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`�`�`° f'7NSTRUCTION <br /> e�erett <br /> ,�,�_�,o PERMIT PERMIT NO. 19016 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ 9UILDING [t� MECHANICAL ❑ PLUMBING C Sltil� <br /> OWNER MAILAOOPES'� Giv ziP MONE <br /> Larry C. Elledge 208 Barbara Lane Everett , WA 9820-3 355-6532 <br /> •�CNAECiOnpESiGNIR M�iIADDRE55 f,irv ziv MONE <br /> GENERIILCUNTRRLtOR Mut�OORE�J f:liV 1�� PHONE UCEN5E� <br /> MECn�NICMCONIP�CTqR MAiI�DORE55 OTv Ziv PHONE IICENSE� ' <br /> Owner <br /> %UMBINOCONTNICTOR M�IL�PORE55 CIiY ZIP PIIONE IICENSE� <br /> LL�55 OF WOqN <br /> ❑ NEW ❑ADDITION ❑ ALTENATION Cl NEPAIR ❑ DEMOLITION ❑ BUIL�IN6 RELOCATIqN <br /> v�iu�tioH or vronK <br /> ! <br /> oeseniee wonK <br /> install Woodstove and chimney <br /> rcet souncc <br /> ❑ ELECTRICITY ❑ QAS ❑ WOODSTOVE O OTHER <br /> PROPOSE�USE Of HWLDiNd <br /> Sinqle family reaidence I HEREBV CERTIFY TfiAT I HAVE READ AND EXAMINED THIS <br /> APPLICATIOM AND KNOW THE SAME TO BE TRUE AND <br /> LEG�LDESC111PilONOfPROPERIY�SMOW�FIOWOR�iTACMfOUHCOPIE51 CORflECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> �ot_e�ocn _or GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> WHETh1ER SPECIFIED HEREIN OR NJT. THE GRANTING OF A <br /> PERA4IT DOES NO7 PRESUME TO GIVE AUTHORITY TO <br /> — VIOLATE OR CANCEL THE PROVISIONS 0�= ANV OTHER <br /> STATE OR LOCAL LAW REGULATING CON.^aTRUCTION O'7 <br /> THE P FORMANCE OF CONSTRUCTION. <br /> JOBAOORESS � SiGNOi Of fO:lifj9[ p ♦Ui110HIIE0A0ENT AROWNCR O�Ti <br /> 208 Barbara Lane X1 � S � —� 2 • !�7 <br /> PLUMBING MEC NICAL <br /> NO. TYPE OF FIXTUHE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET�TOILET� A C � A�H!.1LG UNITS 11 P <br /> BAiNTUB REFqIGEHATION UNITS-H P EA <br /> LAV<TONY�WASH BASIN� pOILERS- B T U M P <br /> SMOWER GAS FlREL'4 C UNITS -� B T U <br /> KITCHEN SINK 6�ISP iORCFO�IA SYSTEMS-- 9 T U M EA <br /> OISNWASNER WALL IIFATERS - 5 T U M <br /> LAUN�RY iRAV UNIT MEATERS -U i U M <br /> CLOT/IES WASHEn EVAPORATIVC COOLERS <br /> URINAL CLOiHFS DRYER$ <br /> DRINNING FOUNTAIN VENTILATION hAN <br /> FLOOR DRAIN RnN6E HOOD <br /> BACKFLOW PRE�ENTERS WATER MEATER <br /> ROUF�RqINS-RAINLEADEAS WOOD STOVE 3 Q Q <br /> SINN�SERVICE- BAR.ETC I METAL FIREPLACE 8 CHIMNEY <br /> FIREPLACEINSERT <br /> HEATPUMP <br /> GAS P PING <br /> E%MAUSTFAN <br /> SUB TOTAL f BUB T0T11L 3 Q Q Q <br /> _ PEflM1T f PENMIT <br /> TOT11L FEE S TOTAL�EE <br /> inONi e'Te�cn nena,E10ac• vn[s[tu.v.K pLAN CMECK NUMf3ER FEE REGEIP�NO <br /> USEZONC lO'111[I� <br /> °���"'`�« FEES VAWATION FEE <br /> LJrrs Lr�o <br /> *��EofcoNSr occunANCrGRouv NOOrnwEi.lv+cuNit•: EWLDING S <br /> PLUMBING <br /> S�ZE Of BIDG NO Of 510nrt5 A.�a J^,L IO�D � <br /> MECHANICAL 3O OO <br /> INVESTIGATION FEE SeC 7(Wle) <br /> FIR€SPPINKLERS REOUIPED ❑YES ❑NO --- <br /> STATE BUILDING SURCHARGE <br /> STATF ENEPGYSURCHqRGE <br /> r^;'llC4il(1NAf�. I1Y V'LINSCNECXff]f1V <I'1'll l()111�`:IIRNI'(11Y <br /> DRNEV�AY PEPMIT <br /> S 'i TOTAL 30 00 <br /> - VEPMIT VAL�D\TION <br /> WMEN Pf1pPl�iLV VAI IDATFD IIN TIII;tiP�CB TM1S IS YOUR PERMIT <br /> �� <br /> e— <br /> O <br /> � <br /> •-- <br />