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„'���`�A��a� ; .. �ONSTRUCTIOP� - <br />everett PERMIT PERMIT NO. 1Z392 <br />CITY MALL 259-8745 <br />EVERETT. \NA 98201 ❑ COMBINATION X� BUILDING ❑ MFCHANICAL ❑ PLUMBING <br />OWNEP MAILFDDRE55 GITY ZIP FHONE <br />George A. Sorenson 1926 Rainier Avenue Everett 98201 252-6320 <br />AqCMrtECTOP0E51GNER MAILADOPE55 CITY Z1P PHONE <br />GENEPAL GONTRAGTOR MAIL ADDPESS GITY ZIP VMONE UCENSE � <br />Same <br />MEGHANICRLCONTRAGTOR <br />MAIL AODHE55 CIiV 21P PHONE LICENSE � <br />PLUMBING CONiPRC'1N MFIL PDDRE55 GITY Z�P PMONE LIGENSE � <br />❑ NEW ❑ AODIiION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVE/FIREPLACE INSERT <br />y.vv. <br />construct car-port <br />Single Famil <br />n S Everett Div. P <br />LOT19-ZBTOGN 38aF_ <br />IOB NDORE55 <br />1926 Rainier Avenue <br />PLUMBINC <br />TYPE OF FIXTURE OR ITEM FEE <br />WATER CLOSET (TOILEn <br />BATHTUB <br />LAVATORY �WASH 9ASIN� <br />SMOWER <br />KITCHEN SINK 8 DISP. _ <br />DISMWASMER <br />LAUNDPYTRAY <br />CLOTHES WASHER <br />WAiER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VAWUM BREAKERS <br />ROOF ORAINS — RAINLEADERS <br />SINK �SERVICE — BAR, ETC.) <br />SUB TOTAL <br />TOTAL FEE <br />1. ENVIRONMENTAL CMECK LIST <br />2. BUILOING PLANS <br />3. FIR[ MYORANi <br />4. FIRE PHOTECTION SYSTEM <br />5. GRAOING <br />ENVIRONMENTAL <br />HEALTM OISTRICT <br />f <br />YES , NO <br />MAX. <br />FOR <br />STG I DAB I DAB <br />� HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION 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 />WHETHER SPECIFIED HEREIN OR NUT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STPTE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTfiUCTION. <br />SIGNATIIRE OF GONiRACiOR OR AIIINONRED AGENT �ATE <br />MECHANICAL <br />AIR COND. UNITS - H.P. EA. <br />FEFRIGERATION UNITS - H.P. EA. <br />BOILERS - M.P. EP. <br />GAS FIRC^ A.C. UNITS - TONNAGE EA. <br />FORCED AIR SYSTEMS - B.T.U. M EA. <br />WALL HEAiERS - B.i.U. M <br />UNIT HEATERS - B.T.U. M <br />EVAPORATIVE COOLEflS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEMOOD <br />AIR MANDLING UNIT - C.F.M. <br />STOVE - WO00 <br />' METAL FIREPLACE d CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />SUBTOTAL f <br />TOiAL FEE S <br />83/12392 I�EE 6.50 I �E��7�o. <br />FEES VALUATION FEE <br />BUILDING SS00. 10 00 <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTY U B.C. <br />SEG. �0� (a� <br />TOTAL ZO OO <br />PENMIT VALIOATION <br />WMEN PROPERLY VALIDATED(IN THI i 4 3 O THIS�xO}1�PF�{i�1T� � <br />ll I U <br />M <br />N <br />YOUR RECEIPT•-� <br />�il���.tJ� YOU <br />aooRess r���� <br />-7ss8� <br />