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the Eoergreen <br /> everett ��NSTRUCTION � � . C <br /> 259 -8745 <br /> PERMIT PERMIT NQ:_ � �� `�� <br /> ❑ DEMOLITION ❑ COMBINATION Cl BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNEIi MAILAO�RESS CITV ZIP PHONE <br /> Edwin R. Petersen 1502 Hoyt Avenue Everett 98201 258-2160 (H) <br /> ARCHiiECi OP OESiGNER MniL qODPE55 CIiY <br /> Z�P PnONE <br /> 258-4327 (W) <br /> GENERALCONTRhCTOR MAILADDBES$ CITY ZIP PHONE LICENSE• <br /> Same <br /> MECHnNICA�CONTRACTOR MAILaDDRE55 CITY ZIP PHON[ IICENSE� <br /> PWMOINGCONTRAGTOR MPILAOORESS CITY ZIP pMONE LICLNSE� <br /> CLASS OF WORK <br /> ❑ NEW C� ADDITION ❑ ALTERATION ❑ pEPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br /> VALUATION OF\VORN <br /> 5 15,000. <br /> DESCFIOE WOpK <br /> 600 S.F. addition - bedroom, bath, kitchen, family area <br /> MEATSOURCE <br /> ❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br /> PaovosEo use oF ounoir�c <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> Sin le famil residence APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> ieonioescnianoHorrnoaearr�sriowae�owonnrrncHFouncoi�iesr CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> i�j1 & 3�ocrc 307 oF Hilton'S lst Addition to GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> WHETHER SPECIFIED HcREIN OR NOT. THE GRANTING OF A <br /> �erett PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO <br /> VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATIN6 CONSTRUCTION OR <br /> THE PERFORMANCE OF CONSTqUCTION. <br /> JOOnDDRESS SIGNATUREOFCONT!RACTOfi.AlITM04iREDPGEAi.ORO'.VNER �qTE <br /> 1502 Ho t Avenue X �� ^--� ^-/ c' . /''�C� •. 9-2 �•- F'L <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> 1 WATERCLOSET�TOILET� A,C—A/HNDLGUNITS—NP. <br /> 1 BATHTUB REPRIGERATIONUNITS—HF.EA. <br /> 1 LAVATORV�WASHBASIN� BOILERS—BT.U:HP. <br /> SHOWER GAS FIRED A C.UNITS—B T.U. <br /> 1 NITCHEN SINN 8 DISP. 5 FORCED AIR SYSTEMS—BSL. M EA. <br /> DISHWASHEfl NALIHEATEFS—BSL M <br /> LAUNDRV TRAY �INIT HEATERS—B T.U. M <br /> CLOTHES WASHER EVAPORATiVE COOLERS <br /> URINAL CLOTHESDRYERS <br /> DRINKING fUUNTAIN VEMILATION FAN '� [��^14? :k:Y.�k:f <br /> FIOOR DRAIN pqNGE HOO� <br /> BACKFLOW PREVENTERS \NATER HEATER � <br /> ROOPORAINS—�flAWLEAD[RS WOODSTOVE g ?� ]Q <br /> SINK�SERVICE--BAR,ETC� METAL FIREPLACE 8 CHIMN $^LD� �(J <br /> FIREPLFCE INSERT $ � <br /> HEAT PUMP �� 418�, i0 <br /> GAS PIPING <br /> E%HAUSTFAN <br /> SUBTOTAL S SUBTOTAL <br /> PEflMIT S PEflM1T <br /> TOTAL FEE 5 2O OO TOTAL FEE <br /> taoNTSETenCK nEnnSETonCK Si0E5EionCN PLANCMECNNUM6ER FEE flECEIPINO <br /> 20' - 20' S' 86/17157 105.30 81886 <br /> USE20NE LOTnRE/ ypCANTSrtE <br /> g_2 Gres ��Ho FEES VALUATION FEE <br /> TVP[OGCONST. OCCUPANCVGBOUP NOOFON'ELUNGIINITS BUILDING S <br /> V—N R-3 1 PLUMBING ZQ p <br /> `bZE OF pIDG NO OF STORIES �An% OCC LOAp <br /> 6OO S.F. ], MECHANICAL <br /> INVESTIGATION FEE Sec.304�e) <br /> FIRE SPRINKIEflS REOUIRE� ❑YES ❑NO <br /> S7ATE�UILDING SURCHnRGE 1 0 <br /> STATEENERGVSURCHnRGE <br /> APPLICATIONACGDY PtANSCHECM[O�Y APPRfORI55URNC[OY <br /> DRIVEWAY PERMIT <br /> A1.6f. S.G. L.C. TOTAL 183 0 <br /> —� — PERMIT VALIOATION <br /> WHEN PROPFRLV WLIOATGD(IN THIS SPACB TlUS IS YOUR PFRMIT <br /> C— <br /> � <br /> �. <br /> N <br /> � <br />