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:vcic�u F'CIiME 1 PERMITNO. <br />259-8745 <br />C DEMOLI710N �7 COMBINA710N O BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />O\YNEB MAILAD�FE55 C�TY ZIP PHGNE <br />Kenneth IDg de Boer 3222 Hoyt Ave. Everett 98201 252-6465 <br />qRCMiTELTOROESiG��ER �AniLADDRESS CITY Zic GHONE <br />GENERAI CONTRI.CTOA A�A1L ApDPESS CITY ZIP PMONE LIC[KSE • <br />Owner <br />MECM4NICALCONiRRCTOR MAILR�DRE55 CItY ZIP PNONE l!CENSE• <br />Owner <br />PLUM9INGCONT9hGTOR MAILAppFE55 CiTY ZIP PHONE LiCENSE• <br />owner <br />CLP55 OF WORN <br />❑ NEW ❑ ADDITION <br />WORN <br />S 1���.�� <br />� ALTERATION � AEPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br />Repair bathroom and kitchen. new plbg. and sheetrock <br />HEnrsouaCE <br />❑ ELECTRICITY O GAS ❑ WOODSTOVE ❑ OTHEH <br />GPOPOSED �SE OF BUILOING <br />AM NED THIS <br />LOT Z1�Z�OCK 769oF <br />�oonooaess <br />PLUMBING <br />-ow aa n1*ac�i roi <br />of Everett <br />TYPE OF FIX.TURE OR ITEM <br />WATER CLOSET �TOILET� <br />BATHTUB <br />LAVATORV (H'ASH BASIN� <br />SHOWER <br />KITCHEN SINK 8 OISP _ <br />DISHWNSHEP. <br />LAUNDFYTRAY <br />CLOTHES WASHEF <br />URINAL <br />ORINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENI'ERS <br />ROOF �RA1N$ — RAINLEADERS <br />SINK �SERVICE — BAR, ETCJ <br />TYPE OF CONST <br />SIZE OF OLDG <br />PIRE SPRINKLERS REOUI <br />APPLICATION ACG [3Y <br />S.H. <br />SUBTOTAL <br />PENMIT <br />TpTALFEE <br />s.z L <br />PLANS LHECNFD [1Y <br />I HERFBY CERTIFY THAf � HAVE READ AND EX I <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PFOVISIONS OF LAWS AND OFDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPI.IED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PPESUME TO GIVE AUTHORITY TO <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />THE PERFORMANCE OFCONSTRUCTION. <br />SIf,NNiUREOFCO TRAC�TO� A RREOFGENT,OROWNPR �ATE <br />X f�C/U� �o�i�i� <br />FEE NO. TYPE OF EOUIPMENT <br />S OO A/C—ArHNOLGUNIT$—HP. <br />S OO flEFRiGERATION UNITS — H P. EA. <br />S OO BOILERS — 67.0 /HP. <br />GAS FIRED A�C. UNIT$ -- B.T.0 <br />_J <br />F OO FORCE�AIRSYSTEMS—BT.U. MEA. <br />WALI.NEATERS—BS.U. M <br />UNIi MEATEHS — B T U. M <br />EVAPORATIVE COOLEHS <br />CLOTHESDRYERS <br />j VENTILFTION FAN <br />], RANGE HO00 <br />WATER HEATER <br />WOOD STOVE � <br />METAL FIREPLACE 6 CHIMNEV <br />FIREPLACE INSERT <br />HEAT PUMP �� <br />GAS PIPING <br />EXHAUSTFAN <br />� <br />S <br />s zo 00 <br />i10[ SETBACK <br />VACnNT SItE <br />]YES ❑NO <br />I:n OF OIVELUNG UNITS <br />unx occ �ono <br />APVR �OR�SSUANCEOY <br />PLAN CHECKNUMBER <br />FEES <br />BUILOING <br />PLUMBING <br />MECHANICAI <br />INVESTIGATION FEE <br />STATE BUILDING SUI <br />—S—UBT�@sn�[ �"•" <br />PEHMR�� <br />TO� <br />FEE <br />VALUATION <br />5�.���. �� <br />S^c.304�e) <br />STATEENERGVSURCHARGE <br />ORIVEWAY PERMIT <br />ree <br />TOTAL I I <br />PERMIT VALIOATION <br />WHEN Vf10PERLV VAUOATED pN THIS SPACE� TMIS IS YOUR PERMIT <br />1 <br />ii <br />3 <br />c+.i <br />� <br />0 <br />� <br />N <br />