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�� <br />everett <br />259-8745 <br />"'� C''�NSTRUCTION � �'` 19�41 <br />PERMIT PERMIT NQ. <br />❑ DEMOLITION ❑ COMBINATION C� BUILDING ❑ MECHANICAL '� PLUMBING ❑ SIGN <br />OMMER <br />MAR ADDRESS CITV 21P PMONE <br />Doug I.ibby 6101 Oakes Ave. Everett, WA 96203 355-5201 ZP P�or,E <br />ARCHITECT OR OES�GNER MAIL AODRESS �'TM <br />Self <br />GENERAL LONTRRGTOF _— MRR ADDRESS CITY ZIP PMONE LICENSE • <br />Self n:'NE LIGFNSE� <br />MEGHANIC/.L CONTRRCTOR <br />MAIL PDDRESS CITY ZIP <br />PLUMBING CONTRRGTOR <br />MAIL PDDRE55 CItY 21P PHONE IICENSE � <br />CLA55OF WOPK <br />❑ NEW ❑ ADDITION C,tl ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCA I <br />S 5000.00 <br />OESCRIBE WOHN <br />Remodel kitchen, rewire five rooms, reroof. .- <br />MEAtSOURCE <br />O EIECTRICITY ❑ G�S ❑ WOODSTOVE ❑ OTHER <br />LOT _ OLOGN _ <br />PLUMBING <br />TVFE <br />TYPE OF FI7(TU <br />WATER CLO`ET �TOILEI � <br />BATHTUB <br />LAVATORY�WASHOASIN� <br />SHOWER <br />KITCNE� SINK 6 DISP <br />DISHWASHER <br />LAUNORVTRAV <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />R04F DFAINS - F7A�NLEAOERS <br />SINK ISERVICE - 6AR. ETC.) <br />ITEM <br />SUBTOTAL <br />CEPMIT <br />TOTALFEE <br />pACK REARSETBRGN <br />20' S4' <br />R-2 <br />V-N <br />OF BLDG <br />1052 <br />S.H. <br />7350 <br />��nNCV GROUP <br />R-3 <br />STOPIES <br />1 <br />YES NO <br />s aiECKEo ov <br />B.E. <br />FEE <br />I HEREBY CL'RTIFY 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 />SIGN�TUP[.QF COn�1iAC�! UTH� ZEO P� T. O�R oOWNER 04TE <br />X /Y7Y �z �x�=:% l� <br />MECHANICAL <br />NO. TYPE OF EQUIPMEn7 <br />A/C — AiHNDLG UNITS — MP. <br />REFRIGERATION UNITS — HP. EA. <br />�OILERS — �7 U.M P. <br />GAS FIRED A�C. UNITS — � T U. <br />FORCED AIR SVSTEMS — B TL. M EA. <br />WALLMEATERS—BS.U. M <br />UNITHEATERS—OT.� �"� <br />EVAPORATNECOOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />pANGEHOOD <br />WATER HEATEP � <br />WOODSTOVE <br />METAL FIREPLACE 6 CHIMNEV <br />FIPEPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN _ <br />FEE <br />SUBTOTAL <br />PERMIT <br />TOTl1l FEE <br />�nacN PLAN CHECK NUMBER FEE RECEIPT N( <br />10' 88�1g441 46.80 95220 <br />VAC4Nl SITE <br />❑Y[5 $1N0 <br />NO OF DWEILING UNITS <br />1 <br />MA% OCC LORD <br />I4/A <br />Af'PP fOR <br />B.E. <br />pY <br />BUILDING <br />PLUM�ING <br />MECHAN�CAI <br />INVESTIGA710N FEE <br />STATE BUILDING SU <br />STATEENERGVSURCHAFGE <br />DRIVEwAY PERMIT <br />3 <br />5^a SOd1e) <br />TOTAL � 1 <br />PERMIT V1ILIDATION <br />WHEN PROPEFLV VALIDATED (IN THIS SPACE) TNIS IS YOUR PERMIT <br />/1�L'1'.�SJ � ��E <br />� <br />751 50 <br />