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��° - C 1NSTRUCTION nCp <br />everett Pl�RMIT PERMITNQ. � J`�`�� <br />259-8745 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING � MECHANICAL 'C] PLUMBING ❑ SIGN <br />ONMER MAIIAODRE55 QiV 21P �HONE <br />Carl J. Engelson 9414 Grand Ave Everett, WA 98203 259-1263 <br />4RCNIi[CTOHOESIGN[R MAllAppfiE55 ❑Tv ZIP MIONE <br />GENERALCONTRRCiOR IdA1LADDF[55 CiTV 21P PHONE LICENSE• <br />Owner <br />MECNTNICRLCONiRACIOF MAILADORE55 CIiY 21P PHONE LICENSE• <br />CONTRACTOi1 <br />❑ NEW ❑ ADDITION <br />MAIL ADDRE55 <br />❑ ALTERATION ❑ REPAIR <br />CITY 21P PIIONE LICENSE� <br />❑ DEMOLITION ❑ BUILDING RELOCATION <br />5 <br />oescnieE wor+K <br />Install wood burning stove in basement <br />HE�TSOURCE <br />❑ EIECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />�,e o� our oir+c <br />fami ly residence <br />LOT _ pIOCK _ <br />JOBADDRE55 <br />4414 Gran <br />PLUMBING <br />Ave <br />OR ITEM <br />WATER CLOSET �TOill <br />BATI:TUB <br />LAVATORY�WASMBA' <br />SHOWEH <br />HITCHEN SINK d DISP. <br />DISHWASHER <br />IAUNDRVTRAV <br />CLOTHES WASHEF <br />URINAL <br />URINKING FOUNTAIN <br />ROOF DRAINS — RAINLEADE <br />SINN �SEFVICE — �AR, ETC � <br />SUBTOTAL <br />PEPMIT <br />TOTpLFEE <br />TVPEOPCONST OC <br />512E Of BLDG NO <br />PIRE SPHINKLERS f7E0UIRED I <br />pPPLICATIONACC.t3Y PU <br />M.M. <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 AUTHOHITV TO <br />VIOLATE OR CANCEL THE PROVIS�ONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION Oq <br />THE PERFORMANCE OF CONSTRUCTION. <br />SIGNAIURE O( CONiAACT AU�Pl Oii12GD AGENT. OP OWNER DATE <br />X �j�-y�� �.� 2/5/88 <br />MECHANICAL <br />FEE NO. TYPE OF EOUIPMENT <br />A C— A-HNDLG UNITS — N P. <br />REFtiIGeNATION UNITS — H P. EA <br />BOILERS -- B.T.U. H P. <br />GAS FIRED A C. UNITS — B.T U <br />FORCEDAIRSVSTEMS—BTL. MEA <br />WAILHEATEPS—OTU. M <br />UNI7HEATERS—BTL. M <br />EVAPORATIVE COOLERS <br />CLOTHESDRVEFS <br />VENTILATION FAN <br />RANGEHO00 <br />WATER HEATER � <br />1 WOOOSTOVE <br />METAL FIqEPLACE 8 CHIMNEV <br />FIREPI.ACE INSERT <br />NEATP7MP <br />GAS PIPING <br />E%HAU::TFAN <br />f <br />S <br />S <br />vacaNi SiTE <br />❑vEs ❑ruo <br />MA% OCC LOAD <br />voaissunNccov <br />SUBTOTAL <br />PERMIT <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />INVESTIGATIONFEE <br />STATE BUILDING SURCHARG <br />STATE ENEFiGV SURCHARGE <br />DRIVEWAV PEfiM1T <br />TOTAL <br />30 <br />EE RECEIPT NO. <br />VALUATION FEE <br />S <br />30 00 <br />Sec.304�e) <br />30 00 <br />1YHLN PROPERLY VALIDATEO ��N iHl':'d11Ct 1 1111ti IS YVUR PEflM1T <br />