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� ��he, Ecer�reen � O � �� � � �� I O � + <br />�;�� ur i <br />e��rett PERMIT PERMIT NO. �-3925 <br />qTY HALL 259�8745 , <br />t7 eaenetj,jve�9�zot ��J pp��NATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNER MAILADDRE55 ~ GITY 21P PMONE <br />EMA NEIL 4014 RUCKER EVERETT WA 98201 258-1264 <br />ARCHREGT OR DESIGNER MAIL AOOPESS CITY ZIP PHONE <br />3ENERPL CONTRRGTOR MRIL AOORE55 GTY 21P PHONE LILENSE � <br />THREE LAKES CONSTRUCTION 6523 - 171st Ave SE SNohomish WA 98290 252-2173 <br />MEGMANIGAL CONTRACTOR MAIL AODRE55 CITY ZIP PHONE IICENSE • <br />PWMBING GONTRFGTOR MRII PDDRE55 GITY 21P PNONE LICENSE � <br />❑ NEW � ADDITION ❑ ALTERATION XXREPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN � WOOD S70VEIFIHEPLACE INSERT <br />` 13 500.00 <br />DESCRIBE N'ORK <br />wT_e�ocn 5 oF <br />43 and S 5' o <br />PLUMBINO <br />N0. TYPE OF FI%TURE OR ITEM <br />i �nTcM CLOSET (TOILET) <br />BATHTUB <br />� LAVATORVIWASH BASIN) <br />SHOWER <br />KITCMEN SINK 8 OISP. <br />DISHWASHER <br />LAUNDRVTRAY <br />CLOTHES WASHER <br />WATER HEA7ER <br />URINAL <br />- OHINKING FOUNTAIN <br />FLOUR ORAIN <br />VACUUM BREAKERS <br />ROOF DRAINS — RA�NLEADEFS <br />euiv,ceovicc _ RAR FTG1 <br />SUBTOTAL <br />PEHMIT <br />TOTAL FEE <br />APPROVALS <br />�. EIIVIRONNENT�L CMECK LIST <br />2. BUILDING PLANS "' <br />3 FIFiFHYDRANT <br />. FIRE PROTECTION SYSTFbI <br />5. GRADING <br />B.DRAINAGE .,,� <br />;'.B.HEAL7H DIS7RICT '--' <br />PPLICATION AGC. BY LANS CHECKED BY <br />�.- -� <br />S-' SJ <br />stg <br />i <br />r� <br />FEE <br />f <br />S <br />S <br />YES �l0 <br />MAX. <br />YES <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE 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 SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERF MANCE OF CONSTRUCTION. <br />514 TURE CON'FDCiOR OR�PyI�THOR'�D AGENT DATE <br />Y � % A /I 9/17/84 <br />MECHANICAL <br />AIR COND. UNITS — Fi.P. [A. <br />REFRIGERATION UNITS — H.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UNITS — TpNNAGE EA. <br />FORCED AIR SVSTEMS — B.T.U. M EA. <br />WALL HEATERS — B.T.U. �1 <br />UNI7 HEATERS — B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILA710N FAN <br />RANGFHOOD <br />AIR HANDLING UNIT — C.F.M. <br />STOVE — WOOD <br />METAL FIREPLACE 8 CHIMNEY <br />FIF.EPLACE INSERT <br />HEAT PUMP <br />SUB TOTAL <br />PERMIT <br />TOTALFEE <br />(NUMBER P <br />FEE <br />FEES VALUATION <br />BUILDING <br />PLUMBING <br />l.1ECHANICAL <br />O7HER <br />PENALTV <br />TOTAL <br />S 13,500 <br />U.B.G. <br />SEG. 703 '-' <br />FEE <br />� <br />S <br />f <br />�HECK FEE <br />RECEIPT NO. <br />FEE <br />104 <br />6 <br />'_ � <br />��8 <br />PERMIT VALIDATION <br />IYHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUP PERNIT � <br />( �� � � Il � � �' � � <br />� � � .. <br />M <br />ISSUANCE BV . ^. - � � �� <br />, i <br />, <br />nno�ess Fae <br />� � � <br />H !— <br />H 'T. <br />H �= <br />� � <br />c <br />� � <br />� �. <br />�p F <br />Cy :. <br />H � <br />� U <br />r <br />O Y� <br />� �. <br />G. <br />�'. <br />C: <br />r: <br />• �] <br />