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ene Et�green <br />CITY OF <br />everett <br />259-8745 <br />" C"�NSTRUCTION <br />PERMIT <br />PERMIT NQ: � O � � � <br />❑ DEMOLITION ❑ COMBINATION �] BUILDING ❑ MECHANICAL '❑ PLUMBING ❑ SIGN <br />ONTlEfI MRIlr1DDRE55 CITY ZIP PHONE <br />Puckett, Jess 5220 79th P1. NE Marysvil. 98270 653-1104 <br />ARCMITECi OR OESIGNER MRIL ADDRESS pTV 21P PHONE <br />Michael D. Grote 1321 Hoyt Everett 98201 252-2976 <br />GENERAL CONTRRCTOR M411 ADURESS CITY ZIP PMONE LICENSE • <br />�9t1t1cX owner <br />A1ECN�NICALCONTRRCTOR MPILAODRE55 CITY 21P PMONE LICENSE• <br />PLUMBING CONiMCTOR MAIL AUORE55 CITY 21P PMONE LICENSE • <br />CLASS OF WORN <br />❑ NEW ❑ ADDITION C�ALTEHATION ❑ REPAIR ❑ DEMOLITION �7 BUILDING RELOCATION <br />VALU�TION OF WORK <br />s 10,559.00 Foundation and deck only. <br />DESCR19E WORK <br />House relocation. <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />ior 13 � 1��aK 188 <br />N2' 15 <br />PLUMBING <br />residence <br />Plat of Everett Div T <br />FIXTURE OR ITEM <br />WATER CLOSET (TOILET� <br />flATHTUB <br />LAVATORV�WASHBASIN) <br />SHOwER <br />KITCHEN SINK 8 DISP. <br />LAUNORYTRAV <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR ORAIN <br />SINK <br />R-2 <br />TYGE OG CONST <br />V-N <br />9CE — BAR. ETC.� <br />SUBTOTAL <br />PEqMIT <br />TOTALFEE <br />REARSET9nCN <br />20 20 <br />LOT ARE� <br />5115 <br />OC:;UPANCY GROUP <br />R-3 <br />512E Oi pLDG NO OF STORiES <br />967 2 <br />�Pi'LICATIONACC DY <br />t4. M. <br />1'LPNS CNECNED OY <br />H.E <br />$5.85 credit on bldg <br />on plan ck fee. <br />FEE <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPIICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF IAWS AND OROINANCES <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 AUTHORITY TO <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW f;EGULATING CONSTRUCTION OR <br />THE PERFORMANCE OF CONSTRUCTION. <br />SIGN4TURE OF CONTRRCTOR. AUTHORRED r1GENT, OR OWNER DATE <br />X <br />MECHANICAL <br />A/C — A/MNDLG UNITS — HP. <br />REFRIGEFATION UNITS — H P. EA. <br />BOILEHS — B.TL./H.P. <br />GAS FIRED f C. UNITS— B.T.U. <br />FORCED AIR dYSTEMS — B.T.U. M EA. <br />WALLHEATERS—flT.U. M <br />UNIT HEATERS — B.TL. (�/'�j/� ; <br />EVAPORATIVECOOLERS <br />CLOTHES DRYERS � <br />VENTILATION FAN ��j � <br />RANGEHOOD B $jj(,H' <br />WATERHEATER • � <br />WOODSTOVE �'16'Jrjb <br />METAL FIREPLACE d CHIMN�� <br />FIREPLACEIYSERT IITi�S � <br />HEAT PUMP �q� <br />GASPIPING �j� <br />E%MAUSTFAN YfYY11�{1TJ <br />>E SEiOnCK P�AN CHECK NUME <br />5 88/20299 <br />CANT SITE FEES <br />VES RJNO <br />�ncnwniwr.uurtc BUILDING <br />1 <br />MA% OCC LOAD <br />N/A <br />APPR FON ISSUFNCE OY <br />PLUMBING <br />MECHANICAI <br />Fee <br />Sue <br />PEpMIT <br />TOTALFEE <br />FEE 87 � 7�j RECEIPT NO. <br />HRRX 10639 <br />VALUATION FEE <br />s�n een nn <br />INVESTIGATION FEE <br />STATE BUILDING SURCHARG <br />STATEENERGVSURCHARGE <br />DRIVEWAV PERMIT <br />Sec.30ale) <br />IB•E• ITOTAL I I 143 Xd8I65 <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED �IN THIS SPACE) TMIS IS YOUR PERMIT <br />permit for overpayment Q� <br />� <br />N <br />O <br />N <br />