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`� �� �'- C.�" NSTRUCI'ION `," � /� q <br /> everett PERMIT PERMFTNC3-: ��`�`�� <br /> 259 -8745 <br /> ❑ DEMOLITION ❑ COMBINATION � BUILDING ❑ MEC;iRNICAL (_� PLUMNING ❑ SIGN � <br /> ONNER Mn'.LAOORE55 CiTY � ZIP FMONE <br /> EXXON Co. USA 116 128th St. SE ZH#5 Everett, U�A 98204 ��7-Oi�6 <br /> �HCHITECT OR pESIGYER 6U'��L ADDBE55 f4Y 21P PMO�.E <br /> GENEMLfANTHACTOR MAllAODR[55 CIN 21P FMONE LILENSE� <br /> Engineering Tech. Services P.O. Box 2287 Melbourne ��902 724-5678 FNr.rnrrs 2hxa <br /> MECH�NIC�LCONTfUC70R MMLqDDRE55 CITY ZIP VMONE LICENSE• <br /> PLUMBING LONTR�CTOP MA L ADDRESS GIiY 2iP iHONC LILFNSE• I <br /> CU$$OF WORN <br /> ❑ NEW �ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDIN(:RELOCAT1011 <br /> V�LU�TION Oi WORN <br /> S 4000.00 <br /> DESGRIBE WOI:N <br /> Satellite dish. <br /> MERTSOUN[ <br /> ❑ ELEC7NICITY ❑ GAS ❑ WOODSTOVE O OTHER <br /> rnovoseo use oF euaon+o <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS � <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND �', <br /> LEGIIL�ESGPIPTIONOFPiIOPEfiTY�5110WBELOW01iATTACHFOURCOPIESI CORRECT. ALL PROVISIONS OF IAWS AND ORDINANCES � <br /> GOVERNING THIS TYPE UF WORK WILL BE COMPLIED WITH i <br /> ior_e�ocK _ov WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TU GIVE AUTHOP.ITY TO <br /> VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br /> THE PERFORMANCE OF CONSTRUCTION. <br /> JOB�DORE55 SIGNRTUR[OF , TPACTOR.AUTHORiZEU AGENT.OR OKMER DATE <br /> � X � �'' <br /> PLUMBING CHANICAL <br /> NO. TVPE OF FI7(TUHE OR ITEM FEE NO. TYPE OF EOUIPMENI' FEE <br /> WATEN CLOSET(TOILET) A/C—A/HNDLG UNITS—H P. <br /> BATI'TUB REFRIGERATION UNITS—H.P.EA. <br /> LAVATORV(WASH BASIN) BOILERS—B.T.0/H.P <br /> SHOWER GAS FIRED A�G UNITS—B.T.U. <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS—BT.U. M EA. <br /> DISHWASMER WALLIIEATERS—BT.U. M <br /> LAUNDRVTRAI' UNITHEATERS—B.T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> URINAL CLOTH'cS DRYERS _ <br /> DRINKING FOUNTAIN VENTILATION FAN <br /> FLOOR ORAIN RANGE HOOD <br /> 9ACKFLOW VREVENTERS WATER NEATER • <br /> POOF DRAINS—RAINLEAOERS WOOD STOVE <br /> SINK(SEPVICE—BAR.ETC.) METAL FIREPLACE 8 CHIM1INEY <br /> FIREPL�CEINSERT <br /> HEATPUMP <br /> � GAS PIPING <br /> E%HAUSiFAN <br /> SUBTOTAL f SUB <br /> PfRMIT f �p T <br /> TOTALFEE S TOT <br /> FRONT SEtOncK Rcwn SEreaGK 9�E S�AnCK P�AN CHECK NUMBER F RECEIPT NO. <br /> -- -- 88/20447 5 0756 <br /> USE20NF. �aTpAEA ypCANT5�TE <br /> ❑res Kno FEES TIO FEE <br /> TYPE OF LONST. CCCUPANGY GROUP NO�'��EIIING�Ni'S �UILDING S�}QGO.C O _ 63 OO <br /> V—N TS�2 � p�UM81NG <br /> 512EOFBLDG. NOOFStOR1ES A:�18.00CI.ORD <br /> N/A N/A Id/A MECHANIGI <br /> INVESTIGATION FEE �'���I�) <br /> FIRESPRINKLERSREOUIf1ED VES NO <br /> STATE BUILDiNG SURChiARGE 3 SO <br /> STATEENEHGYSURCHARGE <br /> A"PLISATIJNRCGBY PLANSCNECNEDDY �PPRWRISSUANGE��' <br /> Dr7iVEWAV PERMIT <br /> !{,'.. I B.E. B.E. TOTAL 66 50 II <br /> . �ERMIT VALIDATGN <br /> 1VHEN PROYERLV VALIDATED QN THIS SPACE)THIS IS YOUR PERMIT <br /> �' <br /> d� <br /> �� <br /> � <br /> N <br /> hDDRESS FILE <br />