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�� � Q'1NSTRUCTION � � n C <br /> everett PE R M iT PERMIT NQ'_ � J� U�. <br /> 259 -8745 <br /> O DEMOLITION ❑ COMBINATION ❑ BUILDING �.I MECHANICAL ❑ PLUMBING ❑ 316N <br /> OWNER MRILNODRESS CIiY 21P RIONE <br /> John Stelfox 1209 Everett Ave Everett, WA 98201 486-2686 <br /> �HCNITEGTORDESIGNEq MRILADOflE55 . CITY 21P FMONE <br /> GENER�LCONTMCTOR MAILADDRE55 CITY 21P PNONE UCENSE� <br /> MECN�NICALCONTRACTOR MAILAD�RE55 CITY ZIP PHONE LICENSE• <br /> Valley Natural Gas 11323 Hwy 99 Everett, WA 98209 aa 355-7730 VALLENG153LT <br /> PLUMBINGCONTR�CTOR M�ILADORE55 CITY ZIP MONE UCENSE� <br /> C1A550F WORK <br /> ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br /> VALUATION OF WORK <br /> S <br /> OESCRIBE WORK <br /> Install conv. burner / 2 water heaters <br /> MEATSOUHCE <br /> ❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br /> P1iOPO5E0 USE OF BUILOING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEG�LDESCRIPTIONOFPROPERTI�SMOWOELOWORAiTACHF011 COPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> GOVERNING THIS TYPE OF WORK WILL 8E COMPLIED WITH <br /> �or_e�ocK _ oF WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO <br /> VIOLATE OR CANCEL THE PROVISI�NS OF ANY OTHER <br /> STATE OR LOC.�1L LAW REGULATING CONSTRUCTION OR <br /> THE PERFORMANCE OF CONSTRUCTION. <br /> JOB ADDRE55 SIGNAT E OF'ON fl CT R.A HO IZEO AGENT,OR OWNER OATE <br /> 1209 Everett Ave J( `�'�3—�'� <br /> PLUMBING MECHANICAL <br /> NO. T1'PE OF FIXTURE OH ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOIIET) A/C—A/HNDLG UNITS—H.P. <br /> BATHTUB REFRIGERATION UNITS—H.P.EA. <br /> LAVATORY(WASH BASIN) 601LEfl5—B.T.U./H.P. <br /> SHOWER GAS FIREO A�C.UNITS—B.T.U. <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS—B.T.U. M EA. <br /> DISMWASMER WALLHEATERS—B.T.U. M <br /> LAUNDRYTRAV UNITHEATERS—B.T.U. M <br /> CLOT1iES WASHEF EVAPORATIVE COOLERS <br /> URINAL CLOTHES DHYERS <br /> DRINKING FOUNTA�N �EN7ILATION FAN <br /> FLOOR DRAIN RANGE HOOD <br /> BACKfLOW PREVENTERS 2 WATER HEATER � 13 O <br /> ROOF DRRINS—RpINIEA�ERS W 00�STOVE <br /> SINK�SERVICE—BAR.ETC.� METAL FIREPLACE d CHIMNEV <br /> FIREPLACEINSERT <br /> HEATPUMP <br /> GAS PIPING <br /> E%HAUSTFAN <br /> 1 conversion burner 9 00 <br /> SUB TOTAL f SUB TOTAL 22 OO <br /> PERMI7 S PEHMIT 1$ 00 <br /> TOTALFEE f TOTALFEE 37 OO <br /> fROrJTSETB�CK RE�PSEtOACK SIDESETBnCK p�ANCHECKNUMBER FEE RECEIPTNO. <br /> USE20NE LOTAqEA y�CANTSITE <br /> ❑ves ❑no FEES VALUATION FEE <br /> TYPEOfCONST. OCCUPRNCYGROUP NO.OFDWELIINGUNITS BUILDING S� „ <br /> .__. _.. _. . . _.._ .__ . . .. . <br /> PLUMBINCa ' <br /> 512E OF B�OG NO OF STONIES MR%ACC.lOAO ��4, . <br /> M[CHANICAL °�""' "�� 37 00 <br /> �NVESTIGATION FEE �S?c;'��04(e) .;"�,[;,i <br /> FIRESPRINKLERSi7E0UIRED ❑VES ❑NO <br /> STATE BUILDING SURCHARGE <br /> STATEENERGYSURCHARGE <br /> �P%.ICATION AGC.BY PlhNS CIIECRE�BY APPB FOR ISSUANC!OY <br /> DRIVEWAY PERMIT <br /> M.M. TOTAL 37 00 <br /> PERMIT VALIDIITION <br /> WHEN PROPERLY VALIOATED(IN TH!S SPACE)THIS IS VOUR PERMIT <br /> �` <br /> �� <br /> t� <br /> Q� <br /> �� <br /> nr�o�Ess r i�E � <br />