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tha+EuerRreen _� �p� �e ',�+ �y,p� <br /> cinoF ��J!i11STF"ti��1.r���l1V � <br /> 9 a <br /> ���ge5 PE�tMII� P�RMITNO. � �27U <br /> ❑ DEMOLITION O COMBINATION ❑ BUILDII�G � MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWN[fl MA�I N�ORE55 CITV <br /> ZIP �MONE <br /> Gerald Vose 2231 Howard St. �verett, WA 98201 353-8345 <br /> ARCYIT[CT OP OESIGNER M>IL ADDHESS Cltt <br /> ZIP PHONE <br /> GENERAL WNTNACTOR MAILq�ORE55 LITY Zip PMONE IICENSEr <br /> MECHPNICAL CONTF4CTOR MAIL PODHE55 CITY ZIP PHONE IICENSE• <br /> Cozy Fieating / Gas Div 20221 - 67th Ave NE Arlington 93223 435-4054 COZYI3D137NC <br /> PWMBiN.COM1TflACTOR M/ILAOORESS CiTV Zip PHONE LICENS[� <br /> QA<S OG WOFK —. <br /> ❑ NEW ❑ ADDITION � ALTtRATION ❑ pEPAIR O DEMOLITION ❑ UUILDlNG RELOCATION <br /> VALUATIJN 6f'vpFN -� <br /> S <br /> DEc�q�pE'.vORK <br /> Repluce oil fuxnace with gas furnace & replace electric water heater with gas one <br /> HEATSOURL[ ' <br /> ❑ ELEC7RIpTV � GAS ❑ KOODSTOVE ❑ OTHEH <br /> PROPOSEO U]E'JF�U�LDING <br /> Single Family reside.nce I HcREBY CERTIFY THAT I HAVE READ AND EXAMINE� THIS <br /> APPLICATION AND KNOW THE SA�4E TO 8E TRUE AND <br /> �EGALpESCFIPTICNOFPRO�ERTY�5MOW0ELOWORfTfACHFOURCOPIES� CORRECT. ALL PROVISIONS OF LAWS AND OF'.DINANCES <br /> LOT�BLOCK _OF GOVERNING THIS TYPE OF WORK WILL �E CUMPLIF.D WI"TH <br /> WHETHER SPECIFIED HEfiEIN OR NOT. THE GRANT�NG OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORI'iY TO <br /> VIOLATE OR CAIJCEL THE PROVISIONS OF ARY O'iHER <br /> STAfE Oii LOCAL LA`N REGUL�TING CONSTRUCTIO!J OR <br /> THE PE FORMANCE OF CONSTRUCTION. <br /> JOBApDRE55 —_ SIG TU OF CONTRnyTOR,AUTH �T,OF ON'NE(1 pNTE <br /> za31 xowara s st. g � �;�� ��-�/ iz/9/a� <br /> NLl;M91NG MECHANICAI <br /> NO. TYPE OF FIXTUFE OR ITEM �FEE NO. TYPE OF EAUIPMENT FF.E <br /> WATENCLOSET�TOILET� A/C- A/NNDI_GUNITS—H.P. <br /> BATHTUB REFRIGERFTION UNITS—HP.EA. <br /> LAVHTORV(WASM BASIN) OOILEHS—8 T.0/H.P. <br /> SHOWEA GAS FIREO A�C.UNITS—B.T.U. <br /> NITCHENSINKSOISP. ]. FORCEDAIHSYSTCMS—FT.U.7S M�� 9 OO 4 <br /> _ DISH\4ASHER N'ALLHE/'�TCqS—�.T.U. M <br /> LAUNORYTRAY � UNITHEATEh9—P.7.U. <br /> CLOTHES WASHER EVAPOfln1lVE CqOLERS <br /> URINAL CLOTHESJFYEHS <br /> DRINKING FOUNTAIN VENTIIAiION FAN <br /> FLOOR DRnIN qR�GE HOOD <br /> BACKFI.OW PRFVENTERS 1 WATEH HEATER rJ <br /> ROOF DF41NS—RAWIEADERS WOOD STOVE <br /> SINK(SERVICE--BAR,ETC.) METAL FIRFPLACE 8 CHIMNEY <br /> FIREPLAC: INSEFi <br /> HEAT PUA7P <br /> GAS PIPING <br /> EXHAUSTFAN <br /> SUBTOTAL S _ SUBTOTAI. 1 5� <br /> PERMIT S PENMIT f <br /> TOTALFEE f TOTALFEE <br /> fRONiSETFnCr '� nEAPSEToaCrc SIOEEETBnCK PLANCHECKNUMBER FEE RECEIPTNO. <br /> USEZONE LOTqqEA <br /> VACANTSITE FEES VALUATION FEE <br /> ❑YES []NO <br /> TYPEOFGOhST. OCCUPANf.YGPOUP NOOFOWELLINGUNi�S BUILf. ,�.� <br /> PLUMBING � � <br /> SIZE OF BLDG. NOAF STOFIES AIM.OCfl IOAp <br /> h1ECHANICAL $O SO <br /> INVESTIGATION FFE 5���.J04�e) <br /> FIRE SPFINKLERS REOUIPED ❑YES ❑NO <br /> STATE BUILDING SURCHFRGE <br /> STHTEENERGV�URCHARGE <br /> APP�ICRTIONACC �Y PLPNSLHECNED�'! PPPR iOR155U4NCE0Y <br /> �RIVEWAV PERMIT <br /> M.M. TOTAL <br /> 30 50 <br /> PENMIT VALI�ATION <br /> WHEN PROPERLY VALIDATED pN THIS SPACE�TI IIS IS VOUR PERMIT <br /> � <br /> �� <br /> N <br /> � <br /> �-- <br /> , <br /> Y-- — . .— �Y� '��e; <br /> �. .k . <br /> � ,:J <br /> err5�� .: �t f. <br />� .. . / ' . . , .-. ..�. � .1 �� � <br /> ,. .�:.� .:�„ . . � i <br /> �_ : .� . : . . _-. ,r.. , , . , .�._ . . . , , . : . . �. . . ._,.�.-.. : . . -� _,. � . . , :. : . .�.�. ' <br /> �s <br />