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lhe Euergreen <br />��T,. oF <br />ev�rett <br />259-8745 <br />��rvsr�ucricaN <br />PE�RMIT <br />PERMIT NQ: _ � � O o � <br />LM DEMOLITION CXCOMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ S�GN <br />OWNER h1AILApDRE55 �IiY iIF pMONE <br />MIKE PERIN 3228 Laurel Dr. Everett WA 98201 259-0559 <br />ARCNRECT OB DESIGNER MF�I AD�ftE55 CITY ZIP PHONE <br />GENENnLCONTRnCTOR AIAILAOORE55 CrtY Z�p <br />LVJ JJJ� <br />EVERE6311 <br />LICENSE • <br />LiCENSE r <br />PLUUBINGCONTRACTOR M1IAiLaDDRESi Clti ZI� PHONE LICF.NSE� <br />CLn$5 Of WORN ,y, <br />❑ NEW L�l ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION C BUILDING flELOCATION <br />V/. W FTION OF \40FN <br />s 13,600. <br />Df5LR19E WORN <br />Second story addn <br />HE/+TSOURCE <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />SingleVfemily��residence <br />�or _ ewcn � 9 or_ <br />Lot 8 and Lot 9 less <br />PLUMBING <br />I.U�� <br />OR ITEM <br />\YATER CLOSET �TOILE'f� <br />BAiNTUB <br />LAVATORV (WASH BASIN� <br />SHJWER <br />KITCHEN SINK 8 DISP. <br />DISHWFSHER <br />LAUNDRVTRAV <br />CLOTHES WASHEF <br />URINFL <br />DRINKING FOUNTAIN <br />FLOOR DRPIN <br />BACKFLOW PREVENTERS <br />ROOF OFAINS - qAINLEA�EflS <br />SINK �SERVICE - �AR. ETCJ <br />SUOTOTAL <br />_ PEqMIT <br />TOTALFEE <br />FRONTSETBnCK R[AR SETdACK <br />2�� 2�� <br />USF.20NE �OTNqEA <br />R-1 <br />TYPEOPCONST OCCUnqryCYGF( <br />V-N R-3 <br />S�ZEOF9LOG NOOFSTORIfS <br />Addn 480 sf 2 <br />FIFE SPRINKLEHS RECUIRE� ❑ YES ❑ N <br />pPr�icniioNacc or r�aNSCN[cKEo <br />mm � sg <br />SiOE [E � 9ACN <br />6' <br />✓AC.ANT SITE <br />❑ 1E5 I�rl NO <br />n <br />IUV NO OF pWELLING UNITS <br />1 <br />... uCC IOAD <br />n <br />I3Y APPR GOR ISSUM�CE PY <br />�C <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW TiIE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIE� HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />THE PERFORMANCE OF CONSTRUCTIOPI. <br />S/iGNAillf�[ Of CONiPAQOR. (�U�MO�I ED AC[Ni.OR ON'NER OAiE <br />A 1��� (• ( ��.� i�.�';(�.<_ � ���� �— ����e <br />RAECHANICAL <br />TYPE OF EOUIPMENT <br />A: C- A�HNDLG UNITS - H F. <br />REFRIGERATION UNITS - H P. EA <br />�OILERS - OS U �N °- <br />G�5 FIRED A C. UNITS - B.T U <br />FORCEDnIRSYSTEMS-BT.0 MEA. <br />WALLHEATEHS-�SU �nin� niY <br />11NITNEATER$-BS.U. � �� <br />f-- <br />EVAPORATIVECOOLERS ���M���Oz <br />CiOTHESDRYEFS ���� <br />VENTILATION FAN F���£ <br />RANGE HOOD �{.Sf{ <br />WATERHEATER � <br />wOOD STOVE E� Sl:El� <br />META� RREPI ACE 8 CHIMNEY{�e{� f� <br />FIREPLACEIhSERT <br />HEAT PL1�dP <br />GAS PIPING <br />EXHAUSTFAN <br />86/17083 <br />FEES <br />BUILDING <br />PLUM�ING <br />MECHANICAL <br />INVESTIGATICN FEE <br />SUBTOTAL 5 <br />PEflM1T <br />TOTALFEE <br />FEE RECEIPT I <br />99.45 � 81832 <br />$ <br />Sec.304�c) <br />STATE BUILDING SURCHARGE <br />STATEENERGVSURCMARGE <br />DRIVEWAV FERMIT <br />TOTAL <br />PENMIT VALiDAT10N <br />WHEN PROPERLV VALI�ATE[J pN THIS Sf'ACE� THIS IS VOl1R FERMIT <br />I <br />FEE <br />