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`�� f 7NSTRUCTION ^ � c <br /> everett PERMIT �ERMITNQ:= � US�� <br /> 259 -8745 <br /> ❑ DEMOLITION ❑ COMBlNATION ❑ BUILDING ❑ MECHANICAL gl PLUMBING ❑ SIGN <br /> OWNEN 1.1AILFDORESS CITV 21P PMONE <br /> ROBERT WELCH 7220 - 77th Ave SE Snohomish WA q82q0 568-64q7 <br /> ARCHITECTORD[SIGNER MAILAO'JBESS CITY ZIP PHONE <br /> GENERRL CONTRACTOH MRR RD�RESS dTY 21P PMONE LICENSE• <br /> $0If10 <br /> MECHANICALCONTRAGTOR MA�IADURE55 CITY ZIP PMONE LICENSE/ <br /> PLUMBINGCONTRACTON MAILA[IDf1ESS QTY 21P PHON! UCENSE� <br /> C'_ASS OF WORK <br /> [�NEW ❑ ADDITION ❑ ALTERAT�ON ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br /> VR�U/TION OF WOIiK <br /> t <br /> DESCPiBE WORK <br /> Extend water service to house site <br /> MEnT50URCE <br /> ❑ ELECTRICITY ❑ GAS ❑ WOODSTOYE ❑ OTHER <br /> FROPOSED USE OF BUII.OING <br /> Single family residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGRlDESCRIPTIONOFPpOPERTY�SlIOWBELOWORATfACNFOURGOP1E51 CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> LOT_�S D�OCN _ OF r,•o�*.��.,� 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 LAW REGULATING CONSTRUCTION OR <br /> THE PERFORMANCE OF CONSTRUCTION. <br /> JOOADORFS�S SIGNATU NTRA:TUR.AUTMORIZ D/GENT.OROWNER �ATE <br /> ��,I.�S X � �/zs ae <br /> Fdv mnor T.an= <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI%TUflE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE <br /> WATF9 CLOSET(TOILET) A/C—A/HNOLG UNITS—M P. <br /> BATHTUB REFRIGERATION UNITS—N.P.EA. <br /> LAVATORV(WASH BASIN) BOILEFS—B.T.U./H.P. <br /> SHO'RER GAS FIRED A.C.UNITS—B.T.U. <br /> HITChEN SINN d OISP. FOqCFD AIR SYSTEMS—B.T.U. M EA. <br /> DISi:'NASIiER WALLHEATERS—BT.U. M <br /> LAUNDRVTHAY UNITHEATERS—B.T.U. M <br /> CLOTHES WASHEH EVAPORATIVE COOLEFS <br /> URINAL CLOTHES DRVERS <br /> ORINKING POUNTAIN VENTILATION FAN <br /> FLOOR LRAIN RANGE HOOD <br /> BAC'SFLOW PREVENTEflS WATER HEATER • <br /> ROOF DRAINS—PAINLEADERS �VOOD STOVE <br /> SINK(SERVICE—BAR.ETG) METAL FINEPLACE fl CHI .n <br /> 1 water FIREPLACEINSERT <br /> HEATPUMP <br /> GAS PIPING _ <br /> EXHAUSTFAN <br /> SUBTOTAL S SUBTOTAL <br /> PEflM1T S PEflM1T <br /> TOTALFEE S TOTALFEE <br /> Fnor+TSETOnGK nEaqSETOncK Si0E5ErBnCK p�ANCHECKNUMOER FEE RECEIPTNO. <br /> USEZONE IOTAREA y�CANTSiTE <br /> ❑res ❑ruo FEES VP.lUAT10N FEE <br /> TYPEOFCONST. OCCUPRNCYGPOUP NOOFDWELIINGUNITS BUILDING S <br /> PLUMBING 15 00 <br /> SIZE OF ULOG NO OF STORIES MA% OLC LOAp <br /> MECHANICAL <br /> INVESTIGATION FEE Sec.904�e) <br /> FIFE SPRINKLERS REOUIRED ❑YES O NO <br /> STATE BUILGING SURCHARGE <br /> STATEFNERGYSURCHARGE <br /> A�PLICATIONACC OY PlANSCNECNE�OV APPli FORISSL'ANCEO�' <br /> DRIVEWAY PERMIT <br /> TOTAL 15 <br /> PERMIT VALIGATION <br /> WHEN PROPERLY VALIDATED pN THIS SPACE)TMIS IS YOUfl PERMIT <br /> Q� <br /> � <br /> � <br /> L� <br /> r� <br /> !�i)���I�.:..;:i {'if:. <br />