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�� <br />cin oF <br />everett <br />259-8745 <br />- C-,NSTRUCTION <br />PERMIT PERMITNO. � S35S <br />� DEMOLITION ❑ COMBINATION � BUILD�NG ❑ MECHAN�CAL ❑ PLUMBIC'G ❑ SIGN <br />OWNER MAILADORE55 CITY 21P PHONE <br />�LS7[Si% George S4inkels 225 Madison Everett 98203 353-1302 <br />ARCHITECTOROESIGNER MAILPDDHESS CITY ZIP PHONE <br />GENEHAL GONTRACTOR MA�L RO�RE55 CITY ZIP PNONE LICENSE M <br />Pac West Const. 10929 Hwv 99 Everett 98208 347-149%1 APCWEC191PP <br />MECNRNICALCONiRNCTON M41�NDDRCSS QTY ZIP PHONE LICENSE� <br />PLUMBINGGONTRAGTOfl MAILAppPE55 CITY ZIG PHOYE LICENS[M <br />CLA55 OF WORN <br />❑ NEW ❑ ADDITION C7 ALTERATION [� HEPAIR ❑ OEMOLITIOII ❑ BUILDING REIOCATION <br />oescaiee woan <br />Re air dama e to front of residence <br />MEI.T SOURCE <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />LEGAI OESCNIYIiUrv or rnvrcn� i �nn�w u�uin a+n.• <br />LOT _ BLOCK _ OF <br />JOBAOONE55 <br />220 Madison <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET� <br />BATHTUB <br />LAVATORY (WASH 6.>SIN) <br />SHOWER <br />KITCHEN SINK & DISP. <br />DISHWASHER <br />LAUNURVTRAY <br />CLOTHES WASHER <br />URINAL <br />ORINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DflAINS — RAINLEADERS <br />SINK (SERVICF: — BAR, ETC.) <br />SUBTOTAL <br />PEflMIT <br />TOTAIFEE <br />TYPEOFCONST. <br />512E OF BLDG. <br />APPLICATION <br />S.H. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXnFAINED THIS <br />APPLICATION AND KNOW THE SAME TO BE .TRUE AND <br />CORRECT. ALL PP.OVISIONS OF LAWS AND ORDIPJANCES <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 AUlHORITY TO <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />THE P. ONfA O TR ION. <br />SiGN UF F[' �OR. AU EDf . �� OA'lNEfi OPTE <br />X GG�/ //�/„�� ,( , � �f % -�5' _ <br />MECHANICAL <br />FEE NO. TYPE OF EOUIPMENT <br />A/C — A/H?IOLG UNITS — H.P. <br />REFRIGERATION UNITS — H.P. EA. <br />BOILERS — B.T U MP. <br />GAS FINED A�C. UNIT$ — B.T.U. <br />FORCEO AIR SVSTEMS — B.T.LL M EA. <br />IVALLHEATERS—B.TL. M <br />UNITHEATERS—B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHESDRYERS <br />VENTILATION FAN <br />RA�JGE HOOD <br />WATER HEATEfl <br />WOODSTOVE <br />METAI FIREPLACE A CHIMNEV <br />F'IREPLACEINSEHT <br />HEATPUMP <br />GAS PIPING <br />E%HAUSTFAN <br />5 <br />VACANT SITE <br />❑YES ❑NO <br />SUBTOTAL <br />PEPMIT <br />NUMPER <br />NOAFDWELLINGUNITS BUILDING <br />issunNce ev <br />D.B. <br />PLUMBING <br />MECHANICAL <br />INVES7IGATION FEE <br />STATE BUILDING SURCHARG <br />STATEENERGVSURCHARGE <br />DRVVEWAY PERMIT <br />FEE <br />RECEIPT NO. <br />e��� r��.00 <br />E: uEBtafim,.� : ! .:;0 <br />TOTAL ( � <br />PEflMIT VALIDATION <br />WHEN PROPERLV VALIDATED (IN THIS SPACE) THIS IS VOUR PERMIT <br />; ! FSS FI; _ <br />� <br />