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CITY OF CINSTRUCTION 1 <br />everett PERMIT PERMITNO. f 9391 <br />259-8745 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL PLUMBING ❑ SIGN <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Bayview Assoc. P.O. BOX 658 Edmonds, WA 98020 774-8876 <br />ARCHITECT OR DESIGNER MOLL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE - <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE - <br />PLUMBING CONTRACTOR MAP. ADDRESS CITY ZIP PHONE LICENSE - <br />R6R Plumbing 4625 67th Ave. NE Marysville, WA 98270 334-4357 RRPLY194RP <br />❑ NEW Gi ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br />VALUATION OF WORK <br />f 500.00 <br />DESCRIBE WORK <br />Rough -in and install sink. <br />HEATSOURCE <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />PROPOSED USE OF BUILDING <br />Office <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />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 CONSTRUCTION. <br />SIGNATU OF CONTRA TJR. ADi11OPIZED AGENT, OR OWNER DATE <br />X /-6-8 <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES, <br />LOT _ BLOCK _ OF <br />p <br />JOB ADDRESS Z III <br />-i4iF1 Bond St. Zh <br />PLUMBING <br />MECHANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET, <br />A,C — A/HNDLG UNITS — H P <br />BATHTUB <br />REFRIGERATION UNITS — H P. EA <br />LAVATORY (WASH BASIN) <br />BOILERS — B T. U1H. P. <br />SHOWER <br />GAS FIRED AC. UNITS — B T.U. <br />1 <br />KITCHEN SINK 6 DISP <br />00 <br />FORCED AIR SYSTEMS — B T U. M EA <br />DISHWASHER <br />WALL HEATERS —OT.U. M <br />LAUNDRYTRAY <br />UNIT HEATERS —8.TU. M <br />CLOTHES WASHER <br />EVAPORATIVE COOL ERS <br />URINAL <br />CLOTHES DRYERS <br />DRINKING FOUNTAIN <br />VENTILATION FAN <br />FLOOR DRAIN <br />RANGE HOOD <br />BACKFLOW PREVENTERS <br />WATER HEATER <br />ROOF DRAINS — RAINIEADERS <br />WOOD STOVE <br />SINK (SERVICE — BAR, ETC) <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUAIP <br />GAS PIPING <br />_ <br />EXHAUSTFAN <br />SUBTOTAL <br />f <br />SUBTOTAL <br />PERMIT <br />fTo <br />nn <br />PERMIT <br />TOTAL FEE <br />f <br />q1 <br />on <br />TOTAL FEE <br />FRONT SETBACK <br />REARSETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO. <br />USEZONE <br />LOT AREA <br />VACANT SITE <br />❑YES ONO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />$ <br />TYPE OF CONST <br />OCCUPANCY GROUP <br />NO OF DWELLING UNITS <br />PLUMBING <br />;h�Po <br />15 <br />O <br />SIZE OFDLDG <br />NO OF STORIES <br />MAX. OCC LOAD <br />MECHANICAL <br />FInESPRINKI.ERSPEOI.IRED CIYES FIND <br />INVESTIGATION FEE <br />SeC 304(e) <br />STATE BUILDING SURCHARGE <br />_ <br />STATE ENERGY SURCHARGE <br />APPLICATION ACC BY <br />S.H. <br />PLANSCHECKEDBY <br />APPD FOR ISSUANCE BY <br />DRIVEWAY PERMIT <br />TOTAL <br />151 <br />Do <br />PFRYIT VAI InATON <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />r_ <br />M <br />M <br />C" <br />T_ <br />ADDRESS FILE <br />