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the Euergrem <br />CITy OF <br />evc�rett <br />259-8745 <br />C-�NSZ� F��lCTION <br />PERI�AIT <br />PEF�MIT IVQ: _- � � � � � <br />❑ DEMOLI710R ❑ COMBINATION ❑ BUILDING � MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNE:i M/IIADpRE55 CP'Y ZIP PHONE <br />Melvin Bridgham 14905 W. Lake Goodwin Stanwood, WA 98292 652-7943 <br />RRCMITECTOROES�GNER MF�LFOORE55 LIIY zIP PHpNE <br />GENEflA�CONTqq�tOF MAILApGRE55 CIfY ZIP PMONE IICENSE• <br />MELHANIG(CONTRRCTOfi M/.ILI.00f1E55 CIIY ZiP PHONE LICENSE� <br />RUM9INGCONTRACTCR MPIL�ODRE55 CIlY 21P PMONE LICENSE� <br />❑ NEW ❑ ADUITION ❑ ALTERATION ❑ REPAIR <br />'RIUFtIpN OF WO(iN <br />s iioo.ou <br />Install gas pipe fcr gas furnace <br />rent so� ince <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE <br />Single family re3.`.9ence <br />wr _ e�ocK _ <br />�onnooaess <br />3516 Hoyt <br />PLUM9ING <br />NO. TYPE OF <br />Oi NTTACM GOUR COPIE`I <br />�� <br />WATER CLOSET (TOILFT) <br />BATH!U� <br />LAVATpRY �WASIi BASIN� <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />OISHWASHER <br />LAUI.IDRY TRAY <br />CIOTMES WASHER <br />URINAI <br />DRINKING FOUNTAIN <br />fL09R DRAIN <br />BNCNKnW Pq[VENTERS <br />FDOF DRAINS — flAINLEADE <br />SINK �SERVICE — BAR ETC � <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />iYPE OF CONST � p;CUPANC� GRCUP NO OF <br />SiZE OF CLDG � NO OF <br />fIRE SPRINKlEFS i�EOUIRED ❑ YES ❑ NO <br />M.M <br />❑ DEMOLITION <br />O OTHER <br />Ll BUILDING RELOCATION <br />1 HEREBY CERTIFY THA7 I HAVE READ AND EXAMINED THIS <br />11PPLICATION AND KNOW THE SANiE TJ BE TriUE AND <br />CORAECT. ALL PROVISIO��S OF LAW� AND ORDINANCES <br />30VERNING THIS TYPE OF WORK Wi�L BE COMPLIED WITH <br />WHETHER S?ECIFIED HEREIN OR NUT. THE GHANTING OF A <br />PERMI7 DOES NOT PRESUME �f0 GIVE AUTHORITY TO <br />VIOLATF OR CANCEL THE F�iOVISIONS OF ANV OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />THE PERFORMANCE OF COKST�UCTION. <br />SIGNnTUP[ � CONTFACTOR TI'J IZED ENT.OR OwAER OnTE <br />X. h. / � �� 12/19/86 <br />"v <br />MECHANICAL <br />FEE NO. ;1'PE OF EOUIPMENT <br />A�C — An:NDLG UMTS — H P <br />REFqIGERATION UNITS —HP. EA <br />Bl`ILEPS — B TL -H P. <br />GASFIREDAC UNITS—�T.0 <br />1 FORCE� AIR SVSIEMS — a T U M EA <br />WALL HEATERS — � TL M <br />UNIT HEATERS — � TL M <br />EVAPOl7A i IVE COOLERS <br />CLOTHESDRVERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATERHEATER � <br />IVOOD STOVE <br />METAL FlREPLACE 8 CHUdNEY <br />I�IHEPLACEIqSEPT <br />HEATPUMP <br />GAS PIPING <br />E%HAUSTFAN <br />SUBTOTAL <br />PEflM1T <br />TOTALFEE <br />NUMBER FEE <br />sire FEES ' <br />❑ NO <br />wELUHGuruirs BUILDING S <br />PLUMBIN3 1�. <br />J LOAD <br />MECHANICAL <br />f,MECKED BY 1 nPPR GOR ISSUANCE tlY <br />INVESTIGATION FEE <br />STATE BUILDING SURCHARG <br />STATEENERGVSURCHARGE <br />�flIVEWAV PERMIT <br />��r.rf�� <br />FEE <br />FEE <br />a000i?s�s z4 00 <br />n�� �4 �, g 4.Oq <br />TOTAL � I 29I00 <br />i <br />CENMIT VqLI�ATION <br />WHEN PPOPERLV VALIDAfLD pN THIS SPACE� THIS IS VOUR PEHMIT <br />11"� <br />� <br />L.C� <br />N <br />a— <br />,._.�_„Sfl _ <br />