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the Evcryqreen <br />CiTY Ot <br />e�erett <br />259-8745 <br />"� t''')NiSTRUCTION � <br />PERMIT <br />PERMIT NO. � + � � G <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING 7G1 SIGN <br />ownEn n�niiaooaEss citr nv rror�[ <br />Everett Fanily Practice 4215 Colby Ave. Everett <br />ARCIICEQOROESIGNER MRILA�ORE55 GTV ZIP PHONE <br />GENEiiRL CONTPACTOR MFIL RD�PESS CITY Z�P PHONE LICENSE � <br />Tube Art Sign 2719 Maple Everett 252-0086 TUBEASI161 BM <br />MECHnNICnLCOMRACTOR MA4ADDRE55 CITY ZIP PMONE LICENSE• <br />PLUMBINGCO'IiRnCTOR AfAILA00RE55 CITV ZIP PMONE IICENSE� <br />CLA55OF WORN <br />�] NEN' ❑ AD�ITION �7 AiTERATION C1 REPAIR ❑ DEMOt.IT10N ❑ BUILOING RELOCATION <br />vnivanoH oF wonK � <br />s 4500.00 <br />DESCRipE WJHK � � <br />Install 1 D/F sign w/pl <br />❑ ELECTRICITY ❑ GAS ❑ WOOGSTOVE ❑ OTHER <br />Medical <br />lOT _ bLOLK <br />4225 Hoyt <br />PLUMBING <br />TYPt OF FIXTURE OR ITEM <br />WP.TEP. CLOSET (TOILET) <br />BATMTUB <br />LAVATORV (WASH �ASIN� <br />SHOWEP <br />KITCHE� SINK 8 OISP <br />DISHWASHER <br />LAUNUFV TfiAY <br />CLOTHES WASNER <br />Ur:INAL <br />Of11NNING FOUNTAIN <br />PLOOR DRAIN <br />BACKFLOw PREVENTERS <br />ROOf ORAINS — RAINLEADERS <br />SINK (S�RVICE — BAR. ETC.) <br />SUB TOTAL <br />PEflMIT <br />TOTAL FF. E <br />{ETPNCK R[�RSETpPCk <br />�E LOTAREA <br />'CONST OCCUP�NCVGROUP <br />��DG NO OF STGlilES <br />�RINNLERS R�Ol11RED ❑ YES ❑ NO <br />1i�pNACC DY i'�nNSC��.CCnE�Bv <br />S.H. <br />I HEREBY CFRTIFY TFiAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PFOVISIOIJS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIEG WITH <br />WHETHER SPECIFIED HEHEIN OR NOT. THE GRANTING OF A <br />PERMIT DOFS NOT PRESUME TO GIVE AUTHORITY TO <br />VlOL.4TE OH CANCEL THE PFOVISIONS OF ANY OTHER <br />STATE OR LOCAL LhW REGULATING CONSTRUCTION OR <br />THE PE&FOFlfi_fi'�A4GFipF�C.'b�lSTF3UCTION. <br />OR O�VNER �FTE <br />x �� <br />M'ECHANICAL <br />FEE NO. TYPE OF EOUIPMENT <br />A,'C — A�MNULG UNITS — H P. <br />REFFIGERATIONUNITS—HP EA. <br />BOILERS - B.TLIHP. <br />GASFIREDAC UNITS—BS.0 <br />FORCED AIF SVSTEMS — �7.0 M FA. <br />WALLHEATERS—BS.U. M <br />UNITHEATERS—�TU M <br />EVAPORATIVE COOLEPS <br />CLOTHESDR�ERS <br />VENTILATION FAN <br />RANG[HOOD <br />WATE7 HEAiEfl <br />WOODSTOVE <br />META� FlRFPI.ACE R CHIMNEY <br />FIREPLAC:INSERT <br />HEATPUMP <br />GAS PIPING <br />EXHAUS�FAN <br />VRCr1NT SrtE <br />❑VES ONO <br />NO OF DWELLING <br />MA% OCC <br />pPPR fOR ISSUANCE 6Y <br />Elec. N.V. <br />L. Callahan <br />SUBTOTAL <br />PEflMIT <br />TdTALFEE <br />PLANCHECkNUMBEfl FEE <br />FEES VALU <br />BUILDING 5 45i <br />PLUMBING <br />A7ECHANICAL <br />INVESTIGATION FEE <br />STATE BUILDING SUFCHARG <br />STATEFNER�VSUFCHAflGE <br />DH{VE4'JAY PEPMIT <br />Set.304�e) <br />U.i/ I <br />i <br />RECEIPT NO. <br />rte <br />TOTAI. I -`�r^.,��.., , _I� <br />_: _� . .�}�, <br />PENMIT VALIDATION <br />WHF.N PfiOFERLY VALIDATEO (W TGI�uSPACE) THI8ISYGUR PERMIT <br />12 I00 <br />CV <br />� <br />a� <br />C�- <br />� <br />