|
�i„� F�,,•,,,��"�,�
<br />��„..,
<br />everett
<br />��„ .,,,�.�.:�.,.:,,.�,,
<br />ever�r,rl. wn s�:a�oi
<br />�ONSTRUCTION
<br />�� PERMIT
<br />COME3INATION • BUILDING • MECHANICAL • PLUMBING
<br />evereri
<br />OWNER NAILI�DUItLGS LIP PHUNL
<br />V
<br />D1D. Vanderberg 5228 87th Ave. N.E. 98205 334-4456 m
<br />— �
<br />�,�RCrlii[IClOrio[SiGNI-�t_._ - -__- -_.-_-Ain�LnUf]IiL;_=._. _-_--_.- I'110NL—_ --UCENS[.-i\'O. �
<br />_ ___ ____.___' - ""_ �
<br />GEN�R.11 CUNTRACTOR MAIL ADDRE55 PNONE �ICENSL N��. z
<br />Same
<br />C
<br />MtC1L�NICA1. CONTIiACTUR MAtL AUDRGSS PHONE LICENSL Nn �
<br />W
<br />m
<br />❑IUMPING CONTflACTOR MAIL ADOfiESS PNON[ LIC[Ntit� NU �
<br />- _ ... __ _ _ _ _.__.._._. __'—__" _
<br />�GRMIT CLASS OF WUnr. �
<br />❑COMf31NATION
<br />�LIUILOING ❑PLUMUING ��MGCHANICnL�
<br />❑New ❑nuuniara ❑ni.n.nr,iinrv ❑reu�nnv
<br />VALUAI ION OF 1VOHK
<br />----- . _. .._ -----...-- —. .. ------
<br />2�000.00 ❑nt-eaoi ie:i� ❑i �n�ct. ❑sieN ❑swintn�we roo�
<br />5
<br />--_..___-_ ._.______ ... .._ _ .. -__
<br />DESCRIBE WORK �
<br />Erect garage
<br />rnoroseu use MECHANICAL
<br />single family garage _
<br />TVPE OF ENERGY
<br />L@GAL�ESCf11PTIONOFPROPERTV6HOWf3ELOWnRl�1iACM ❑(;/�5 ❑ELEC.
<br />�OVR O IESI
<br />� 409 ShcRt N1CI101as Add NO. _TYPE OF E�UIPMENT FEE
<br />LOT OLOCK_OF -- - �NRCOND.UNITS-IIP.El�. $ I
<br />REI-RIG[flATION UNII3 II.P. GA. �-
<br />_ - -'- OOILERS H.P. [A. --�- � -�-_ �
<br />FOqCED AIR SVSTEMS-O.T.U. MEA.
<br />_"' -_ - I
<br />JOO AD�RLSS SPACE & WqLL HEATERS - B.T.U.
<br />2019 Highland uwT nenr�as n.i.u. i
<br />[VnPOHA7IVECOOLEFS
<br />PLUMBING 'i c�on�cs onvens i
<br />__.._------ . _..---------- T—
<br />--�-- vcrvn�nnoN rntv
<br />HANGEHOOU I
<br />NO. TVPE OF FIXTURE OR ITEM FEE niit IlnNouNG UNIT___ C.F.M, �
<br />UATH TUBS S - - — �
<br />CLOTHLS::'^�::II[li � WATER HEAT@H.. ..� -� "�� � —�—
<br />DISH WASHER$ � FAG [IUILT FIREPLACE .W CNIMNEV
<br />Dfi1NKINGFOUNTAINS i � - --- - �
<br />GAS. SVSTEM�. NO OP Ol1T�ET5 �-
<br />FLOOR DHAINS i . _ __"_ -_.-___ . .__.' '___'-'.__-- __y _
<br />KITCHEN SINKS & �ISP. � _ _ __ _ __ _ _ ___ . _ _ �UO TOTAL 5 �
<br />6�RSWKS � _ ___ _ _ �rnnniT 5
<br />ROOF DRNNS - RAIN LEADC-RS � iornL FE[ 5 �
<br />SHOWER RAl'HS 1HI5 P6PMIi IILCOMES NUIL ANI] VOID IF WOHK OR CONSTqUC
<br />SERVICE SINKS TION AUTHORIZCfJ IS NOT COMAIENCED lVI1�HIN 1'n nnvc, nq !f
<br />SUMPS tiLWAGE PUMP CONSfPUC110N Ofi wOHK IS SUSPFNnE� OR nUnNDONED FOR n
<br />�— P[RIOD OF 120 DnY$ l�T ANY TIWL AI'1Eli WOHK ISCOMMFINCEO.
