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- . <br /> - C'�'�ISTRUCTION " <br /> � � � PER�VIIT APPUCATION <br /> COMBINATION • BUILDING • MECHANICAL • PIUMBING <br /> OWNEF MAILAUDNESS� ZIP PMUNE <br /> David A. Brandvold P,O. Box 3066 Everett WA 98203 355-1135 <br /> ARCMITE.� OR OE51(iNER AIL ADDRESS NONE LICENSE NU <br /> OEN[PALCONTpACTOR MAILADORE55 /MONE � UCEN$E NO. <br /> Same as Owner BR AN DD A2990K <br /> MECHANIGA�CON�RAGTOR MAILAODHESS PNONE LICENSENO. <br /> Evergreen State Sheetmetal • <br /> �LYMtlINGCONTRACTOR MAILADDRESS ►NONE LICENSENO. <br /> Ray's Plumbing <br /> �ERMIT CLASS Oi WORK • — <br /> �COMBINATION ' I , <br /> �BUILDINC �VLUMBING g,]MECMANICAL I <br /> �NEW ❑ADDITION ❑ALTEfinfluN ❑HU'MH <br /> VALUATI N OF WORK —' �---'"' """'-'- � <br /> S �OOO ❑�EMOLISH ❑FENCE ❑SIGN ❑'iW�MMIN<ivUOl. 1 <br /> DESCHIBE WONK 1 <br /> � Construct sin le famil residence I <br /> rnorosEo use OTHER PERMITS OR APPROVAlS y <br /> � I� Single famil residence � RE ZONE � SPECIAL USE <br /> LkGAL DtSCRIPTION OF PROPERT�/ISNOW BELOW OR ATTACM � <br /> FOUX CO►IE51 <br /> � �o� s�ocKL�,3ocsattached }���j pr #.VARIANCE � SF'.ORUNE � <br /> „ �,� 5 E PA CHECK LIST RE�UIRED I <br /> " - � ' ?T !G',�SiOr�.� / LC YES <br /> ,: <br /> G-� /7- z9- S s� No • , <br /> �o�wooatss / <br /> P IOO� !- MECHANICAL <br /> • PLUMBING TY�E OF ENERO♦ i <br /> � , U�:nS ❑EIEC. . <br /> � . � , NQ TyVE OF E�UIPMENT FEE <br /> . . _�_"-•— • <br /> AIR COND.UNITS-H.P. EA. S I <br /> NO. TYPE OF FIXTURE OR ITEM FEE RkfRIGERATION UNIfS 1/.Y. [A. ��T� I <br /> flA1Hi11d5 f -- BOilERS N.P. EA. - '---'--"---^ j ; <br /> � CIOiHES WASMEN FORCED AIR Sr5TEM5� B.T.U.MEA. 1 -T- ! <br /> OISN WASHERS ...___ __._. _._ __ L ' <br /> DRINKING FOUNTAINS t ' <br /> � . FI.00H ORAINS � SPACE 6 WALL MEATERS �- B.I.U. _� �� I <br /> � KITCNEN SINKS d 1 � UNIT /IEATERS e.T.U. � �.� <br /> ' tlAH SINKS � EVAVOqATIVECOOlEHS —�- '� <br /> �� NOOF DRAINS RAIN lEAOERS ��� 1 � <br /> 1 CL0T11ESDRYERS <br /> SHQWER AATHS —r— �. JO i <br /> SERVICE SINKS 1 VENTILATION FAN <br /> �i SUMVS -SEWAGE PUMP 1 RANGE HO00 � <br /> URINAIS _ AIH N/1NOLINf VNIT . ..... Gf.M. ..�_ 1 <br /> WATE�1 CLOSETS - _' --'-' "' . _` _ - '_ I I <br /> � WATEH .NEATE H... .. . __ _..�..... ._ .��� <br /> � WATEH HEATENS - ELECTRIC ,_-.r „ _ __y,___ . <br /> WASN BASINS • fAC. lUILT FIREPLnCE R CNIMNEv <br /> IAUNDRV TRA - �OAS. S�STEM NO OP OUTlt13 � T ' <br /> . _ _ " _" ... ..SUO TOML�� 5 �GY7 <br /> 1 '—_' "'" IERMIT .-S ..__^.--_— <br /> 1 <br /> SUBTOTAL T(�T�LiEE 5 _�:IU <br /> PERMIT s T��IS Pf.liMlT UECOMES NUI L AND VOIb 1{ WOIIK 11R CUNSTRVC <br /> T A , �IpN AUf110P1'LED IS NOT ('C1MM(NCFn WITNIN /?0 U\v!:, OH tF <br /> CUNSTRUCfION OH WOhK I.i SU7:P1'NnED 00 A0/1NOONFD F(1R q <br /> i WATER SERVICE S12E BLOG.SUPPLV SIZE PEmoo oF t7o Onvs ni nNr tlMk nF TEN WOpI; i!:CPN�.IENCED. <br /> I PtAR YAHOSETBACK � ��ERkiiY CERTIF�' �//A7 I IIAVE REAU ANn CrAMINEA TIIIS �P� <br /> I � PUCATION ANO KNOW THk 54ME TO IIE TpVE AN�CORRFCi. ALL <br /> -�J-' '�" ��F ��T ►ROVISIONS OF LAWS ANb ONDINANCES 40VERNING T1115 TVPE <br /> 1 OF WOHK 1VILL BE COMP{.IED WIIN WHET�IER $PECIFIfU MEREIN <br /> USf iUNt lOt ANCA VACANI SITE OP NOT, 1!IE Gf1AN:ING OF A PERMiT DnES NOT YRESVME TO <br /> (➢WE AU7110NITY TO VIO�AfE OR C�INCEL T11E MRUVISIONS Of <br /> �-� Z ' ❑YES ❑NO ; qNV OTMER STATE OR LOC/�L L4W /iCCUMTING CONtiTNUCiION <br /> TY►E�fONST. OCCUMNCY GROUI NOAF OWELLING �R TNE VE(IFONMANCE Oi CONSiHVC7�pN. <br /> ✓— /J R _3 uH�Ts � • <br /> t12E Of BlD6. NO. F STORiES MA%.00C. IOAD X ��� ` � �� � •� <br /> � �J <br /> X� f/ <br /> � `SIG NEOfCONT ACiORORAU�II.AGENT � <br /> �IHk O/N�� IIA�'k /��NT /IN!!:i'HINK1.1115 � <br /> �J NO R OVESE`� �np �AN M CK NUMOEN MIAN CIIkCK f k! <br /> A C/�� � I LC A _ NECUPT Nn. <br /> 3►kC1AL CONDITIONS: �Q /lj�l_p fJ <br /> J <br /> � FEES ~ VALUATION FEE <br /> - --—T <br /> _.�---'� i <br /> ---'- euao�Hc s��a'� _/_%7..-r U <br /> SEPA REVIEW COMPIETE � ❑YES ❑ NO ' ���"""�""� ��U iO U <br /> eonfacf PIOIIf1111q d�P�. MtC11ANICAI'_-�•'-' • ��u <br /> OtNE11 � <br />