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u�� <br />cm oF <br />evexett <br />259-8745 <br />� C'�NSTRUCTION ^ '�' <br />PERMIT <br />PERMIT NO. <br />21292 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING �1 MECHANICAL ❑ PLUMBING ❑ SIGN <br />��R MRILnpORESS CITV ZIP PNONE <br />�IE[i[Xyi[1pCNXEff6c Jane Venturo 23216 127th Ave. NE Arlington 98223 435-4929 <br />ARGNITEGt OR OESIGNEN M41L RDDRE55 CITV 21P PHONE <br />GENERq CONTRIICTON MAllA00RE55 dtY 21P PHONE LICENSE• <br />MECH�NIGAL CONTRA�TOR MRIL ADOPE55 CITY 21P VHONE LILENSE • <br />Owner <br />PLUMBINGCONiR�CTON MRILADDRE55 dTY ZiP PNONE UCENSE� <br />CLASSOF WORN <br />❑ NEW ❑ ADDITION ❑ ALTERATION ❑(iEPAIP ❑ DEMOLITION ❑ BUILDING RELOCATION <br />VAW�TION OF WORK <br />i <br />install woodstove <br />HEATSOUF'E <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTMEN <br />lOT <br />SFR <br />BLOCN � <br />v�uMsiNa <br />WATER CLOSET <br />LAVATORV �WASH OA: <br />SMOWER <br />KITCHEN SINK 8 DISP. <br />DISHWASMEF <br />UUNDHV TRAV <br />CLOTMES WASMER <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVEN7 <br />ROOF DP.AINS — RAiI <br />SINK (SERVICE — BAI <br />TYPE OF CONST. <br />BLOG <br />APPLICATION RCC f1Y <br />S.H. <br />OR I7EM <br />fUSTOTAI f <br />PERMIT t <br />TOTAIFEE f <br />1RSETBI.CN S�DESETBACN <br />1AREA yqCINT5ITE <br />❑VES ❑NO <br />CUPANCY GROUP NO Of OWEILiM <br />� o� stoniEs MR% OCG IORD <br />❑ YES ❑ NO <br />FNSGMEf.NEDOY APPPFORISSU <br />I HEREBY CEFTIFY THAT I HAVE READ AND E%AMINED 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 HEfiEIN 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 ERFORMANCE OF CONSTRUCTION. <br />SiGNA URE Of CONTRACTOR. AUTHONI2ED RGENT.OR OWNER ' ID TE <br />X �'��u'- �%� 30 � <br />TYPE OF EOUIPMENT <br />A�C — AMNDLG UNITS — M P. <br />REFHIGENATION UNITS — H P. EA. <br />BOILERS — BS.U.MP. <br />GAS FIRED AD. UNITS — B.T.U. <br />FORCED AIR SVSTEMS — B T.U. <br />WFLL MEATERS — B T.U. <br />UKIT HEATERS — D i.U. <br />EVAPORATIVECOOLERS <br />CLOTHES DFVERS <br />VENTILATION FAN <br />RAIJGE HOOD <br />WATER HEATER <br />WOODS70VE <br />METAL PIREPLACE d CHIMNEV <br />FlREPLACEINSERT <br />HFATPUMP <br />GAS PIPING <br />E%HAUSTFAN <br />M EA. <br />M <br />M <br />FEE <br />30 <br />_ c�a: ss .ao <br />FEES VALUATION FEE <br />ur+rts BUILDING S <br />PLUMBING <br />MECHANICAL 30 00 <br />INVESTIGATIONFEE Sec 304(c) <br />STATE BUILDING SURCHARGE <br />STATEENERGVSURCHARGE <br />JCE BV <br />�RIVEWAV PERM1IIT <br />TOTAI 30 00 <br />PEHMIT VALIDATION <br />WHEN PROPERLV VALIDAT@D �IN THIS SPACE) THIS IS YOUR PERMIT <br />N <br />� <br />N <br />a-- <br />N <br />� <br />