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fhe Evergreen . �- �`'�`��ST R U CT I O N � � � <br /> cin oF <br /> everett � c <br /> 259 -8745 PERMIT PERMITNO. �� �132 <br /> ❑ DEMOLITION O COMBINATION ❑ BUILDING � MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNEP AIAIIADDRE55 CITY 21P FMONE <br /> Steve Ameden 2432 Jackson Everett 98203 353-8665 <br /> PaCMIiELT OR OESIGNER MAII AD�PE55 CrtV 21P P1�ONE <br /> GENERAL CONTPACTOR MAIL ApORE55 CITY ZIP PMONE UCENSE� <br /> Owner <br /> MECHPNICALCONTRACTOR IAAILP�ORE55 C�iV ZIP PMONE UGENSE• <br /> owner <br /> PL�M�INGCONTRRCTOB MAiLAD�PE55 CiTV ZIP P��ONE LiCENS[r <br /> CLASS Of W OFK <br /> ❑ NEW ❑ ADDITION � ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING HELOCATION <br /> VALllAT10N OF WORH <br /> $ <br /> OESCPIBE WORN <br /> Install pellet stove <br /> HERTSOURCE <br /> ❑ ELECTRICITY ❑ �AS ❑ WOODSTOVE ❑ OTHER <br /> PPOPOSEO USE OF B111L01NC <br /> Sin le £amil residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED ThIIS <br /> 4 Y APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> �ecn�oesemrriowo�rr�o�enrrisrowoEwwor+nrrncHvouneoaiesi CORRECT. ALL FROVISIONS OF LAWS AND ORDINANCES <br /> GOV�RNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> LOT��LOCN _ OF <br /> WHETHER SP�CIFIED HEREIN OR ":�T. 'F1E GRANTING OF A <br /> PERMIT DOES NOT PRESU�+1E TO GIVE AUTHORITY TO <br /> VIOLATE OR CANCEL THF. PROVISIONS OF ANY OTHER <br /> STATE ON LOCAL LAW RF:GULATING CONSTRUCTION OR <br /> THE PERFORMANCE OF CCNSTRUCTION. <br /> JOO�\OORESS SIGN/TOR[OfCO fiACT AIITHOFIZ[D�GENT.OROWNER -IATE <br /> 2432 .7ackson Ave. X �' ��`� �—��- 8`� <br /> PLUMBING M1IECHANICAL <br /> ,NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF i_OUIPMENT FEE <br /> WATER CLOSET(TOILET� NC—A�HN�LG UNITS—H P <br /> BATHTU5 REFRIGERATIOH UNITS—H P.EA <br /> IAVATORV(WASH�r1SIN) �OILERS—B TL./H 1' <br /> SHOWER GAS FIRED A C.UN�TS—B T U <br /> KITCHEN SINK 8 DISP FORCED AIr7 SVS".EMS—B TL M EA. <br /> OISMWASHER WALLHEATERS—D.TL. M <br /> LAUNDRY TRAY UNIT MEATEFS—B T.U. M <br /> GLOTHES WASHER F.VAPORATIVE�700LER5 <br /> 11F:INAL CLOTHES DFYliRS <br /> DR W KING f OUNTAIN VENTILA-i ION Fi N <br /> PLOOR ORAIN RANGE HOOD <br /> BACKFLOW PREVENTF.RS W�TER HC>:Tcn <br /> ROOF DRAINS—F.:IVLEA�EfiS w00�STOVE <br /> SINK(SEPVICE—BAR.ETCJ METAI FIhFPLACF$CHIMNEV <br /> FIREPLACEINSERT <br /> HEAT PUA1P <br /> GAS PIPING <br /> E%HAUSTFAN <br /> 1 Pellet stove 30 00 <br /> SUBTOTqL s suerorn� 30 00 <br /> PERMIT 5 PEflM1T <br /> TOTALfEE 5 TOTALFEE 3O OO <br /> FnONT SETonCrc REnR SETHnCK Si�[SETonCR PLAN CHECK NUMBER €�y�4/B9 9:0/iViC61f.'10�1p4189 �4::4::::# <br /> / <br /> USEZONE lO1AREF VACANTSITE ^ � <br /> ❑vEs ❑r+o FEES rA Ib�N� � FEE <br /> TYPEOFCONST OCCUV�NCYGROUP NOOFOWELLiNGUNRS BUILDING �'HECY S3 .00 <br /> PLUMBING <br /> S�ZEOF�IOG NDOfSTONES 1d4% DCCLOAO <br /> MECHANICAL 3 00 <br /> INVESTIGATION FEE Sec.304(e) <br /> FIRE SPRINKIEPS REOUIRED ❑YES ❑NO <br /> STATE BUILDING SJRCHARGE <br /> STATEENERGVSURCHARGE <br /> f.PPLICATIONPCCOY PLANSCIIECNEDOY /.PPRiONI55L1ANCE�V <br /> DRWEWAV PERMIi <br /> S.H. TOTAL 3 00 <br /> PERMIT VALIDATION <br /> V'1H[N PROPERI V V�LIDAiEU(IH THIS$Pl�GB THIS I$YOUR PE(ildlT <br /> N <br /> (�'� <br /> l_L) <br /> r <br /> N <br />