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we� <br />aTv oF <br />ever�tt <br />259-8745 <br />" P'rJNSTRUCTIaN ~ <br />PERMIT <br />�. <br />PERMIT NO. � 7 7 2 4 <br />O DEMOLITION � COMBINATION I� BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNEP Mr11LRDDRE55 CITY ZIP PHONE <br />David Brandvold 1415 Madrona Everett 98203 355-6000 <br />�RCHITECTOPOESIGNFR MAILADDRE55 CITY ZIP PHONE <br />.Gary Parkinsoii Medical Dental Bldg. Everett 252-2153 <br />GENERALCONTRRCTOR MAiLA�UflESS GITY ZIP PYONE I.ICENSE� <br />Owner <br />MECHANICRLG9NTRRCTOR MnILAODPESS CITV 21P PHONE UCENSE� <br />PLUMBING CONiNRCTOP MHIL ADDRE55 CITV ZIP pp10NE LICENSE � <br />CLA55OF WORK <br />❑ NEW ❑ ADDITION GZ ALTERATION ❑ pEPAIR ❑ UEMOLITION ❑ DUILDING RELOCATI9N <br />WLURTION OF WORK � <br />S 20��.�� <br />OESCNIBE WORK <br />Install new garage door and change deck. <br />HEATSOUPC! <br />❑ ELECTHICITY ❑ GAS ❑ WOODSTOVE <br />PROPOSED IISE OF BIlIL01NG <br />Residence <br />�or 32 a�ocK <br />1415 Madrona <br />PLUMBING <br />Maple Heights <br />FI%TURE OR ITEM <br />WATER CLOSET (TOIL <br />9ATHiUB <br />IAVATORY�WASH BA: <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />URINAL <br />OFINKING FOUNTAIN <br />FLOOR ORAI�I ' <br />ROOF DRAINS — RAINLEADE <br />SINK (SERVICE — BAR, ETG) <br />R-i <br />V-N <br />SIZE OF BLDG. <br />Deck&GAR. ALT. <br />APPLILATION ACC �Y <br />M.M. <br />SUBTOTAL <br />PEflM1T <br />TOTAL I�EE <br />�nncr cnour <br />R-3&M <br />BY <br />B.E. <br />ES ❑ NO <br />❑ OTHEH <br />I HEREBY CERTIFY THAT I HAVE flEAD AND E%AMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORIIINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETH�R SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO <br />OLATE OR C NCEL THE PROVISIONS OF ANY OTHER <br />�T �LAR! yfEY;ULATING CONSTRUCTIOP: OR <br />AGENT, OP <br />� <br />MECHANICAL <br />FEE NO. TYPE OF EOUIPNI�NT <br />A/C—A/HNDLGUNITS—H.P. � <br />REFRIGERATION UNITS — H.P. EA. <br />BOILERS — B.T.U./HP. <br />GAS FIRED A�C. UNITS — B.T.U. <br />FORCEO AIH SYSTEMS — B,T.U. M EA. <br />WALLMEATERS—B.T.U. M <br />UNITHEATERS—BT.U. M <br />EVAPORATIVE COOLEP.S <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATEq <br />WOOOSTOVE <br />METAL FIREPLACE & CHIMNEV <br />PIREPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />OF CWELLiNG UNITS <br />1 <br />�. occ. ioao <br />L.C. <br />SUBTOTAL <br />PERMIT <br />TOTALFEE <br />87/17724 <br />FEES <br />BUILDING <br />PLUMBING <br />MECHANICA� <br />INVESTIGATIOt��, Pjal <br />STATE BUILDING SURCHARG <br />STATEENERGYSURCHARGE <br />ORIVEWAV PERMIT <br />FEE <br />=EE flECEIPTNO. <br />13.65 83537 <br />VALUATION FEE <br />� 2000.00 45 <br />I^c/19/87 3:2 FM OOOpH4091 <br />H000177:4 <br />E <br />X� <br />15 <br />1 <br />� � � <br />TOTAL I I � ILO <br />PEqMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE� THIS IS YOUR PEflM1T <br />�� <br />N <br />N <br />� <br />� <br />l,ii'�Ji:i�L� Fi'�E <br />