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u��,�+�, <br />C17Y OF <br />�verett <br />259-8745 <br />^ C �N�TRUCTION <br />QERMIT <br />PERMIT NQ; _ � r�U�? <br />� DEM6LITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MAILA�DPESS CITY ZI PHONE <br />Gene and Sue Closser 102 Beech St. Everett, WA 98203 347-�082 <br />MAIL AOOPESS <br />CIiV ZIP PHONE <br />GENERALCONTRRCTOR MNILApDRE55 CITY ZIP PHONE LICENSEx <br />Owner <br />MECHANICALCONTflACTOfl MAILADDPE55 CITY ZIP PMONE LILENSE� <br />PWMBINGCONTRACTOR MAILADDPE55 CITV 21P PHONE LICENSE� <br />CLASS OF WORK <br />❑ NEW ❑ ADDITION ❑ AITERATION ❑ REPAIR $] pEMOLITION O BUILDING RELOCATION <br />VALUNTION OF WORK <br />E 5t��u�9H <br />Demolition <br />❑ GAS ❑ WOODSTOVE <br />Single family residenc.e <br />�GAL DESCflIPTION OF PqOPERTY ISMOW BEL <br />LOT 19 6LOCN _ <br />Hills <br />JO�ADDR[55 <br />809 Madison St. <br />PLUMBING <br />Cadys addition to Beverly <br />NO. TYPE OF FI%TURE OR ITEM <br />WATER CLOS'c7 (TOILET) <br />BATHTU9 <br />LAVATORYjWASHBASIN) <br />SHOWEF <br />KITCHEN SINK 8 DISP. <br />DISHWASNEfl <br />LAUNDRVTRAV <br />CLOTHES WF,SHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKfLOW PREVENTERS <br />ROOF DHAINS — RAIIJLE.4DER5 <br />SINK (SEflVICE — BAR, ETG) <br />SUBTOT0.L <br />PEPMIT <br />TOTAL FEE <br />FFONTSETpACR PEAPSETOACK <br />USEZONE LOTAREA <br />TYPE OF GONST. OCGUPANGV GRI <br />SRc' OF 6LDG. NOAF STORIES <br />/.PPLICATION Af.C. BY <br />M.M. <br />PLANS CHECNEp BY <br />Hen <br />f <br />S <br />S <br />VALANT SITE <br />❑ YES ❑ NO <br />❑ OTHER <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEO THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDI�IANCES <br />GOVERN�NG 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 AUTHORITY TO <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />Tt�E PERFORMANCE OF CONSTRUCTION. <br />S�GNf��UHE OF CONi1FG��C. AUTNORIZED NGENT�B OWNER onTe <br />FEE TYPE OFEUUIPMF.NT <br />A/C — A/HNDLG UNITS — HP. <br />REFRIGERATION UNITS — H.P. EA. <br />DOILERS — B.T.U./H.P. <br />GAS FIRED AL. UNITS — B.T.U. <br />FORCED AIF SYSTEMS — D.T.U. M EA. <br />WALLHEATERS—B.T.U. M <br />UNIT HEA"i ERS — B.T.U. M <br />EVAF�RATIVE COOLERS <br />CLOTHESORYERS <br />VENTILATION FAN <br />RANGEHOOD <br />1YATER HEATER • <br />IVOODSTOVE <br />M'tTAL FIREPLACE 8 CHIMNEV <br />FIREPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />APPR. FOR ISSUANCE DY <br />L.C. <br />BUILDING <br />PLUMBING <br />lAECHANICAL <br />INVESTIGATION FEE <br />SU6TOTAL <br />PEflMIT <br />TOT� �E � <br />0084589�'^ c <br />Ii0t�0�70484 <br />LvrT�u�rioN47. .:3 <br />�FW�NSF p_ £76. ,.32 <br />n c <br />{IQUU1'698� <br />e s�cH � .so <br />SL��04(e) $ �.5� <br />STATE BUILDING SURCHARG <br />STATEENERGYSURCHARGE <br />DRIVEWAY PERMIT <br />TOTAL <br />FEE <br />1 <br />PERMITV4LIOATION — '.._.. ""'•"' <br />WHEN PROPEALY VALIDATED ON TN�1S6P146�j`�HIS IS YJUR PERMIT <br />SEIJE;' .'U. L'D � <br />'u 1 :1?°,'- Q) <br />` �„r.:,T�..i: <br />c�— <br />AGDHESS FILe" <br />