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r� eve�rem <br />��T� 0�: <br />everett <br />259-8745 <br />� C'�NSTRUCTION �' '1 <br />PERMIT <br />PERMIT NO. 2 � � J 6 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING f7 MECHANICAL ❑ PLUMBING ❑ SIGN <br />OW�'1EP MAILP�DRE55 CITV ZIP PMONE <br />James Pollock 6702 Lombard Ave. Everett 98201 355-1187 <br />PRCHITELT OR DESIGNER �/ IL RD�RE55 CITY ZIP FHONE <br />GENERRLCONTRAGTOR MRILA�DRE55 C"Y ZiP PMONE LICENSE+ <br />MELNANICRICONTR�CTOR MAILROORESS CITY ZIP PMONE IICENSE� <br />YYYZ Valley Nat. Gas 2605 Mr�ugal Everett 96201 355-1187 VALLENG153LI <br />PLUMBING CONTRRGiOR MRIL PD�PE55 CITY 21P PIIONE LICENSE � <br />_•-_.,> .._... <br />❑ NEW ❑ AD6ITION �1 ALTENATION O REPAIR ❑ DEMOLITION � BUII.DING RELOCATION <br />VRLUATION OF W0f1K <br />f <br />Install £urnace and water heater. _ <br />MEATSOUPCE <br />❑ ELECTHICITY ❑ GAS ❑ WOOUSTOVE ❑ OTHER <br />"�! <br />LOT � OLOCK _ <br />JOB <br />PLUMBING <br />NO. TYPE OF FIXTUR <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWEF <br />KITCHEN SINK 8 DISP. <br />DISHWASHER <br />LAUNURVTHAY <br />CLOTHESWASHER <br />UFINAL <br />TVPE OF <br />SIZE Oi <br />DNINKING FOIiNTAIN <br />FLOOR ORAIN <br />BACKFLOW PREVENTFRS <br />ROGF ORAIhS — RAINl6PD <br />SINK �SERVICE — BAF, ETC. <br />S.H. <br />SUBTOTAL <br />PEflM1T <br />TOTALFEE <br />OCCUP4NLYGROUP <br />NO <br />PLnNS CMECKED DV <br />FEE <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TflUE 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 NGT PRESUME TO GIVE AUTHORITY TO <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTflUCTION OR <br />THE PERFORMANCE OF CONSTkUCTION. <br />SIGNATUREOFCO-�N}iR}A�C�TO'�j /UTj�001ZCDOGENT.OROWN[R OATE �/ <br />X ��1N1ADIlJLlltl D. ����1I \� <br />A/C — A/NNDLG UNITS — H.P. <br />REFRIGERATION UNITS — HP. E <br />BOILERS — B.T.U.MP. <br />GAS FIRED A.Q UNITS — B.T.U. <br />FORCED AIR SYSTEMS — B.T.U. <br />WALI HEATERS — BSL. <br />LNIT HEATERS — B T.U. <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />�ENTILATION FAN <br />RANGEHOJD <br />WATCa HcATER <br />WCGDSTOVE <br />METAL FIREPLACE 8 CHIMNF� <br />FIREPLACEINSEFT <br />HEATPUMP ��� <br />GAS PIPING � <br />E%HAUSTFAN � <br />S SUB Y <br />f PERM <br />f TOTA' <br />S�oE SETBaCK pLAN CHECK NUMBER FE <br />l/CANTSrtE FEES � <br />❑ VE$ ❑ NO <br />NO.OFOWELLINGUNITS BUILDING �� <br />PLUMBING <br />MFN OCC LOAD <br />MECHANICqL <br />or <br />INVESTIGATION FEE <br />$TATE BUILGING SURCHARG <br />STATEENERGYSURCHARGE <br />DRIVEWAV PERMIT <br />M EA. <br />M <br />M <br />Sec.30d�e) <br />FEE <br />FEE <br />TOTAL I I <br />PERMIT VRLIDATION <br />WMEN PROPEFLY VALIDATED �IN THIS SPACE) THIS IS VOUR 7EI7MIT <br />�� <br />�..�1 <br />O <br />� <br />N <br />