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the EuoBreen <br />ciTv oF <br />Everett <br />259-8745 <br />� t'�NSTRUCTfON '� <br />PER�IAIT <br />,-. <br />PERMlT NQ: _ � � � � � <br />G DEMOLITION O COMBINATION ❑ BUILDING � MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNEfl <br />MAILAOORE55 CITY ZIP PHONE <br />Valerie Auahe 5801 Lombard Everett c47-6762 =P pHONE <br />PRCNrtELT OH DES�GNER MAIL RDDNESS <br />GENERALGONTRNCTOR MAILADORESS CITY ZIP PNONE 4CENSE/ <br />MECMFNICAICONTRACTOR MFILAOOflE55 QTV ZIP PMONE UCENSE/ <br />CITY <br />:LA55 OF WORK <br />❑ NEW O ADDITION �7 ALTERATION ❑ HEPAIR ❑ DEMOLITION ❑ BUILDING RELOCA <br />5 <br />Inst--�� a-s f�red fu n and wate h t <br />Y.EATSOURCE <br />❑ ELECTRICITY O GAS ❑ WOODSTOVE ❑ 07HER <br />LOT �� BLOCN � <br />PLUMBING <br />TVPE OF FIETU <br />WATEF CLOSET (TOILET� <br />BATHTUB <br />LAVATORY�WASH BASIN) <br />SHU\NEfl <br />KITCHEN SINK 8 OISF. <br />LAUNDRYTRAY <br />1'RINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />' DRAINS — I <br />�SERVICE — <br />pY <br />S.H. <br />;•7.l <br />SUBTOTAL <br />PEPMIT <br />GPOUP <br />FEE <br />I HEREBY CERTIFY `HAT I HAVE READ AND E:<AMINED 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 VJILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTIMG OF A <br />PFRMIT DOES NOT PRESUME TO GIVE AUTiiORI'I'Y 70 <br />V�OLATE OR CANCEL THE PROVISIGNS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />THE PERFORMANCE OF CONSTRUCTION. <br />SIG4ATURE OF CONTRAGT(�AUT11 IZ /GENT, OR OWNER ^�^ JI <br />NO. TYPE OF EOUIPMENT <br />A/C - A/MNDLG 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 AIR SVSTEMS - BS.U. M EA. <br />WALL HEATERS - BS U. M <br />UNITHEATERS-BT.U. M <br />EVAPORATNECOOLERS <br />CL07HE5 �RVEP.S <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER • <br />W OOD STOVE <br />METAL FIREPLACE 8 CHIMN�Y <br />PIREPLACG INSERT <br />HEATPUNP <br />GAS PIPING <br />E%HAI�ST FAN <br />SUBTOTAL <br />PEHMIT <br />TOTALFEE <br />CK PLAN CHECK NUMBER FEE <br />�E FEES VALU <br />NO <br />iLLINGUNITS BUILDING S <br />PLUMBWCa <br />LORD <br />MECHANICAL <br />OY � APPP FORISSUFNCEOY <br />INVESTIGA710N FEE <br />STATE BUILOING SURCHARG <br />STATEENERGYSURCHARGE <br />DRIVEWAV PERMIT <br />TOTAL <br />V�Sec.304(e) .. <br />RECEIPT <br />� <br />FEE <br />.�..m�� .....�.,........ <br />WHEN PROPERLY VALIDATED �IN THIS SPACE) THIS IS VOUR PERMIT <br />,.rr� ?�S� F���..c <br />30 <br />� <br />50 <br />� <br />• <br />