW AND 298.200 WAC. <br />x <br />src,�erui� O�IE <br />CIIY OU9NE55 LICFNSC NO <br />FEE NO. TYPE OF EOU <br />—• — <br />: NC—NHNDLOUNRS <br />' FORCEOAIHSYSTEMS <br />� HEAI' PUMP <br />TOTALFEE f <br />FOR OFFICE USE ONLY: <br />iRONiRETflI�LK REMiSFTPAC1t <br />uSEtor�e ioi�n¢� <br />NE16111 LIMIt�iION NO Oi Ow[llINO <br />IINIIC <br />� I OAiE <br />SIUE SFTBAC1c <br />MCANI SIIE <br />❑TES ❑ NO <br />SRE OFnB/10041 ^G <br />�/I L� '�i• I <br />❑YCS �yNO <br />RANGEHOOD <br />WATEq HEATER <br />W00� STOVE <br />FIfiEPLACE INSERT <br />GAS FIREPLACE <br />GAS RANl1E <br />� <br />SUB TOTAL f <br />PERMIT S <br />TOTALFEE f <br />PI�NLII[C/lUMOfl�1"J f[� I�,,� IIECFIPINO <br />7 / 7, <br />FEES VAIUATION <br />OVIIUINfi � <br />� � <br />: / P111Y0M(i <br />MFCII�NICAI <br />— �DfNbONqR�NCnff.M <br />owrn <br />� St�t[ Onllu�Nn Slinf,uMGf <br />CITY OF EVERETT runur, wnnas <br />LOCALSALES <br />TAX COOE IS 9105 TOTAL <br />