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`�EV�`�` "' ST'RUCTI�IV � � cc <br /> CITV CF ■ �� 1 N�. <br /> everett V PERN@IT PERMITNQ:_ �ODU " <br /> 259 -8745 <br /> ❑ DEMOLITION ❑ COMBINATION � BUILD�NG ❑ MECHANICAL ❑ PLUMBING ❑ SIGN I <br /> OWNER MHILADDRESS CITY ZIP PHONE <br /> Jay and Dru Orr 4510 123rd P1. NE Marysville 98270 653-2251 <br /> pPCMITECTOR0E51GNER IAAILAODRE55 CITV ZIP PHONE <br /> GENERAL CONTRACTOP MAIL ADOFE55 CITY ZIP PNONE LICENSE x <br /> Three Iakes Const. Co. 19612 SOth St. SE Snohomish 98290 568-1263 TREELC127DP <br /> MECHANICALCONTRALTOR MAILAODHE55 CITY 21P PFIONE Cf�NSE/ <br /> PWMBINGCONiRAGTOR MAILA��RE55 CITY ZIP PHONE IICENSE� <br /> CLASS OF WORN <br /> ❑ NEW ❑ ADDITION ❑ ALTERATION �l HEPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br /> VAWATION OF WORH <br /> E Z�rJ��.�O <br /> DESCFiIBE WOPK <br /> Replace sub-flooring in kitchen, dinning room and laundzy room. <br /> Henr souncE <br /> ❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br /> PROPOSED USE OF BUILDING <br /> Single family residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOVJ THE SAME TO BE TRUE AND <br /> LEGALDESCNIPTIONOFPROPERTY�SHOWDELOWOFATTNCHFOUFCOPIES� ppRRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> GOVERNING THIS TYPE OF WORK WILL BE COMPLIED W:TH <br /> LOT_B�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 PROVISIONS OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br /> THE PERFORMANCE OF CONSTRUCTION. <br /> JO�ADORE55 GIGNATU OPCONTFFCTd AUTHORIZEOAGENT.OROWNER OATE <br /> 1815 Lombard X � s �' ^�'a -� -�� <br /> PLUMBING EHANICAL <br /> NO. TYPE OF FIXTURE OR tTEM FEE NO. TYPE OF EQUIPMF:�T FEE <br /> WATER CLOSET(TOILET) A/C—A/HNDLG UNITS—H.P. <br /> BATHTUB REFRIGE(iATION UNITS—H.P.EA. <br /> LAVATORV I'�'�ASH BASIN) BOILERS—B T.0/H.P. <br /> SHOWER GAS FIRED A.C.UNITS—B.T.U. <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS—B.T.U. M[4. <br /> DISHWASHER WALLHEATERS—B.T.U. M <br /> LAUNDRYTRAV UNITHEATERS—O.T.U. M <br /> CLOTHES WASNER EVAPORATIVE COOLERS _ <br /> URINAL CLOTHES�fiYERS <br /> DRINKING FOUNTAIN VENTILATION FAN <br /> FLOOR DRAIN RANGE HOOD <br /> BACKFLOW PREVENTERS N�ATER HEATER � <br /> RO�F DRAINS—RAINLEADERS �'�'OOD STOVE <br /> SINK(SERVICE—DAR,ETC.� � METAL FIREPLACE 8 CHIMNEV <br /> FIREPLACEINSERT <br /> HEAT PUMP '� 7 �� <br /> �. ..,._. .. <br /> GAS PIPING <br /> E%HAUSTFAN 7 <br /> ' i <br /> _i�_._- - <br /> SUBTOTAL S SUB <br /> PERMIT 5 PER � <br /> TOTALFEE S TOTALFEE <br /> FnoNT�EiBaCK iiEARSETBFCK siDESETBnCN p�ANCHECKNUMBER FEE RECEIPTNO. <br /> USEiONE LOT�REA yqLANT5ITE <br /> ❑ves ❑No FEES VALUATION FEE <br /> TYPEOFCONST. OCCi�PpucYCfiOU�' NO.OFDWELLINGUNITS BUILDING S ZSOO.00 S4 OO <br /> PLUMDING <br /> SIZEOFpLDG. .JO OFSTORIES � MAX OCC LOFD <br /> MECHFNICAL <br /> INVESTIGATION FEE Sec.304�e) <br /> FIRE SPRINKIEFS F7EOUIRED ❑VES ❑NO <br /> STATE BUILUING SURCHARGE 3 50 <br /> STATEENERGYSURCHARGE <br /> FPPUC/TIONACC.�Y F�dYSCHEGKEO�Y APPRFORISSUANL'[BY <br /> DRIVEWAV PERMIT <br /> S.H. TOTAL 57 0 <br /> PERMIT VALIDATION <br /> WH[N PROPEFLY VALIUATED(IN THIS SPACE)THIS IS VOUR PERh11T I� <br /> LD <br /> CD <br /> O <br /> N <br /> �Sf�' . <br /> � ����9�t'�II <br />