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`�� � P�NSTRUCTION - � CCQ <br /> everett PERMIT PERMITNQ:�� UUo �_ <br /> 259 -8745 <br /> ❑ DEMOLITION � COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNER MRIlA00RE55 CITY ZIP FHONE <br /> D & D INVESTMENTS #9 Bel Lake Suite ql Bellevue WA 454-3993 <br /> ARCNITECT OR OESIGNER MAIL/DDRE55 CITY ZIP PHONE <br /> GENERAICONTRFCTOR l.:MLADDRE55 CITY 21P PMONE � LICENSE� <br /> STATEWIDE BUILDING SYSTEMS 205 - 241st ST SW Bothell WA 98021 483-0416 <br /> MECHRNICRLCONTRACiOR MAILAD�RE55 CITV STIgPEBS14401 PMONE LICENSE• <br /> PLUMpING CONTRACTOR MAIL ADDRE55 CITY 21P PNONE IICENSE� <br /> CLA55 OF WOPI( <br /> ❑ NEW ❑ ADDITION C� ALTENATION O REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br /> VALURTION OF WORK <br /> s 58�0.�0 <br /> OESLRIBE WORK <br /> Install pratitions, doors, plumbinq <br /> NEFTSOURCE <br /> ❑ ELECTRICITV O GAS ❑ WOODSTOVE ❑ OTHER <br /> PROPOSE�USE OF BUIIDING <br /> Beaut SI10 I HEREBY CERTIFY THAT I HAVE READ HNO EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO bE TRUE AND <br /> LEGALDESCRIPTIONOFPROPERTV�SHOWBELOWORATTACNLOURCOPIES) CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> LOT_BLOCK _ OF GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO <br /> VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br /> THE PERFORMANCE OF C NSTRUCTION. <br /> JOB ADORESS SIGNATU OF CONTRACTOR.A 2E�qGENT,OR OWNER DATE <br /> 111 SE Everett Mall Wa Bld X � <br /> PLUMBING MECHANIC��L <br /> NO. TYPE OF FI)(TURE OH ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> � WATER CLOSET(TOILET� 5 OO A/C—AMNDLG UNITS—H P. <br /> BATHTUB REFRIGERATION UNITS—H.P.EA. <br /> Q LAVATORY�WASHBASIN) ZO OO BOILERS—B,T.U./H.P. <br /> SHOWER GAS FIRED A C.UNITS—B.T.U. <br /> KITCHEN SINK 8 DISP. FORCEO AIR SYSTEMS—B T.U. M EA. <br /> DISHWASHER WALLHEATERS—B.T.U. M <br /> LAUNDRV TRAY UNIT HEATERS—B T.U. M <br /> � CLOTHES WASHER 5 OO EVAPORATIVE COOLERS <br /> URINAL CLOTHESDRYERS <br /> ORINKING FOUNTAIN Z VENTILATION FAN �3 OO <br /> FLOOH DtiAIN RANGE HOOD <br /> BACKFLOW PREVENTERS WATER HEATER • <br /> ROOF DRAINS—RAINLEA�ERS WOOD STOVE <br /> SINK�SERVICE—BAR,ETG) METAL FIREPLACE d CHIMNEV <br /> FIREPLACEINSERT <br /> HEAT PUMP <br /> GAS PIPING <br /> EXHAUSTFAN <br /> SUBTOTAL S 3O OO SUBTOTAL <br /> PERMIT S PERMIT <br /> TOTAL FEE S 3O OO TOTAL FEE <br /> FRONTSETBnCR FEnn5Ei0ACK Si�ESETUACK PLANCHECKNUMBER FEE RECEIPTNO. <br /> NA NA NA 86/16681 52.65 80474 <br /> USEIONE LOTAREA yqCANT5ITE <br /> C—� NA ❑ves f�]r+o FEES VALUATION FEE <br /> TVPEOFCONST. OCCUPANGYGIIOUP NOOFUWEILINGt1NR5 BUILOING SC,HOO EI� <br /> V-N B-Z PLUMBING 3O OO <br /> SIZ[OF pL�G NO OF SiORIES MAX OLC LOAD <br /> �Z4� Sf 2 �Z MECHANICAL 13 O� <br /> INVESTIGATION FEE Sec.304(e) <br /> FIRE SPRINKLERS REOUIRED C]YES ❑NO <br /> STATE BUILOING SURCHARGE 5 <br /> STATEENEFiGYSURCHARGE � <br /> APPLICRTIONACCOY PLANSCMECN[DOV APPRFORISSURNCEOY ��L(ol <br /> DRIVEWAV PERf.11T �"" <br /> sg jef lc T�TAL p� S .00 125 50 <br /> PERMIT VALIDATION ��{ SS3.00 <br /> WHEN PROPERLY VALIDATEO pt�TNISufiAGE)TMIS���Fi PERMIT <br /> C7 Sl1L'1 � <br /> ��� vI2J.� � <br /> �0 <br /> �� <br /> f• <br /> . i:�i �.., , i' c <br />