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theEveCrgree� .�:.,. �r7NSTRUCTItrJN ��y '�� <br />everett pERMIT WERMITNQ: � ���� <br />259-8745 <br />C}Z DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ M�CHANICAL 'O PLUMBING ❑ SIGN <br />OWNER MAIIAOORE55 CITV ZIP PHONE <br />Ja�C.Burgess 5014 23rd Ave. W. Eberett, WA 98203 353-9E79 <br />ApCMRECT OR OESIGNER ti�AIL PODRE55 LITY ZIP PMONE <br />GENERALCONTFAGTOF MAIIPDDRE55 CITV ZIP PHONE LICENSE+ <br />Owner <br />MECHANICALCDMRACTOd MAILAp�PE55 CITV ZIP PMONE UCENSE• <br />PLUMBINGCONTRACTOP M/ILPOORESS CITY ZIP PHONE LICENSEn <br />O NEW V^ O ADDITION ❑ ALTERATION ❑ HEPAIH I.3 DEMOLITION ❑ BUILDING RELOCATION <br />5 <br />Demolish and remove �MiHBXff� Buildinq. <br />HEATSOURCE <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />PROPOSEO USE OF �WL�ING <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMItJED THIS <br />Single fami�.y residence APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />�ecnioescniaTioNOFrnoaenrv�v�owee�owoannncHvouacoriesi CORRECT. ALL PROVISIONS OF LAC.3 AND ORDINP.NCES <br />�or9&10 e�ocK 11 <br />PLUMBING <br />NO. TYPE OF FIXTURE OR <br />WATER CLOSET (TOI'.ET� <br />9AiNTU6 <br />LAVATORV�WASN BASW) <br />SHOWER <br />KITCHEN SINK 8 �ISP. <br />DISHVIASHE� <br />LAUN�RVTPAV <br />URINAL <br />OPINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENT[RS <br />flOOF URAIhS — RAINLEADERS <br />SINK �SERVICE — BAR. ETCJ <br />SUBTOTAL <br />PERMIT <br />TOTALFEE <br />USE ZONE � LOT �FEA <br />OF GONST <br />0.PPLICNTION <br />S.H. <br />'s Fisst Add. <br />GOVERNIN6 THIS TYPE OF WORK WILL BE COMPL�ED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PEaMIT DOES NOT PRESUME TO GIVE AUTHORITY TO <br />VIGLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING COnSTRUCTlO�'J OR <br />T� PERFORMANCE OFCONSTRUCTION. <br />51 NA UPE OF C TRACT AUTNORIZED AGENT. OR OWNER D TE <br />X � C.G� �,�? Pi'�L �"Y�.i',� <br />FFE NO. TYPE OF EOUIPMENT FEE <br />A�C — A.MNDLG UNITS — NP <br />REFRIGERATION UNITS — H.P. EA <br />BOILERS — BS.0 /H P. <br />GAS FlREC > f„ UNITS — B.T.U. <br />FORCE� AIR SYSTEMS — 8 T.U. M EA. <br />WALLHEATERS—BS.U. M <br />UNIT HEATERS — BSL. M _ <br />EVAPORATIVE COOLERS <br />CLOTNESDRVEflS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER � <br />WOODSTOVE <br />METAL FIREPLA�E 8 CNIMNEV <br />FIFEPLACE WSERT <br />HEAT FUMP <br />GAS PIPING <br />E%HAUSTFAN <br />5[TBACK <br />SUBTOTAL <br />PENMIT <br />TUTALFEE <br />CHECKNUN6ER FEE <br />VAC/ NT SITE FEES <br />❑VE$ ❑I:O <br />NG OFpWELIINGUNIiS BUILDING <br />PWMBING <br />VO OFSTONE$ MA% OCC.lOPO <br />❑ YES ❑ NO <br />PLANS CHECKED OV �PPR FOR ISSU�NC[ �� <br />L. C. <br />MECHANICAL <br />INVESTIGAT�ON FEE <br />STATE BUILOING SURCHAHG <br />STATE EIdERGY SUf�CHARGE <br />DfiIVEWAY PERMIT <br />VALUA <br />s <br />Sec.304(e) <br />NO. <br />FEE <br />TOTAL I I <br />PERMIT VALIDATION <br />WH[N PROPE.RLV VALIDI+TEL� (IN THIS SPACE� THIS �S VOUR PERMIT <br />3150 <br />�� <br />�� <br />N <br />t7� <br />� <br />