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u"� '' ('`�NSTRUCTION - _ C <br /> CITY OF <br /> everett PERMIT PERMITNQ:� � ���`� <br /> 259 -8745 <br /> ❑ DEMOLITION � COMBINATION [�BUILDING ❑ MECHANICAL ❑ PI.UMBIN6 ❑ SION <br /> OWNEP MFILADDRESS CITY ZIP PHONE <br /> Conrad Van Beek 2102 Oakes Ave. EUerett, WA 98201 259-5207 <br /> ARCHITECTONDESIGNEF MRILApURESS QTY ZIP PHONE <br /> GENEMLCONTPACTOR M�I�AO�RESS CITY 21P PNONE LIGENSE• <br /> Owner <br /> MEGHANIC�LGONTRAGiOR M�ILADDRE55 CITY 21P PHONE LICENSE• <br /> PLUMBING CONTR�CTOR MAIL ApDFESS CITY ZIP PHONE IIGENSE• <br /> CL�SS OF WORK <br /> ❑ NEW ❑ ADDITION ❑ ALTERATION �REPAIR ❑ DEMOLITION ❑ BUIL��NO REIOCATION <br /> VALUATION OF WORk <br /> f 100�.�0 <br /> DESCRIBE WORK <br /> reroof <br /> NEATSOURCE <br /> ❑ ELECTAICIT' ❑ GAS � WOODSTOVE ❑ OTMER <br /> PROPOSED USE OF BUILOING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> Sinale fmailv residence APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEQ�IDESCHIPTIONOFPROPERTY�5HOW8ELOWORATP1CMfOURCOPIE51 CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> �or_e�ocK _or GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WlTH <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 /> JOB�DDflE55 SIGNATURE OF CONTRACTO AUTHORIZED AGENi,OR OWNER DATE <br /> � <br /> 2102 Onkoa Ave_ � .�7 <br /> PLUMBINd MECHANICAL <br /> NO. TYPE OF fl%TURE ON ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET) A/C- A/HNDLG UNITS—HP. <br /> BATHTUB REFqIGERATION UNITS -H.P.EA. <br /> LAVATOflY(WASH BASIN) BOILERS—B.T.U.MP. <br /> SHOWER GAS FIRED A�C.UN�TS—O.T.U. <br /> KITCHEN SINK 6 DISP. FORCED AIR SYSTEMS—B.T.U. M EA. <br /> DISHWASHER WALLHEATERS—B.T.U. M <br /> UUNDRVTRAV UNITHEATERS—B.TL. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> UFINAL CLOTHESDRYERS <br /> OPINKING FOUNTAIN VENTILATION FAN <br /> FLOOR�PAIN RANGE HOOD <br /> BACKFLOW PREVENTERS WATER HEATER � <br /> ROOF DRAINS—RAINLEADERS WOOD STOVE <br /> SINK(SERVICE—BAF,�TC.) METAL FIREPLACE 8 CHIMNEV <br /> FIREPLACE INSERT <br /> HEATPUMP <br /> GAS PIPING <br /> E%HAUSTFAN <br /> SUBTOTAL S SUBTOTAL <br /> PERMI7 S PENMI7 <br /> TOTALFEE t TOTALFEE � <br /> FRONT SETBRCK REAR SETB�CK SIDE SE70RCN PLAN CHECK NUMBEii FEE RECEIPT NO. <br /> USE20NE LOTAREA yqCr1NT51TE <br /> ❑ves ❑No FEES VALUATION FEE <br /> TYPEOFCONST. OLCUPRNCYGROUP NOUFDWELIINGUNITS BUILDING S lOOO.00 ZS OO <br /> PLUMBING <br /> SIZE OF BLDG. NO.OF SiORIES MA%OCC LORD <br /> MECHANICAL p3/30/67 4::'FM 0004�ft4669 �ka�G�t <br /> INVESTIGATION FEE Sec.�04(e) <br /> FIRE SPRINKIERS REOUIRED VES NO <br /> STATE BUILDING SURCHARGE �DG �::. .00 <br /> STATEENERGYSURCHARGE E SRCH $ .SO <br /> RVVLICRTION r1CC BY PUNS CMECNEO OY APPfl FOR ISSUANCE OY <br /> DRIVEWAY PERMIT <br /> S.H, TOTAL <br /> PERMR VALIDATION <br /> WHEN PROPERLV VALIOATED(IN THIS SPACE)THIS IS VOUR PERMIT <br /> �� <br /> L` <br /> Q� <br /> L` <br /> r� <br /> ADURESS FILE <br />