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lhe ESiergreen <br />CITY OF <br />�verett <br />259-8745 <br />- C'�`�NSTRUCTION �� '�' . q c <br />PERMIT PERMITNQ:: I �U�� <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL � PLUMB�NG ❑ SIGN <br />OWNER AIAllA00RE5S CITY ZIP PHONE <br />Sa£eway Inc. P.O. Box 90947 Bellewe, L9A 98008-0947 455-8688 <br />ARCNITECTORpE51GNEN MARAODRESS CITY Zlp PNONE <br />Design Dept - Same as lfdlH above <br />GENEHA:CONTRqCTOR MlILA0DBE55 C17Y ZIP PHONE UCENSEx <br />KirtleyCole Associates P.O. Box 605 Snohomish 98290 <br />MECMANICALCONTq/CTOR MAI�F��RESS CITV Z�p � PMONE LILENSE� <br />PLUMBINGGONTRACTOR MqILA00PE55 CITY ZIP PMONE LICENSE• <br />Swanson Dfechanical 16831 Mcrae Rd. Arlinqton 96223 652-7471 SWANSM162DA <br />CLNSS OF WONN <br />❑ NEW ❑ ADDITION � ALTEFATION ❑ REPAIfl ❑ OEMOLITION ❑ BUILDING RELOCATION <br />3 <br />Plumbinq alteration <br />HEAT SOU1iCE <br />O ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />PFOPOSEO USE OF BUILOING <br />LOT _ BLOCK _ <br />PLUMBING <br />TYPE OF FIXTI <br />YlATER CLOSET (TOILET� <br />0.4THTUB <br />LAVATOflV�WASHBASIN� <br />SHOWER <br />KITCHEN SINK 8 DISF. <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />ORINKING FOUNTAIN <br />FLOOR �RAIN <br />BACKFLOW PREVENTERS <br />HOOF ORAINS — RAINLEA <br />512E OF BLDG. <br />APPLICATION�CC DY <br />S.H. <br />— BAR. ETC.) <br />UI:lYf3,T,7 <br />SUBTOTAL <br />PEpMiT <br />TOTALFEE <br />LOT AREA <br />NO OF STONIES <br />I HEREBY CERTIFY THAT I HAVE READ AND EXANlNED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVEFNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERfv11T DOES �IOT PRESUME TO GIVE AUTHORITY TO <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL lAW REGULATING CONSTRUCTION OR <br />THE PER ORMANCE OF ONSTRUCTION. <br />S�TIGWIT ^ F CON�ACTOR, AU OflIZEDAGENT, OR OWNER DATE <br />'A . -A- / . I.�.i _ n n n . �i � � ✓� � <br />MECHANICAL <br />FEE NO. TYPE OF EQUIPMENT <br />NC — A/HNDLG UNITS — M.P. <br />REFRIGERATION UNITS — H.P. EA. <br />BOILERS — B.T.U./Y..P. <br />GAS FIRE� A C. UNITS — B.T.U. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />WALLHEATEfiS—B.T.U. M <br />UNIT HEATERS — B.T.U. M <br />EVAPORATIVECOOLERS <br />CLOTHESORYEFS <br />VENTILATION FAN <br />SS OO RANGEHOOD <br />WATER HEATER • <br />WOODSTOVE <br />ZS OO METAL FIREPLACE & CHIMNEV <br />FIREPLACE INSERT <br />HEATPUMP <br />GAS PIPING <br />E%HAUSTFAN <br />VACANT cITE <br />❑ VES ❑ NO <br />Mf.%. OCC. L0�0 <br />uNr,s BUILDING <br />PLUMBING <br />MECHANICAL <br />SUBTOTAL S <br />PERMIT 5 <br />TOTALFEE 5 <br />FEE RECEIPTNO. <br />VALUATION FEE <br />S <br />Ilbl�::9/;�r i::-' " ��.:90 00` <br />INVESTIGATION FEE <br />STATE BUILDING SURCHARG <br />STATEENERGYSURCHARGE <br />DRIVEWAY PERMIT <br />�;,L�Cc.304�e) :iS ).L� <br />f.li�_[':� 'S I.GU <br />TOTAL I I <br />PEflMIT VALIOATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PcF1.l1T <br />ADOReSS FILE <br />• <br />•• <br />� <br />