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Nur F.vcrgrarn <br />C�, Y �F <br />z�erett <br />259-8745 <br />r7NSTRUCTI�N <br />PERMIT <br />PERMIT NO. � 6�l l� <br />❑ DE?AOLITION ❑ COMBINATION ❑ BUILDING L�i MF.CHAC:ICAL ❑ PLUMBING O SIGN <br />OKNE�V MAIIADDPE55 CITY Z�p PMONE <br />Rebecca King/Stepnen King 6531 Lombard Everett, WA 98203 355-2003 <br />ARCMRECiORpC$IGN[N MAiLAO0p65 C!iY pIP PMpYE <br />GfNER�LCONTRRCIOR A�PILAD�RE55 CIiY Z�p PHONE LICEHS[� <br />1.',CC��ANICALCONTRACTOR MAILn00fiE55 CITY ZIP PMONE UCENSC�+ <br />PLUM�ING LONTRRCTOR <br />CLA55OF WOlIN <br />L7iNEW ❑ ADDITION <br />VA WATION OF WORK <br />5 <br />AIAIL ADOiiE55 <br />❑ ALTEHATION 0 pEPAIF <br />oesciv�ue wonK <br />Install woodstove <br />MfAT50URCE <br />❑ ELEC7'RICITY I] GAS ❑ WOODSTOVE <br />Single family residence <br />iecn� o[sena�rioH ov anoaen�v �sNow oe <br />ior _ o�ocK _ oF <br />PLUMBING <br />WATER CLOSET �TOILET) <br />OATHTUB <br />LAVATORY�WASHOASIN' <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISHWASHEfl <br />LAUNDRVTRAV <br />CLOTHES WASHER <br />11FINAL <br />DRII�KING FOUN7AIN <br />FLOOR �RAIN <br />OACKFLOW PREVENTERS <br />onnc noeiuc — oeiw ce <br />USE ZONE <br />cOrvsT <br />APPLICdTIpNI.CC [3Y <br />SUBTOiAI <br />PERMIT <br />TpTALFEE <br />liEAR SE I u..�" <br />Al1EA <br />PLANS Q�ECKED OY <br />❑ DEMOLITION <br />❑ O?HER <br />21P PHONE LIC[NS[� <br />❑ BUILDING flEIOCATION <br />I hIEFlEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />wuncoaies CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERN�NG THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WFIETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES MOT PRESUME TO GIVE AUTHORITY TO <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />THE PERFONMANCE OF CONSTRUCTION. <br />9G�aATC � O� COIiTnnCiOq, �uTNOR¢Lpl.G[NT, OB OIYNEP DATE <br />X 7 /Z /AG <br />FEE <br />VACANT 51'f[ <br />❑YES ❑NO <br />APPI� f0l1155U�NCE[:Y <br />MECHANICAL <br />NO. TVPF OF EOUIPMENT <br />A-C — A�HNDLG UNITS — HP. <br />REFRIGEFATIUN UNI � S— HP. EA. <br />BOILERS — B.T.U.MP. <br />GAS FlRED A C UIJITS — �.T.U. <br />FORCED AIR SVSTEMS — B.T.U. M EA. <br />WALLHEATERS—B.T.U. M <br />UNITHEATERS—B.T.LL M <br />EVAPURATIV: COOLERS <br />CLOTHESDRVERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATEP H'cATER <br />]. WOODSTOVE <br />METAI. PIREPLACE 6 CMIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PioING <br />EXHAUST FAN <br />SUB TOTAL <br />PERMIT <br />TOTALFEC <br />FEES <br />BUILDING _ <br />PLUMBING <br />MECHANICAL <br />INVESTIGATION FEE <br />STATE BUILDING SURCHARG <br />STA7EENERG�SURCHARGE <br />DRIVEWAV PEfiMIT <br />Sec.304�e) <br />� <br />FcE <br />70TAL I ��y; 5�.� <br />PENMIT VALIDATION <br />WHE� PROf'ERLV VALIDATED �1N THIS SP.4CE� THIS IS YOUR PERMIT <br />30 <br />