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259-8745 <br />PERMIT PERMITNQ:: �� `+`�� <br />❑ DEMOLITION ❑ GOMBINATION [� BUILDING � MECHANICAL ❑ PLUMBING ❑ SIGN <br />OYMER MAILAOORE$$ CITY ZIP PHONE <br />Carmen Scoleri 6100 Et�ergreen Way Everlct 98203 347-4179 <br />r1RCHITECT OF DESIGNFA MAIL ADDRE55 CITY ZIP PHONE <br />Jerry Brown 4?Z7 129th St. NE h]axysville 96270 659-7240 <br />GENEHAL CONTRACTOF MAIL FUORESS CITY ZIP PMONE LICENSE • <br />Owner <br />MECHANiCALCONTRACTOF MAILAD�FESS CITY IIP PMONE LICENSE� <br />PLUMBINGCONTflACTOH MAILAOOfiESS GITY ZIP PHONE LILENSE/ <br />❑ NEW ❑ ADD:'iION <br />VALUATION OF WORN <br />S 10����.0� <br />DESCRIBE wORK <br />New roof system <br />MEATSOURCE <br />O ELECTHICITY ❑ GAS <br />❑ ALTERATION ❑ pEPAIR <br />Manufacture and sale of <br />�OT �_ OLOCK <br />J00 AO�RE55 <br />6124 <br />PLUMBING <br />N-� <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORV(WASHBASIN', <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />OISHWASHER <br />LAl1NDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKIN3 FOUNTAIN <br />NI:I <br />BACHFLOW PHEVENTEliS <br />ROOF DRAINS - RAINLEAD[RS <br />SINK (SERVICE - BAR, ETC ) <br />$UoTOTAL <br />PEflM1T <br />TOTAL FEE <br />l <br />USEZOHE I �aTnPEn <br />TYPE OF CONST. <br />V-N <br />❑ WOO�STOVE <br />� I CI <br />❑ DEMOLITION <br />❑ OTHER <br />❑ BUILDING RELOCATION <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATIUN 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 PqOVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />THE PEF;FORMANCE OF CONSTRUCTION. <br />SIGNA E dF �ONTqqCTON. UTNORI2ED AGENT, OR OWNEIi pATE <br />X �o��_,� �,_�,_ �� �-�a�- xs <br />FEE NO. TYPE OF E�UIPMENT <br />A/C - A/HNDLG UNITS - H.P. <br />REFRIGEFATION UNITS - H.P. EA. <br />BOILERS - B.T.U./H.P. <br />GAS FIRED A.C. UNITS - B.T.U. <br />FGRCED AIR SVSTEMS - B.T.LL M EA. <br />WALLHEATERS-B.T.U. M <br />UNITHEATEFS-B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHESDRVERS <br />� VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER � <br />WOODS70VE <br />METAL FIREPLACC 8 CHIMNEV <br />FIREPLACEINSEflT <br />HEAT PUMP <br />GAS PIPING <br />E%HAUSTFAN <br />SUBTOTAL <br />CNECKNUMDER F�€N CH <br />83/21497 g �}�5 <br />i0 u res eiNo <br />�NCVGROUP NOOFOWELIINGUNITS BUILDING <br />B-2 0 <br />SIZE OF BLDG. NO. OF 5 <br />1786 1 <br />APPLICATION ACC. BV <br />B.E. <br />PLANS CHECNED OY <br />PLUMBING <br />JGG.LOAO <br />N�A MECHANIC�! <br />B.�. � B.E. <br />E <br />INVESTIGATIO�+ Yldtl k ��' 304(e) <br />S7ATE BUILDING SUFCHARGE <br />STATEENERGVSURCHARGE <br />DRIVEWAY PERMIT <br />FEE <br />��14466 <br />FEE <br />TOTAL I I 155I60 <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />�' <br />� <br />� <br />r' <br />N <br />ACDRESS FILE <br />