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rhe E:�crgreen <br />��T� �F <br />everett <br />259-8745 <br />"� C�NSTRUCTION <br />PERMIT <br />�ERMIT NO. � J� 6 6 <br />❑ DEMOLITION Q COMBINATION ❑ BUILDING O MECHANICAL ❑ PLUMBING ❑ SIGN <br />owr+en uni� nooness aiv zir wwHe <br />Harold Anderson 7511 Deverly Dlvd. Everett, 47A 98203 355-4490 <br />RRCHITCCiOR0E51GNER MAILAOpR[55 CIiV 21P i'HONE <br />GENERRLCONTPeCTOl1 MnRAUCPE55 CitY LIP PHONE LICENSE� <br />Owner <br />MECHRNIC�L CONIBRCiOR MnIL ApDRE55 CIiY 21P PMONE LiCENSE � <br />VLUMBWGCONiP�CTOq MnILApDfiG55 CItY 211' PNONE UCENSE• <br />0.�ss ov wonrc <br />❑ NEW ❑ ADDITION ❑ ALTEHATION C� HEPAIP ❑ OEMOLITION ❑ 6UILDING RELOCATION <br />VRLUAiION OF WORN <br />f5000.00 <br />oescam� woaK <br />Repair plumbing, sheetrock walls, repair windows and roof. <br />MEATSOURCE <br />❑ ELECTNICITV ❑ GAS ❑ WOODSTOVE ❑ OTHEH <br />Single family residence <br />.EGRL OESCRIPiIONOF PROPERTY�SIIOW OELOW 1 <br />icr _ o�oc� _ ov <br />OD�DDRESS <br />7525 Beverly BYY Blvd. <br />PLUMBING <br />NO. <br />TYPE <br />SIZE OF <br />TYPE OF Fl; <br />WATER CIOSET �TOIL <br />BATHTl1B <br />LAVATORY�WASN BA: <br />SHOWER <br />KITCNEN SINN 8 DISP. <br />DISHWA3HER <br />WASHER <br />URINAL <br />FLOOR ORAIN <br />BALNFLOW PRE1 <br />FOOF DRAINS — <br />SINK �SERVICE - <br />RP�UGTION ALC �V <br />S.❑ <br />ITEM � FEE <br />$ <br />5 <br />SUB TOTRL _ S _ 15 C <br />PERMIT f <br />TOTALFEE f 1S C <br />REAR SETOnCn SiD[SETOACN <br />l0T RREA yqCRNT SITE <br />❑YES CNO <br />OCCUPRNCyGROl1V NOOfDWEILINGIINITS <br />No oF 5ronlEs MAz o[C Loao <br />) i l YES O NO _ <br />oisu¢cuo[xFonv at+Pqfoni55UnNCE[iv <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TFUE AND <br />CORRECT. AL� PROVISIONS OF LAWS AND OROINANCES <br />GOVERNING THtS TYP� OF WURK 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 CONSTRUCTION. <br />SIGNAIUR[A� CONiRACTOR. nUTnOR12ED AGENi, OR OWNER DRiE <br />X __�.-� , � � �!.�;.,.i„�- ��1��� <br />MECHANICAL <br />TVPE OF EOUIPMENT <br />Ar� — A/HNDLG UNITS — H P. <br />REFflIGERATION UNITS — N P EA <br />OOILE(i5 — B T. W H P <br />GASFlPEDAC UNITS—BS.U. <br />FORCEDAIRSVSTEMS—BTU. MEA. <br />WALLHEATERS—OT.0 M <br />UNITHEAiERS—BTU M <br />EVAPORATIVE COOLERS <br />CLOTHESDRYERS <br />VENTILATION FAN <br />PANGENOOD <br />WATER HEATER <br />WOOD S70VE <br />\If FIREPLACE 8 CMIMNEY <br />F...cPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />EXh4UST FAN <br />FEe <br />SUBTOTAL <br />PENMIT S <br />TOtALFEE S <br />PIAN CHECN NUM�ER FEE RECEIPT NO. <br />FEES VALUATION FEE <br />BUILDING g 5000. 00 <br />PLUMBING <br />MECHANICAI <br />INVESTIGATION PEE Sca 904�e) <br />STATE BUILOING SURCHARGE <br />STATEENER7VSURCHARGE <br />DRIVEWAV VEFMIT <br />TOTAL 1 <br />PERMIT VALIDATION <br />WHEN Pf10PEPLY VAU�ATFO IIN THIS SPACEI THb i3 VOUR PEHMIT <br />,,. , . ��. <br />87135 <br />