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"�� C�NSTRUCTION � � � 'c <br />everett PERMIT PERMITNQ:- �� U�� <br />259-8745 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING C]� MECHAN�CAL ❑ PLUMBING ❑ SIGN <br />OVMEN MAILAD�RESS WA 98�*� Z52�1'��921P P110NE <br />Robert Kensinger 915 Broadway Ave Everett, <br />APCMITECTORDESIGNEA MAILAOCRE55 CITV ZIP R10NE <br />GENEML GONTMCTOR MAILADDflE55 CITY ZIP R10NE LICENSE / <br />AIECr1ANICRLCONiFAGTOR MAIL�DDRESS LITY Z�P PMONE ULENSE� <br />custom 5 Bothell WA 98012 481-5515 CUSTOGS231P6 <br />np R�ONE UCENSEr <br />CL�SS OF WORN <br />❑ NEW ❑{AODITION ❑ ALTERATION <br />S <br />install water heater & converson burner <br />❑ pEPAIR ❑ OEMOLITION ❑ BUII.DING RELOCATION <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE O OTHER <br />lOT � BLOCK _ <br />915 Broadway Ave <br />PLUMBING <br />;�I:l <br />WATER CLOSET �TOILI <br />BAiHTUB <br />LAVATOPV M1VASH BA', <br />>HOWER <br />KITCHEN SINK 8 DISP. <br />DISNWASMEP. <br />L.�UNDRY TRAV <br />URINAL <br />FLOOR DRAIN <br />BACKFLOW PREVENiFRS <br />ROOF DRAINS - RAINLEADERS <br />SINK ISERVICE - 6AR. ETC.) <br />SUdTOTAL <br />TVPEOFCONST. �� <br />512E OF BLDG NO <br />FIRE:?RINKLERSFEOUIRED I <br />RGPIICRTIONACCBV PL <br />M.M. <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 OriDINANCES <br />GOVERNII�G 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 />STA R LOCAL LAW FEGULATING CONSTRUCTION OF <br />T PER RMANCE OF CON.T��UCTION. <br />_.. _.._ _.,.,..._......,.., .�,.....o..�ner.cvr nnn�vdW' OaTE <br />FEE NO. TYiEOFEOUIPI <br />A/C - A�HNDLG UNITS - H P. <br />REFRIGERATION UNITS - M P. I <br />BOILERS - 0 T.U./HP. <br />GAS FIRED A C. UNITS - B T.U. <br />FORCED AIR SYSTEMS - B T.U. <br />WALL HEATERS - OS.U. <br />UNIT MEATERS - B.T.U. <br />EVAPORATIVE COOLERS <br />CLOTNESURYEHS <br />VENTILATION FAN <br />PANGEHOOD <br />WATER HEATER � <br />WOODSTOVE <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />�x GASPIPING <br />E%HAl'ST FAN <br />M EA. <br />M <br />M <br />1 conversion burner 9 <br />s SUBTOTRL 15 <br />f PEpMIT 15 <br />= TOTAL FEE 3O <br />SiDE SETancK PLAN CHECN NUMDER FEE RECEIPT NO. <br />VRCRNTSITE FEES VALU TION• FEE <br />❑YES ❑NO n <br />NO.OFOWELLINGUNITS BUILDING �IO�OLibZI <br />— PLUMDING ,,.,,.r.n� inn <br />MF% <br />APPR. FON ISSIIANLE �Y <br />MECHANICAL ,�ri.MECH <br />50 30 <br />INVESTIGATION FEE '"-" - Sec. �ua(e� <br />STATE BUILDINC� SURCHARGE <br />STATEENERGVSURCHARGE <br />ORIVEWAY PERMIT <br />TOTAL 30 <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIOATED �W THIS SPACE� THIS ISYOUfl PERMIT <br />AIi7R[SS fII.E <br />L� <br />N <br />GO <br />e— <br />N <br />