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�� <br />cirv aF <br />everett <br />259-8745 <br />'1-31-b? <br />`"'� C�NSTRUCTION "� '"`' . <br />PERMIT PERMITNQ:-� SJU� <br />� DEMOLITIQN ❑ COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />�NMER M41L ADDRE55 dTY ZIP PHONE <br />Uob De�ver Oonstruction 3302 108th P1. SE Everett 98208 337-6394 <br />ARfHRECT OR D SIGNER MAI� AO�RESS �ITV IIP PMONE <br />Same <br />GENERALCONTl1ALiOR MAILAOORE55 CITY 21P %10NE �IGENSE� <br />Same BOBDECC192RU <br />MECMRNICALCONTRACTON MAILADDRESS CITY 21P PMONE �ICENSE• <br />PLUMBINGCONTR�CTOR MAILAO�RESS CITV ZIP PMONE LICENSEx <br />CUSS OF WORR � — - � <br />� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ OEMOLITION ❑ BUILDING RELOCATION <br />VALU/.TION OF WONN <br />f 54��00.�0 <br />DESCRIBE WORK <br />Oonstruct new residence <br />MEATSOURCE <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />LOT ? 6LOLK _ <br />PLUMBING <br />�� <br />USE ZONE <br />TYP[ OF <br />isHow <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />sidence APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />VONATTACNPOUf1COPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />02-16-86 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 CA EL THE PROVISIONS OF ANY OTHER <br />T OR LO L W REGULATING CONSTHUCTION OR <br />T FORMA CONSTRUCTION. <br />SIG TU - CO � RIZED AGENT, OR 01VNER DA7E <br />X R� O� � � 1 � �� � ��i <br />OR ITEM � FEE <br />WATER CLOSET (iOILET) <br />BATHTUB <br />LAVATORV�WASH BASIN) <br />SHOWER <br />KITCHEN SINN 8 DISP. <br />DISHWASHER <br />LAUNDRYTRAV <br />CLOTHES WASHER <br />URINAL <br />ORINKING FOUNTAIN <br />FIOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS — PAINLEADERS <br />SINK (SERVICE — BAR, ETC � <br />V-N <br />512E OF OLDG <br />1144 + Gar416 <br />S.H. <br />SUBTOTAL <br />PERMIT <br />TOTALFEE <br />OLCIIPANCY GROUF <br />R-3 <br />1 <br />B.�. <br />ov <br />S 45 <br />S <br />S <br />sioe seTaneK <br />6' <br />VACANT SITE <br />� VES ❑ NO <br />NO.OF DWELLING UNITS <br />1 <br />M/%.00C LOAO <br />N/A <br />APPR FOR ISSUANCE OY <br />L.C. <br />MECHANICAL <br />NO. <br />A/C — AMNDLG UNITS — H P. <br />FEFRIGERATION UNITS — H.P. En. <br />BOILERS — BS.0 -H P. <br />GASFIREDA�C UNITS—B.T.U. <br />FORCED AIR SYSTEMS — B.T LL M EA. <br />WALLMEATERS—BS.U. M <br />UNITHEATERS—�T.U. M <br />EVAPORATIVE COOLERS <br />CLOTFIES DRYERS <br />VENTILATION FAN <br />R�NGEfi00D <br />WATERHEAT[R • <br />WOOD S70VE <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEATPUMP <br />GAS PIPING <br />E%HAUSTFAN <br />6'// 18565 <br />FEES <br />SUB TOTIIL - " ' -' <br />PERMIT - � "' <br />TOTAL FEE = - ��- � � � <br />FEE '- <br />260.97` ' <br />BUILDING <br />PLUM�ING <br />MECHANICAL <br />INl'ESTIGATION FEE <br />STATE �UILDING SURCHARG <br />STATEENERGVSURCHARGE <br />DRIVEWAV PERMIT <br />VALUATION <br />5 54.���.0� <br />Sec.�04(e) <br />;EIPT NO. <br />90568 <br />FEE <br />_ _ 58 <br />TOTAL I I ' <br />PERMIT VALIDATION <br />WHEN PfiOPERLY VALIDATED �IN THIS SPACE) THIS IS YOUR PERMIT <br />�„ ��.,,���: � � �_ . <br />2� <br />�n <br />co <br />tn <br />� <br />� <br />