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u� Eu�s� <br />CITY OF <br />�everett <br />259-8745 <br />^ONSTRl1CTIONt� <br />PERMIT <br />PERMIT NO. � 71 6 G <br />❑ DEMOLITION ❑ COMBINATION CJ BUILQiNG ❑ MECHANICAL O PLUMBING ❑ SIGN <br />OWNF.H MRILAOORE55 CITY ZIP PNONE <br />JANET M. ROSEN 1456 Madrona Everett WA 9&203 252-2643 <br />AqCNITECTOP0E51GNEN MAILADDRE55 CITY 21P PMONE <br />GENERRLCONTPAGTOH MAILAOORESS GITY 21P PHONE LICENSE� <br />JOHN MINKS 1112 - 89th Ave SE Everett WA 98205 334-1603 MItVKS�1K142J5 <br />MECHANICNLCONTRACTOH MAI�ADOFESS CITY ZIP PHONE LICENSE� <br />PLUM8INC CONTRACTOR MAIL A��PESS CITY 21P PHONE LiCENSE � <br />U NEW O ADDITION � ❑ ALTEWATION C� HEPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br />VALUATION OF WOFK � <br />58�0�.�� <br />Reside; reroof _ ___ <br />HEATSOURCE <br />L ELECTNICITY ❑ GAS ❑ WOUDSTOVE ❑ OTHER <br />Itesi dence <br />�or _ e�ocK _ <br />Maple Hts Blk 000 D O1 Nly 100 ft <br />1456 Madrona <br />PLUMBING <br />TYPE OF FIXTUHE OR ITEM <br />WATEB CLOSET (TOILET� <br />BATHTUB <br />LAVATORY (WASH BASIPI) <br />KITCHEN SINK 8 OISP. <br />�ISHWASHER <br />LAUNORYTRAY <br />CLOTHES WASHEF <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR ORAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS — RAINLEADERS <br />SINK (SEIiVICE — BAR. ETC ) <br />SUBTOTAL 5 <br />PENMIT S <br />TOTALFEE 5 <br />�R SEtBACK SIDESETBACN <br />f AREA yqCANT SITE <br />❑ YES ❑ NO <br />CUPANCYGPOOP NOOFDWELLI <br />OF STORIES MA%. OCC. LOP <br />PLpNSCMECNEDOV � APPR. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TQ BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVEflNING 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 />THE PERFORAIANCE OF CONSTRUCTION. <br />SIGN flE OF C•ONTRnCiGR. RUTHORIIEO FGENT, OR OWNER OATE <br />X �s�f�..c_P, l�'I � .i 9/12/86 <br />TYPE OF EOUIPMENT <br />4/C — A/HNDLG UNITS — H.P. <br />REfRIGERATION UNITS — H.P. EA. <br />BOILERS — B.T.U./H.P, <br />GAS FIREO A.C. UNITS — 9.T.U. <br />FORCED AIR SVSTEMS — B.T.U. <br />WALL HEATERS — B.T.U. <br />UNIT HEATEfiS — B.T.U. <br />EVAPORATIVE COOLERS <br />CLOTHESDRYERS <br />VENTILAiION FAM <br />flANGEHOOD <br />WATER HEATEfl <br />WOODSTOVE <br />METAL FIREPLACE 8 CHIUNEV <br />FIHEPLACEINSERT <br />HF.AT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SUB TOTAL <br />PERMIT <br />FEES <br />BUILDING <br />PLUMBING <br />MECHANICAI <br />INVES71GA710N FEE <br />STATE BUILDING SURCHARG <br />STA7EENERGYSURCHARGE <br />DRIVEWAY PEF.MIT <br />� <br />M EA. <br />M <br />M <br />Sec.304(e) <br />RECEIPT NO. <br />TUTAL I I �OO <br />PENMIT VALIOATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) TNI515 YOUR PERMIT <br />i��� .,r,�:.s f:..�_ <br />N <br />CD <br />� <br />N <br />� <br />