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`�� C 7hSTRUCTION <br />everett pERMIT �ERMITNQ:_ � ���� <br />259-8745 <br />❑ DEI.:OLITION ❑ COMBINATION �BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OVMER MRIL ApDPE55 CITY ZIP PHONE <br />Mrs. Dorothy Clark 6629 Beverly Lane Everett 98203 <br />�RGNITEGI OR DESIGN[R MAIL ROORESS CiTv ZiP PHONE <br />Star Home Improvement <br />MECHANICAIGONTRACTOR <br />M41L ApDPE55 <br />5313 S. 2nd Everett <br />MRIL AODRE55 <br />CIiY <br />98201 <br />CITY <br />353-9278 <br />ziv <br />LICENSE � <br />STARHIC147t;1 <br />PMONE UCENSE� <br />PIUMBINOCONTR�CTON MRIL/�OPE55 CITV ZIP PHONE LICENSE� <br />C'.A:S OF WORN <br />❑ NEW O ADDITION ❑ ALTEHATION �J REPAIq U DEMOLITION ❑ BUILDING RELOCAT�ON <br />V�LUATION OF WONK <br />s 5400.00 <br />OESCRIBE WORN <br />New roof and gutters <br />HEATSOURCE <br />❑ ELECTRICIT� ❑ GAS `7 WOOOSTOVE <br />VFOPOSFO IISE OF B W IDiNG <br />5ingle family resldence <br />�or 4 aiocK _ <br />Beverly Hills Div. 6 <br />JOB�ODRESS <br />6629 Beverly Lane <br />PLUMBING <br />WATEF CLOSET �TOILET� <br />BATHTUB <br />LAVPTOflV �WASH BASIIJ� <br />SHOWER <br />NITCHFN SINK 6 DISP. <br />DISHWASHER <br />LAl1NDRY'fRAV <br />CLOTMES WASHER <br />UFINAL <br />DRIPINING FOUN: AIN <br />FLOOR DRAIN <br />BACKFLOVJPREVENTERS <br />ROOF ONAIN6 — RAINLEADE <br />SINK �SERVICE — BAR. IETC � <br />SIZE OF BIOG <br />SUB TOTAL <br />PENMII' <br />TOTAL FEE <br />NO OF STORi: 5 <br />PVPIIGATIONRCCOV I PLpYSCHECNEDOY <br />S.H. <br />VACANT S�TE <br />❑VES ❑NO <br />❑ OTHER <br />I HEREBY CERTIFY THAT I HAVE READ Ali!) EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVEl1NING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPFCIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GiVE AJTHORITY TO <br />VIOLAI-E OR CANCEL THE PROVISIONS OF ANY OTHER <br />S7'ATE OR LOCAL LAW ^�GULATING CONSTRUCTION OR <br />TH�PERFQRMANCG tif C(}NSIc',!CTION, <br />X�u� <br />M£CNANICAL <br />JB f +^CR D�TE <br />�/�. <br />FEE NU. TVPE OF EOUIPMENT <br />A/C - A/HNDLG UNITS - H P. <br />PEiRIGERATION UNITS - H.P. EA. <br />BOILERS - B.T.0 MP. <br />GAS FIRED A�C. UNITS - B.T.U. <br />FOPCEDAIRSVSiEMS-bT.U. MEA. <br />WALL HEATERS - B T.U. M <br />UNIT HEATERS - B T.U. M <br />EVAPOflATIVE COOLERS <br />CLOTHESDRYERS <br />VENTILAl10N FAN <br />RANGEH000 <br />WATER HEATEN • <br />WOOD STOVE <br />METAL FIREfLACE 8 CHIMNEV <br />FIREPLACEIYSERT <br />HEAT PUMP <br />GAS PIPING <br />E%HAUSTFAN <br />APPR fOB ISSUANCE UY <br />BUILDING <br />PLUMBINC <br />MECMANICAL <br />INV[STIGATIONFEE <br />FEE <br />SUB TOTAL <br />PERMIT <br />TOT n. <br />FF.E � RECEIPT NO. <br />���1�%�� <br />11 ATION FEE <br />S o0 <br />, Set.J041e) <br />S7A7E BUILDING SURCHARG <br />STA7E ENERGVSURCHARGE <br />ORIVEWAY PERMIT <br />TOTAL <br />WHEN PROPEPLV VALIDATED QN TMIS SPACE� THIS IS YOUfi PERMIT <br />il!1Uf;CGS FILE <br />