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���, .,� <br />ce�erett <br />c��� �ini_i.��sa��as <br />� ,� i-�; i , r. �vn ��saoi <br />n <br />u <br />CONSTRUCTION <br />PEkMIT <br />� <br />C(�MBINATION • [iUILDING • MECHANICAL • PLUMBING <br />everett <br />"�vrvri� ninii. nnonu;s rm r���o�u� <br />David A. Brandvold P.O. Box 3066 98203 355-.1135 m <br />_ � <br />.�HCliil[CI OIiDE51�GNClt- -- -- —"--A1r111_ADDHlSS �--- -PIIUNE LIC[IJtiCIJP � <br />-'-' _ '"_ .. __ ._ _. "_ _-_-___-_"___-___ <br />� <br />GF-.NIRM.COh1HACTUR � �L11L,1UL'RC55 � PHONE-------� LICEhS[NU. z <br />David A. Broandvold P.O. Box 3066 355-1135 -DA-299QK C <br />'•�LCNt�YIC4LCONiRf�Cf011 � MAILADDRE55 NHONL LIC[NSCNO � <br />W <br />m <br />�'i�UMf31NG CONTRl�CIOfI Nl11L I�U�RE55 PHUNE LICLNS[ NO � <br />PLRMIT CLASS OF WORK <br />}v�-�COM�INATION <br />.u[iVILDING �I'LUAtI11NCi ��1ECH�INICl�L <br />`�. NLW ❑AODI110N ❑ALTEHAiION ❑RGPNH <br />nn <br />—_'__' _ —'_—__ _ _-_---_-_ _._ <br />VALUATION OF WOfiK <br />g 60�000.00 ❑oennoi.i;n ❑i �Nr.t- ❑sir.N ❑swin^.r,nr� , rurn_ <br />---- -- _.. --- -- -- ---_._ . _ . . .. ._ _. <br />ULtiCFiI(SL WORF . .... _ ._ -_.-- __-- <br />Construct single family residence <br />PHOPO :LU USE <br />single family residence MECHANICAL _ _ _ <br />TVPE OI FN[NGl' �- <br />L@G1L DESCRIPTION OF PROPEHTY ISI10W RELOW pR ATTACII ❑GAS ❑EIEC. <br />FDUF COPIE51 _ <br />3 RydRS AddltlOT1 �d0. � TYPE OF E�UIPMENT � FEE <br />LOT �LOCK—OF_ ______ _ . . - - --- � -- -- <br />� i11ii COND. VNITS- H.R EA. 5 I <br />�Hf.l1tIGLHATIDNUNITS H.P.El�. �— <br />IBUII.Cf�; IIP.[l�._. __-"__-_--' _ 1 <br />H 1-28-�1 1: r�>rxceo nin Sv$TEMS-I3.T.U. MEA. � 0 <br />� <br />JOA ADORESS --�--� .._ . . .. . . . . ' I;PnCE !Y WALL HEATFFS - A.T.U. <br />2i8 Highland Road ����air��enreNs x.r.u. i <br />� t VnPORl�TIVE COOLERS <br />PLUMdING 1����.or��esonveHs 3 i 00 <br />_ . _ _ - --- � — — <br />... � '\�LNTILATIONI-AN _ Q � QQ <br />1 � HANG@ NOOD I� pp <br />NO. TVPE OF FI%TURE OR ITEM FEE � nit�, unNOl.wG UNii �� C.F.M. 1 <br />8AT'H TUBS S � � <br />1 CLOTHES Wl�SHEH � I� WnTER �{EATER <br />DISH WASHENS � ---- ---- --'---'-'-- ---- <br />1 PAG �V ILT FIREPLACE R CIIIMNEV � � OQ.. _ <br />DRWKINGFOUNTAINS � ---�------- ------7- - <br />.1r�5. SVSTEM. NO OP OVTLETS _� <br />FLOOR UFAINS � "___"_ -_-_ . _ __.. _ _ _ _-. _' _- __ <br />KITCHEN SINKS & DISP. -Z j�--�Q __ _____ ______ _ tiV[t TOTnL 5 __1q � �� _ <br />BAR SINKS i PERMIT 5 -T <br />'___-___ __ '--�-___ <br />ROOF DRNNS �� fihlN LEADERS i TOTAL FEB 5 I Q�_ <br />SHOWER BATHS THIS PFRMIT IIGCOMES NULL CNO VOlfl IP WOHK OR CONSTRVC <br />SC-HVICE SINKS TION AUTIIOR12En IS NOT COM'AENCBO WITIIIN 120 pAVS, OR If <br />SUMPS -� $EWAGE PUMP — CONS7NVCTION OR WOHK IS Sl15PENUEII OR AUANOON@D FOR A <br />UR WALS � N��IOD OF 1?0 DAYS nT ANV TIMG AF TGfl WOPK IS COMMFNCEb. <br />� N'i\TER CLOSETS i - ���<<����� CERTIFV TIIAT I HAV[ REAU �1ND E`!AMWED T1115 AF <br />� PLICATIpN I�NI) KNOW TH[ SAMC TO Rf. TRUE AND CORRCCL ALL <br />WATER HEATERS - ELECTRtC 2�00 rrvovisioNs oF �nW, nNn ut�ownNccs cove�Nih„ rrus i vre <br />3 wnSH onsiNS 6� 00 or� worac �viu. ue con�rueo wini wr�ernEn srtc�rieu ���weiN <br />LAUNDRY TRAVS �60 OR NOT. TIi[ ciRnNTWCi OP .� PEfiMli f�(�bt: Nitt PItE::Un1E TO <br />� GIVE I�UTHORITV 10 VIOLAT[ Ofl CANCI.L 1111- PHOVI;ION3 OF <br />__ ___ ANY OTII[R STAiC OR LOCAL LAW I�LKIii �Ui[dc', C��N':TI�UCI�(�N <br />� ORiHEN[HFORMANCGO(CnNS�RUCIi���.. <br />1 <br />� SUB TOTAL 2( QQ ___ � � <br />PERMIT S " � � . <br />iOTAL FEE cj���'�O:_cr(_�-�'C��F - - - '+�-; /�� __ <br />WATERSEflVICESI2E BLCIG.SUPPLVSIZE SlcrvnluREOPcoMRnc7onoRnUiii.r,G�Nr� �C�nr6-' <br />SID[Yi1Hp5ETIlACK ;TR[ET:hTf1ACK fi6ARVA(9flSLTUACK�'LANCH@CKNUMBGq PLANCIIECKFEC <br />G' 20' 7.0' 79/170 ��t 103.50 REciivT no <br />-us� zoNe �� l.or naen �vncnNr sire �— 37317 <br />R-1 .�vEs ❑No FEES VALUATION FEE <br />TVPF OF CONST. OCCUPANC� GROUP NO.Of-OWhL1.ING <br />VNITS � <br />V-N R-3 1 - ---- ------ � --- <br />SIIL OF ULOG. - NO. UF STORI[S MAX.00C. IOAD— NUILDINCG 5 60,000.00 207 i 00 <br />1 — —�_ _ —_ <br />1'1_VM1IIi1NG 26 ; �0 <br />FIliE 20NE HASEMENi FIHESPRINKLGHS _ -- —_ <br />3 yes aeQuEceo ��o rnec��nNica� 18 i 00 <br />----- ----- ��- ---- <br />'l'FCIAL CO�IDITIONS: p7�y�q � <br />_ .__ ".__-"__�IT___ __ ._'.__ -.-_' -_' I__-'_ <br />Single_famil�residence__op],y y_ ,�i;Nn�rv �;i_c.:�oam� i <br />� °° . . . -- � - - ------ �- --- ---- - - - - 1- ---- - <br />.___ . ._y�_. -_..—_-______--_—_ 251 � 00 <br />..� - - rorn� i <br />--� �,�t_ -- -- ---- t - __ ��'1�q�I /�m1T % /(�� s - <br />f. ....,_(._�=__�'__ �7TSS 1V11Vfif'HOUrWLnT�AJL�tFD11NTlllS.�unC I. ISY�WiVENNII� <br />_ � ^a � . . . . . . _ � y.. <br />_ __Y__ �. -__ - . , . . . <br />'_�_m ,��, _ � ti R REC.EI . YOt1R RECBIPT <br />-<- O-- C, - - <br />� �;;� � TNANK YOU . <br />�:v�:,.,. �.iiw«im r�� ,u-:�ua.-� ---�nuu�ii�i- ir .. � , . <br />� V.C. <br />r <br />�;� „r,, 7�: '� �� 79 <br />