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e�� <br />cin oF <br />everett <br />259-8745 <br />�` ('�'JNSTRUCTION � . 1c <br />PERMIT PERMIT NQ:- � f J�� <br />❑ DEMOLITION ❑ COMBINATION #$ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ 81GN <br />OWNER MAI�ADORESS CITY 21P PHpNE <br />Dean Orr 2028 Rainier �e. Everett 98201 252-5665 <br />ARCMITECTORDESIGNER MAILAOOPE55 CITY 21P PNONE <br />MRIL ADDRE55 <br />GITV 21P PHONE LICENSE � <br />Ovmer <br />MECHANIGAL CONTRPCTOR MAIL RUDRE55 CITV 21P PHONE LILENSE • <br />ttUMBINGCONTRACTOR AIAILADDRE55 �ITY ZIP PMONE UCENSE� <br />I ❑ NEW V�^ ❑ ADDITION ❑ ALTERATION � REPAIR ❑ DEMOLITION ❑ BUILDIN6 HELOCATION <br />� V�LUATION OF WORK <br />I S �.�����.Q� <br />H Fire damage repair <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHEH <br />Residential 5�� <br />19,20 418 <br />�OT _ BLOCK � <br />JOBAODHESS <br />3Q� 2028� Rainier Ave. <br />PLUMBING <br />TYPE OF <br />WATER CLOSET (T( <br />RATNTUB <br />LAVATORV�WASH BASIN) <br />SHOWEH <br />KITCHEN SINK 6 DISP. <br />DISHWASHEP <br />LAUNDRVTRAV <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />flACKFLOW PREVENTERS <br />ROOF DRAINS — RAINLEA <br />SINK �SERVICE — BAR, ET� <br />TYl+E OF CONST. <br />APPUCATION <br />S.H. <br />SUBTOTAL <br />PENMIT <br />TOTAL FEE <br />REARSETBACN <br />LOT AqEN <br />OCCUPqNCYGNOUP <br />NO OF STORIES <br />❑ YES ❑ NO <br />PLANS CHECNED OV <br />FEE <br />�jYES ❑NO <br />N0. OF OWELLING <br />APPfi <br />I tiEREBY 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 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 REGULATING CONSTRUCTION OR <br />THE PERFORMANCE OF CONSTRUCTION. <br />SI�IPTURE OF CONTPAGTOR. AUTIiOFIZED AGENT, OR ONTlER CATE <br />X <br />A/C — A/HND�G UNITS — H.P. <br />REFRIGERATION UNITS — H P. EA. <br />DOILERS — B T.0 M. P. <br />GAS FIRF.D A�C. UNITS — B T.U. <br />FORCED AIR SVSTEMS — B.TL. M EA. <br />WALLHEATERS—D.T.U. M <br />IINITHEATERS—B.T.0 M <br />EVAPORATIVE COOLERS <br />CLOTHESORVER$ <br />VENTILATION FAN <br />RANGEHOOD <br />WATERHEATER � <br />WOODSTOVE <br />METAL FIREPLACE 8 CMIMNEV <br />FIREPLACEINSERT <br />HEATPUMP <br />GAS PIPING <br />EaHAUSTFAN <br />SUB <br />RECEIPT NO. <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />INVESTIGATION FEE � Sec.304(e) <br />STATE BUILOING SURCHARGE <br />STATEENERGVSUFCHARGE <br />DRIVEWAY PERMIT <br />TOTAL <br />PEHMIT VALIDATION <br />WNEN AROPERLY VALIDATED QN THISSPACE) THIS IS YOUR PEFMIT <br />;•C�� i;ESS FI'_G <br />50 <br />