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everett � ��NSTRUCTION -� �' <br /> 259 -8745 PERMIT PERMITNO. 2l.'�O4 <br /> ❑ DEMOLITION $7 COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ P�UMBING ❑ SICaN <br /> OWNER MAILADpRE55 CITY ZIP PMONE <br /> Mike Peacock 4809 Forest Dr. Everett 98203 259-7083 <br /> ARCHITECT OR OESIGNEN MAIL ADDRE55 CITY ZIP PHONE <br /> Self <br /> GENERAL LONTRqCTOR MAIL ADDRESS CITY 21P PHONE LICENSE� <br /> Self <br /> MECH�NICAL CONTflRCTOR MAII ADORESS CITY ZIP PHONE �ICENSE M <br /> Self <br /> P�UMBINGGONTqqCTOR MAILAOORESS QTY ZIP PHONE �ICENSEII <br /> Self <br /> cuss oF woaK <br /> ❑ NEW �ADDITION �A�TERATION ❑ HEPAIR ❑ DEMOLITION ❑ BUILDINO RELOCATION <br /> V�LIIATION OF WORIt <br /> s1Z�50�.�� <br /> DESCRIBE WORK <br /> 60 sq, ft. dininq room additioa and uperade kitchen and add windows. <br /> MFATSOURCE <br /> ❑ ELECTRICITY O GAS ❑ WOODSTOVE ❑ OTHEN <br /> PROPOSED USE OF BUILDING <br /> Reisdence I HEREBY CER'fIFY THAT I HAVE READ AND EXAMINED THIS <br /> LEGRLDESGRIPTIONOFAiOPERTY�SHOWOELOWORATTACHFOUNCOPIES) APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> CORRECT. ALL PROVISIONS OF IAWS AND ORDINANCES <br /> �or27 BLOCK _ OF The nl 70' of lot 27 GUVERNING THIS TYPE OF VlORK WILL BE COMPLIED WITH <br /> WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br /> Forest Park Add Div A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO <br /> VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br /> THE PERFORMANCE F CONSTRIlCTION. <br /> JOBAODRE55 SIGNATURE FCOTRACO AUTMORIZEDAGENT,ORUWNEq pATE <br /> 9809 Forast Dr. X � � _ �8�' <br /> � PLUMBING MECHANICAL <br /> NO. TYPE OF FDITURE OR ITEM FEE NO. TYPE OF E�UIPMENT PEE <br /> � WATER CLOSET(TOILET) A/C–A/HNDLG UNll�u–H.P. <br /> BATHTUB REFRIGER4TION UNITS–H.P.EA. <br /> � LAVATORY(WASH 6ASIN) BOILERS–B.7.U./H.P. <br /> I SHOWEP GAS FIRED A�C.UNITS–B.T.U. <br /> ! 1 KITCHEN SINK d DISP. S 00 FORCED AIR SYSTEMS–B.T.U. M EA. <br /> � j DISHWASHER � 5 0 Wp�LHEATERS–B.T.U. M <br /> � LAUNDRYTRAV <br /> � UNITHEATERS–B.T.U. M <br /> � CLOTHES WASHER EVAPORATIVE COOLERS <br /> URINAL CLOTHES DRVERS <br /> i — URINKING FOUNTAIN 'JENTILATION FAN <br /> FLOOR DRAIN - RANGE HOUD <br /> _ BACKFLpW PREVENTERS WATER HEATER <br /> ROOF DRAINS–RqINLEADERS WOOD STOVE <br /> SINK(SERVICE–BAR.ETC.) METAL FIREPLACE 8 CHIMNEY <br /> FIREPLACEINSERT <br /> HEATPUMP <br /> GAS PIPING <br /> EXHAUSTFAN <br /> BUBTOTAL f SUBTOTAL <br /> PENMR S PEN #� <br /> TOTALFEE S TOTALFEE <br /> FNONiSEfBACK REARSEiBnCN SiOESETBnCN PLANCHECKNUMBER F�a� RECEIPTNO. <br /> 20 20 6 88/20304 B1.DG93.641 .Qb642 <br /> VSE IONE LOT AREA <br /> R�1 VRCANT SITE <br /> ❑rEs BINo FEES ION FEE <br /> TVPEOFCONST. OCCUPANGYGROUP ND.OFOWELLINGUNITS BUILDING .0 <br /> V-N R-3 1 �" <br /> PLUMBING <br /> SIZEOFBLDG. NOAFSTOHIES MA%.00GLOAD <br /> 60 Add I, N�A MECHANICAL <br /> INVESTIGATION FEE Sec.30d(e) <br /> FIRESPRINKLEPSREOUIRED L�VES NO . <br /> STATE BUILDING SURCHARGE 3 SO <br /> STATEENERGYSURCHARGE <br /> APPLICATION RCC.BY PLANS CHEGKED BY pppR.FOR ISSUANCE BY <br /> ORIVEWAI'PERMIT <br /> M.M. B.E. B.E. T07AL <br /> PEpMIT VALIDATION <br /> WHEN PROPERLV VALIDATED(IN THIS SPArE)THIS IS VOUR PERMIT <br /> �' <br /> � <br /> �� <br /> � <br /> N <br /> , .. �_._�, , ,i <br />