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�� �' C"�NSTRUCTION <br /> ��T��F <br /> everett PERMIT PERMITNO. C.� 3S4 <br /> 259 -8745 <br /> O DEMOLITION ❑ COMBINATION ❑ BUILDING � MECNANICAL ❑ PLUMBING � SIGN <br /> ONTlEiI M�n ApORE55 CIiY IIP {MpNF <br /> Jay W. Kellogg 1010 Charles Everett 98201 252-3422 <br /> •RCMREGT OR OESIf.NEil M�IL�pDf1F ti5 f,RY <br /> )In M�pNE <br /> Owne r <br /> OENEfUL CONTFACTON M�n eUOqE55 GtY SiP PIIONk IICENSE• <br /> MECN�NIL�L LOHTR11CtOR MMl��DHC55 Gir ZI� (MONE LICFNSE� <br /> �LUMBiNO CONiR�CTOR MMl�DOQE55 GTV lU' M�ONE LiCENSE• <br /> CLASS Of WpiN <br /> ❑ NEW ❑ ADDITION ❑ ALTERATION O REPAIR ❑ DEMOLITION ❑ BUILDINO REIOCATION <br /> v�wenor+or wonK <br /> i <br /> �ESCRiBE'AORN <br /> Inspect Woodetove <br /> NE�TSOUNC[ <br /> ❑ ELECTRICITY ❑ fiAS [H WOODSTOVE ❑ OiHER , <br /> Paoroseo usE ov eunoiNa <br /> SFR I HEREBV CERTIFV THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEO�l0E5CRIPTIONOfAVOi'EIIIY�SMOWf1ELUWOO�TT\CNFOIIRCOPIE51 CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> �or_eiocK _ or 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 /> VIOIATE OR CANCEL THE PROVISIONS OF ANY OTHER <br /> STA E OR LOCAL LAW REGULATING CONSTRUCTION OR <br /> THE EHFORMANCE OF CONSTRUCTION. <br /> �oe�ooaEss siaNe me o�coetn�cron �urr n¢c •,eNt.on oxMEn o�re <br /> 1010 Charlee X <br /> PLUMSINO ME H N AL <br /> NO. TYPE OF F�XTURE OH ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSEi�TOILET� �C -AiHNOLQ UNITS-H P <br /> BATHTUB REFRIGERATION UNITS-H P EA <br /> LIIVATORV(WASM DASIN� �OILEPS-B T U/N P <br /> SI/OWER GAS FIPED A C 11NIT5-N T U <br /> KITCHEN SINN 8 OISP FORCED AIR SV5TEM5-B EA � <br /> DISHWASHER WqLL NEATERS-B T U <br /> LAUN�RY iR4Y UNIT HEATERS-B T U <br /> CLOTHES WASHER EVAPOl1ATWE COOLENS� <br /> URINAL CLOTMES D1ivEfl5 <br /> ORINKINO FOUNTAIN VENTILnTION FAN <br /> FLOOR DRAIN RANGE HOOD <br /> BACNFIOW PREVENTERS WATER NEATE� <br /> POOFDRAINS-RAINIEADERS 1 WOODSTOVE 3O OO <br /> 31NK�SERVICE--BAR,ETC� METAL fIREPLALE 8 CHIMNEY <br /> FIREPIACE INSERT <br /> HER�PUMP <br /> GAS PIPING <br /> EXHAUSTFAN <br />. BUBTOTAL f BUBTOT�L 3 <br /> PERMIT f PERMIT <br /> TOTALFEE f TOTALiEE <br /> iRONt SETBIICN nE�n SEto�Ck SiDE SEiHnCK RqN CHfCK NUMfiER FEE (iECEIPT NO <br /> UtiEZONE LOT�RE� <br /> V�C�NI SITE FEES VALUATION FEE <br /> ❑YES ❑NO <br /> TYPE Of CONST Of.CUP�NCY OROU� NO Of pWEIIING UNrtS BUILOING E <br /> PLUMBING <br /> SIZE Of pl.DO NO O�STORIES M�M OCC LOAp <br /> MECNnNICAL 30 00 <br /> INVESTIGA110N FE[ Sec 301�e) <br /> FIR SPRINKLERS REOl11RED - YES NO <br /> STATE BUIL�ING SURCNARGE <br /> STATEENERGVSURCHAPGE <br /> •PPLIGTION�CCOv rtnHsu�[r.e[mm �rrnrnnissu�Nr,[nv <br /> DRIVEWAV VERMIT <br /> TOTAL 30 00 <br /> — pERMIT VALIOATION <br /> WIIIiN PROPERLV VAIIUATFII pN iM15 tiPACE�Th115IS VOVR PEPMIT <br /> �� <br /> �.� <br /> �� <br /> t� <br /> N <br /> i,., �., . . � <br />