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r�� ..—, <br />CITY OF <br />everett <br />��� a54-88to <br />C'�NSTRUCTION <br />PERMIT <br />PERMIT NQ _ I � O � � <br />❑ DEMOIITION ❑ COMBINATION ❑ BUILDING I� MECHANICAL ❑ PLUMBING O SIGN <br />OWNER MAILAUORE55 CITY 21P �ONE <br />Daniel Baxter 3811 Federal Avc Everett 252-3518 <br />ARCHITECTOROESIGNER MAILAODHE55 CITY ZIP PHONE <br />OENEIUL CONTRACTOR MNIL AD�RESS CITY ZIP PMOhE LICENSE � <br />MECHANICALCONTNACTOR MAILAODRE55 CITY ZIP PHONE LICENSE• <br />Natural Gas Equipemnt 1625 E Marine View Dr. Everett 248-2441 NATURGE321K4 <br />PLUMBINGCONTP/CTOF MRILADDRESS CITY ZIP PHONE LICENSE� <br />f,LASS OF WOHK <br />❑ NEW ❑ ADDITION LI ALTERATION ❑ REPAIH ❑ DEMOLITION ❑ BUILDING RELOCATION <br />S <br />OESCRIBE WOPN <br />inatall furnace and water heater (both gas) <br />NEATSOURCE <br />❑ ELECTRICITY ❑ GAS ❑ 'IYOODSTOVE ❑ OTHEH <br />single family residence <br />.EG�L DESCRIPTION OF PROPEPTY �SHOW 9ELOW OR A' <br />LOT _ BLOCK � OF <br />i0B AODHE55 <br />3811 Federal Ave <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORYIWASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISHWASHER <br />LAUNDRYTRAV <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS — RAINIEADERS <br />SINK (SERVICE — BAR. ETQ) <br />SUBTOTAL <br />PERMI7 <br />TOTAL FEE <br />TYPE OF GONST. � <br />S12EOFBL�G NO <br />FIRE SPRINNLERS REQUIFED I <br />APPLICATION ACC �Y PL� <br />VACANT SITE <br />]YES ❑NO <br />NO OF OWELIING UNITS <br />MA% OCC LOAD <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br />APPLICATION 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 PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LA`N REGULATING CONSTRUCTION OR <br />THE P FORMANCE OF CONSTRUCTION. <br />SIGNAT RE fl�AC] OR AUTNORI2E0 AGENT.OP O'NNF.R OPTE <br />X �k,( .� �t���8 � <br />MECHANICAL <br />TYPE OF EOUIPME <br />— A/HNDLG UNITS — H.P. <br />RIGERATION UNITS — H.P. EA. <br />BOILEFS — B T.U./H.P. <br />GAS FIRED A�C. UNITS — B T.U. <br />FORCED AIR SVSTEMS — 0 T.U. <br />WALL HEATERS — B.T.U. <br />UNIT HEATERS — B.T.U. <br />EVAPORATIVE COOLERS <br />CLOTHESDRVERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATERHEATER � <br />WOO� STOVE <br />METAL FIREPLACE d CHIMNEY <br />FIREPLACEINSERT <br />NEATPUMP <br />GAS PIPING <br />EXHAUSTFAN <br />M EA <br />M <br />M <br />SUBTOTAL <br />PENMIT <br />TOTALFEE <br />'LAN CHECK NUMBER FEE RECE <br />FEES � VAWATION `�' �^" �� <br />BUILDING s <br />PLUMBING <br />MECHANICAL <br />INVESTIGATION FEE <br />STATE BUILDING SURCHARG <br />STATEENERGYSURCHARGE <br />DRIVEWAY PERMIT <br />� <br />:.� Sec:3Plle) <br />_� ,,:, <br />rcc <br />TOTAL I I <br />PEPMIT VALIDATION <br />WHEN PROPERLV VALIDATED QN THIS SPACE) THIS IS VOUii PERMIT <br />naofa�ss n�e <br />��� <br />�E� <br />