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� '� '" �' ' "' � � ` �CONSTRUCTION <br /> �,, � ., � -� -_ - everett <br /> 1 � PERMIT <br /> � r ,o r <br /> ldl3 F1"(O�1 <br /> ev� et�� <br /> ��E�T�T�����3 CQ�tIVATION • BUILDING • MECHANICAL • PLUMBING ' <br /> OWNER . MAILAOf)RESS ZIP PHONE � , <br /> David A. Brandvold P .O. Bax 3066 98203 355-1135 m � <br /> MAIL ADOfiESS PHONE LICENSE NO. 3 ' <br /> ARCHITECT OR OESIGNER • , <br /> � <br /> GENERAL CONTRACTOR MAIL ADOHE55 PHONE LICENSE NO. Z � <br /> C <br /> Same 3 <br /> - PHONE LICENSE NO. W . <br /> MECHANICALCONTRACTOR MAILAODRESS , <br /> � m <br /> � � <br /> ' PLUM8ING CONTRACTOR MAIL ADOR65S PHONE LICENSE NO. �, <br /> � � <br /> PERMIT CLASS OF WORK � <br /> �OMBINATION ' <br /> � �UILDING [�PLUMBING �MECHANICAL ��W �/�ODITION ❑I\Ll'ERATION ❑REPAIR M . <br /> � _—__ <br /> VALUATION OF WORK <br /> ' 4S�OOO.00 ❑DEMOLISH ❑FENCE ❑SIGN ❑SWIMMING POOL <br /> S ( <br /> DESCRIBE WORK . <br /> Construct einqle family �:esidence <br /> CPpOPOSED USE MECHANICAL _ ; <br /> , Single Family Residence — � <br /> TVPE OF ENEFGY �GAS ❑ELEC. �' <br /> � LEGAL DESCRIPTION OF PFOPERTV (SHOW BELOW OR ATTACH <br /> j fOUR UP ESI � <br /> , . , � ',�-� 193 Everett D1V. "T° NO. TVPEOFEUUIPMENT FEE <br /> �� � � � LOT BLOCK—OF AIR COND.UNITS-H.P.EA. s �_ J <br /> REFRIGEFiATION UNITS-H.P. EA. <br /> � ,.� ��; BOILERS-II.P. EA. � t <br /> '+:.,��.�'; ��, G L�I�Z9"S FORCEO AIR SYSTEMS-B.T.U. MEA. I{ <br /> y � � I <br /> '� � y� SPACE d WALL MEATEPS - B.T.U. ' <br /> JOB AD�RESS � <br /> `` ,� .�� ; 1003 Pi�e Stieet UNITNEATERS-A.T.U. I <br /> ��y„�: EVAPORATIVE COOLERS I <br /> � � ���� �'� PLUMBING CLOTNESDRVERS _ � i <br /> . , :=)y ��� 1 VENTILATIONFAN Z OO i <br /> � 1 RANGE NOOD 3 I OO <br /> � �µ�P= "�` NO. TVPE OF FI%TURE OR ITEM FEE AIR NANDLING VNIT- C.F.bL ., <br /> BATM TUBS S _ I <br /> - - � CLOTMES WASHER � WATER HEATEH � <br /> � ' DISM WASHERS � FAC. BUILT FIREPLACE b CHIMNEV I <br /> DRINKING FOUNTAINS � GAS. SVSTEM: NO OP OUTLETS �� <br /> � - � FLOOR ONAINS � Su0 707AL S B 100 � <br /> � � KITCH N SI � • rERMIT S <br /> BAR SINKS -- TOTAL FEE 5 I . <br /> �- OOF OAA�� - RAIN LEADERS <br /> SHOWER BATNS TMIS PERMIT BECOMES NULL AN� VOID IF WORK OR CONSTRUG , <br /> TION AUTHURI2ED IS NOT COMMENCED WITHIN 120 OAYS, OR IF <br /> � SERVICE S�NKS CONSTRUC7'ION OR WORK IS SUSPENDED OR ABANDONEO FOR A � <br /> � SUMPS-SEWAGE PUMP � PERIOD OF 170 DAVS AT ANY TIME AFTER WORK IS COMMENCED. , <br /> URINALS 1 HEREBV CERTIFV THAT I HAVE READ AND EXAMINED THIS AP� , <br /> - � WATER CLOSETS .a� 7UCATION ANO KNOW THE SAME TO BE TRUE AND CORRECT. ALL . � � , , <br /> WATER HEATERS - ELECTRIC � PROVISIONS OF LAW$ AND ORDINANCES GOVERNING THIS TVPE <br /> W/1SH BASINS � OF WORK WILL BE COMPLIED WITN WHETHER SPECIFIED HEREIN <br /> LAUNDRV TRAVS �Fi NOT, TME GPANTING OF A PERMIT DOES NOT PRESUME TO <br /> GIVE AUTNORITV TO VIOLATE OR CANCEI THE PROVISIONS OF <br /> I ANV OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br /> I � qR THE PERFORMANCE OF CONSTFUCTION. <br /> I � <br /> SUB TOTAL <br /> � PERMIT s — � � <br /> E X � <br /> WATERSERVICESIZE 9LDG. SUPPLYSIZE ATUFEOFCO PORAUTH.AGENT DAT <br /> � SIDE VARO SETBAGK STREET SETBACK REAR VAHDSETBAC PIAN CHECK NUMBER PLAN CHECK FEE <br /> 5 <br /> � Z�� ZO � 7BI7SB FEE B88�C RECEIPTNO. <br /> :; <br /> USEZONE LOTAREA VACnNTSITE <br /> � g�2 6200 S(I. F .[7�VE5 ❑� FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCV GROUP UNiOs DWELLING � <br /> V-N R-3 1 <br /> g�24� X34G. NO.OFSTZRIES MAX.00C. LOAD BUILDING 54S�OOO. 00 17�00 <br /> PIVMBING ZOI OO <br /> � FIRE2LNE BASEMENT FIRESPRINKyLE�R{S B OO <br /> . . 3 �None R �yESED [JT70 MECHANICAL � <br /> � <br /> SPECIAL�:ONDITIONS: OTHEfI � <br /> �" <br /> V PENALTV • SEC.7071a1 � <br /> . M TOTAL 2 O O I O O <br /> . � . - :i � <br /> , � O PERMITVALIDATION <br /> WHEN PROPERLY VAIIDATED lIN TIIIS$71lCiI,��S Ig V0�R PERMIT <br /> c �fOUR RECEIP'� <br /> ''� : 7HANK YOU� <br /> � nlo��[nnnl�:t��llv �• nM1:.1:�qCRlUnv lnlMnOv11H0111'.9��nrvf1 Nr � � <br /> C -� <br />