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`�� '� C'�NSTRUCTION ^ " <br />everett PERMIT PERMITNO. 2� 33O <br />259-8745 <br />❑ DEMOLITION k3cCOMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MRILADDPE55 CITY 21P PNONE <br />Ralph Schuck 15621 OK Mill Rd. Srohomish 98190 339-0817 <br />ARCHITECTOROESIGNER MRILADDIlESS CITV 21P FHONE <br />GENERRLCONTRACTOR MAILADDfiE55 CITY 21P PHONE UCENSE• <br />owner <br />MECHFNICRL CONTNACTON MAIL RDDRE55 CITY 21P PHONE UCENSE � <br />%UMBING GONTRAGTOR MAII RO�RESS CRY 21P PHONE LICENSE � <br />I C1A550FWORK <br />Q NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING FELOCATION <br />VALUATION OF WORN <br />s 59,580.00 <br />New Construction <br />HGT SOURCE <br />❑ ELECTRICITII ❑ GAS <br />PPOPOSED'qE OF BUILOING <br />6 <br />LOT _ BLOCK <br />1606 <br />PLUMBIN6 <br />Dr. <br />WATER CLOSET (TO�LET) <br />�[iTHTUB <br />UVATORV (WASH BASIN) <br />SHOWER <br />NITCHEN SINK 6 OISP. <br />LAUNDRYTRAV <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />ROOF DRAINS — RAINI <br />SINN �SERVICE — BAR, <br />2� <br />R-1 <br />❑ WOODSTOVE ❑ OTHER <br />residence <br />OR ITEM I FEE <br />SUBTOTAL f <br />PEHMIT S <br />TOTALFEE S <br />�R SETBACK SiOE SET�AC <br />20 6 <br />AREA VACRNi51TE <br />�nnn ❑vE5 IIN <br />TYPECFCONST. OCCUPRNGYGNOUP <br />V-?? R-3 <br />SiZEOFPLOG NO.OFSTORI[5 <br />1788 <br />FIRE $PRINKLERS P <br />�PRIGPTION�CC OY <br />M.M. <br />PLPNS LNECNED BY <br />S.W. <br />MR% OLC LOAD <br />N/A <br />APPR FOR ISSUANCE dY <br />J.W. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATIO;J AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETFfER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHOHITY TO <br />VIOLATE OR CAt�CEL THE PROVISIONS OF ANY OTHEF <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />THE PERFORMANCE OF CONSTRUCTION. <br />SIGNATUFF�O� CONTRACiOR. AU7MOR12E0 AGENT, OR ONTIEP �ATE <br />I.1 <br />NO. TYPEOFEOUIPMENT <br />A/C — A/HNDLG UNITS — H P. <br />REFRIGERATION UNITS — H.P. EA. <br />DOILERS — B.T.0 /HP. <br />GA$ FIRED A.C. UNITS — B.T.U. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />WALLHEATERS—BT.U. M <br />UNITHEATERS—B.T.U. M <br />EVAPOHATIVE COOLERS <br />], CLOTHESORYERS <br />j VENTILATION FAN <br />], RnNGEHOOD <br />]_ WATERHEATER <br />WOODSTOVE <br />1 METAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEATPUMP � <br />GAS PIPING <br />E%HAUSTFAN <br />SUB <br />PLAN CHECK NUMBER <br />88/21330 <br />FEES <br />BUILDING <br />PLUMBING <br />MECHANICAL � E SRCH <br />i� <br />.� � � <br />11 . �1 <br />INVESTIGATION FEE Pldil C� ��41e <br />STATE BU�LDING SURCHARGE <br />STATEcNERGVSURCHARGE <br />�RIVEWAY PEHMIT <br />TOTAL <br />PERMIT VALIOIITION <br />WHEN PROPEqLV VALIDATEO (IN THIS SPACE) THIS IS YOUH PERMIT <br />,:i .��,!_.;:, � ��. <br />11 71 <br />3 50 <br />15 00 <br />20 00 <br />617 71 <br />0 <br />c+ri <br />c� <br />� <br />N <br />