<br />URINl1i5 J- I II@REIIY CERTIFY 1HAT I 11l�VE PLA[l AND EXAMINED T1115 Ar'
<br />WATER CIASGT$ P�JCNION AN� KNOW illE SAM@ TI�l3E iRUE AND CORHLCT. ALI.
<br />WATER HEl1TER5 - ELECTRIC I pqpV15lON5 OF LnW; AND ONOWhNCCS GOVLfiNIN(3 T116 TYPt
<br />WA5�1 RASINS j- OP WONK WILI_ �E COMPIJBD WITI WH[TH[N SP[CIFICD HEREIN
<br />LAUNDf2Y THAYS OH NO1, THE GHnNTING ol' n PE-�n111 l)O[, NOT PR@SUME To
<br />� GN[ 11UTHORIiY 10 VInLAfE pP C/1NC@L THE PROVISIONS OF
<br />ANV Ol'll[R ;lAll� Ofi IUCAI. I.At!� fi[GVLATING CONSTliUCTION
<br />� ON TIIE PEfi�ON�I�hCI OI' CONtitHUCIION
<br />_ __ . I
<br />SUB TOTAL
<br />PERMIT S
<br />TOTAL FEE x
<br />WATEFi SERVICE SIZE dLDG.SUPPLY SIZE SiGNmui�Cnr cUNii�nclUHolznUnl nGENi � Dnl[
<br />SID[YARDSET�ACK SiliEETiBT[3l�CK RGARVI�RI�SGTl3l�CKPLnNCHff,KNUNIiLit PL/11VCHECKFEC
<br />5' 20' 20' 79/277 rec r�eceirr No.
<br />- — 10.00 38704
<br />USE LONE LOT AHEA VACAN7 ti1T[
<br />g–Z --- -� ------...- ---- —. .
<br />❑res (�No FEES VALUATION FEE
<br />1 VPE OF CONST. OCCUPANCY (iROUP NO.Of OWL�LING � —,-
<br />V–N M-1 uNirs p _ _ __ _ i
<br />sTze oF u�oc— No. or sronies Ml�X.OGC. LOl�f] - IiUILUING 52000.00 20 j 00
<br />20'x24' 1 —�
<br />r�un�mNc �
<br />f IH6 ZONE RASEMENi FIHESPRINKLERS - � __
<br />3 REOUIREU MECHANICAL I
<br />❑VES �10
<br />_'�--
<br />;PECIIIL CONDITIONS�. pT��Eq �
<br />- - I
<br />---"-- - —P[NALI'V SEC.70�1u) I--
<br />..-_..-____3_ ._- _. _. _____-__.__-l___-_._
<br />TOTAL 20 I 00
<br />P[fiMIT VAU�ATION
<br />-- - — W�,�N,�,��,,.E,,,, ���,,,�,�,>,�ry:�7,r;�:,�,,�_��'0"Y'�:R'n�,.._„�,�,i
<br />--- -- y'7UR RECEIPT
<br />�r„i�:... ...��i�iid�.-;- ,.,� ,�..ii n -G.-�-ii�r��..�.,i,..:.ii 'fi �r'1NK YOU
<br />I,-- v.c.' —
<br />�,
<br />Af'H 1
<br />
|