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u,QE�„�,� <br />cin oF <br />everett <br />259-8745 <br />Q�7NSTRUCTION � � = � 18689 <br />PERMIT PERMIT NQ = _ _ <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDIIIG ❑ MECHANICAL $] PLUMBING ❑ SIGN <br />OWNER MNILADORESS CITY ZIP PHONE <br />Prolube 13001 Lake City Way Seattle, WA <br />RRCMITEGTOR�ESIGNER MFI�ADORE55 C�TY ZIP PHJNE <br />GENERALGONTflRCTOfl ��FII.ADORE55 CITY ZIP PHONE IICENSE� <br />Puget West Box 669 Edmonds, WA 98020 <br />MELHANICALCONTRACTOR MAILADORESS CITY 21P PHONE LICENSE� <br />VLUMBINGCONTRACTOR MAILADORE55 CITY 21P PHONE LICENSEx <br />R& R Plumbing 9720 - 183 Pl NE Arlington, WA 98223 435-4576 <br />CLASS OF WOflK � <br />F�NEW ❑ ADDITION ❑ ALTEqAT10N ❑ REPAIfl ❑ DEMOLITION ❑ BUILDING RELOCATION <br />VRLUATION CF WORK <br />t <br />DESCRIBE WORK <br />Znstall new plumbing <br />HEATSOURCE <br />O ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />LOT _ BLOCK _ <br />308 SE Everett Mall Way <br />PLUMBING <br />TYPE OF FI%TURE O <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORV�WASHBASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISHWASHER <br />LAUNORYTRAV <br />CLOTHES WASHER <br />URINAL <br />DRINKIMG FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF ORAINS — RAINLEAOERS <br />SINK (SERVICE — BAR, ETCJ <br />size oF o�oc. <br />M.M. <br />SUBTOTAL <br />PEPMIT <br />TOTALFEE <br />AREA <br />CHECNED BY <br />s <br />s <br />s <br />VFCANT SITE <br />o ves ❑ r+o <br />NO. OF DWELLING UNITS <br />APPR. FOR ISSUANCE BY <br />I HEREBY 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 GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY UTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATU OF CONTflACTOR. AUTHOqIZEU A aEN', OR OWNEH UATE <br />X � p„J � . ,p � S/24/87 <br />TYPE OF EOUIPME <br />A/C — A/HN�LG UNITS — H,P. <br />REFRIGERATION UNITS — H.P. EA. <br />BOILERS — B.T.U./H.P. <br />GAS FIRED A.C. UNITS — B.T.U. <br />FORCED AIFl SVSTEMS — B.T.U. A1 EA. <br />WALL HEATEFS — B.T.LL M <br />UNITHEATERS—B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER • <br />V;OOD STOVE <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSER7' <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />PLANCHECK NUMBER <br />FEES <br />BUIL�ING <br />PLUMBING <br />MECHANICAL <br />INVESTIGATION FEE <br />STATE BUILDING SU <br />SUBTOTAL <br />PEPMIT <br />TOTAL FEE <br />FEE <br />STATEENERGYSURCHARGE <br />:� <br />V'(:�'JiEi�+�L'i <br />DRIVEWAY PERMIT � C�iLCI� :�4=I�.'JO <br />FEE <br />6�50 <br />15'00 <br />i� <br />25 <br />T07AL I I 46 <br />PEHMIT VALIOATION <br />WHEN PROPERLV VALIDATED (IN "HIS SPACE) THIS IS VOL'R PERMIT <br />n.flf�!ir.;5 f��i e <br />�• <br />•• <br />