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�� <br />cin oF <br />everett <br />259-8745 <br />(�NSTRUCTION " '� <br />PERMIT PERMITNO. 18534 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING � MECHANICAL ❑ PLUMBING ❑ SIGN <br />Q�ER MAILADORESS CITY ZIP PMONE <br />Rickets, Robert 6321 Fleming St. Everett, 98203 353-1434 <br />�RCMITEGTORDESIGNER MAILAOORESS CITY 21P PHONE <br />GENEHALCONTMCTOfl MAILAODRESS GIiY 21P PMONE LICENSEN <br />Natural Gas Equip. 1625 E. Marine View Dr. Everett 98201 258-2441 NATURGE321K4 <br />IMECHPNICPLCONTRACTOR MrIILNDDHESS CITY 21P PHONE IICENSE• <br />I ��Ty 21P PHONE �ICENSEI <br />i PLUMBINGGONTflACTOR MRII.nDOflESS <br />CL�SS OF WORK <br />❑ NEW ❑ ADDITION �tl1LTERATION ❑ REPAIR ❑ OEMOLITION ❑ BUILDING RELOCATION <br />VALU�TION OF WOflN <br />S — <br />Install qas hot water heater and gas furnace. <br />❑ ELECTRICITY ❑ GAS <br />Single family residence <br />LOT � BLOCK _ <br />6321 Fleming St. <br />PLUMBIN(i <br />Np, TYPE OF FU <br />WATER CLOSE7 ROILI <br />BATHTUB <br />LAVA70RVIWASHBA: <br />SHOWER <br />KITCHEN SINK 6 DISP. <br />LAUNDRV <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAW � <br />BACKFLOW PREVENTERS <br />ROOF DRAINS — RAINLEADERS <br />SINK ISERVICE — BAR, E7C.) <br />SUBTOTAL <br />PERMIT <br />TOTAL FEE <br />FRONTSETBAGR REARSETBACN <br />USEZONE LOTPREA <br />TYPEOFCONST. OCCUPANCYGROUP <br />SIZEOFBL�G. NO.OFSTORIES <br />FIRESPRINKlER5RE0U1RED ❑VES ❑NO <br />RPPLICPTIONACC.BY PLANSC4ECNEDBY <br />S.H. <br />❑ WOODSTOVE <br />❑YES ❑NO <br />NO. OF DWELLING UNRS <br />MAX. OCL. LOAD <br />APFP FOR ISSUANCE BY <br />C orHen <br />I rieREBY 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 ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRAfVTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAI LAW REGULATING CONSTRUCTION OR <br />THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CON-T-RA-�jTOR. AUTHORIZED AGENT. OF OWNER••�/ DATE.�/ <br />X 1��1� � 1�. l�n�-%19�1.�ii, i�r���_l— <br />TYPE OF EOUIPMEN7 <br />A/C — A/HNDLG UNITS — H.P. <br />REFRIGERATION UNITS — H.P. EA. <br />BOILERS — B.T.U./H.P. <br />GAS FIRE� A C. UNITS — B.T.U. <br />FORCED AIR SYSTEMS — B.7L. M EA. <br />WAILHEATEflS—B.T.U. M <br />UNIT HEATERS — B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRVEFS <br />VEN71LA710N FAN <br />RAN7EHOOD <br />WAT[R HEATER <br />WOO[:� STOVE <br />ME7P� FIREPLACE 8 CHIMNEV <br />FIREPLACEINSERT <br />GAS PIPING <br />C.%HAUST FAN <br />SUBTOTAL <br />PENMIT <br />TOTAIFEE <br />FEE <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />INVESTIGATION FEE <br />STA7E BUILDING SURCHARG <br />STATEENERGVSURCHARGE <br />DRIVEWAY PERMIT <br />$ <br />Yi%�`�;'u'7 ilis;..RNs UDO�iNc•JI' {:.tt:i. <br />�;.-S�c.3oale) ^�j41.": <br />TOTAL � � <br />PERMIT VIILID�TION <br />WHEN PROPEf±LV VALIDATED (IN THIS SPACE) TH1515 VOUR PEfiMli <br />��_,..,�r:i F'Lc <br />50 <br />