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`�� �` f'`7NSTRUCTION � � <br /> everett PERMIT PERMITNO. � 8760 <br /> 259 -8745 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING C$MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWr1ER MAILADDNE55 CITY ZIP PNONE <br /> Francois and JoAnne LeBlavec 4720 Mermont P1 Everett, WA 98203 252-5493 <br /> RRCMITEGT OR OESIGNEP MAIL ADDflESS CITY ZIP MONE <br /> GENERR�CONTRAGTOR MRILADOPE55 CITY 21P PMONE UCENSE� <br /> Owner <br /> MECMANILAICONiHACiOR MAILADDPE55 GTY 21P PNONE UGENSE� <br /> PLUMBING CONTR�CTOR MAIL ADURE55 CITY ZIP PMONE LICENSE• <br /> C1�55OF WORK <br /> C�NEW ❑ ADDIT�ON ❑ ALTERATION ❑ REPAIN ❑ DEMOLITION ❑ BUILDING RELOCATION <br /> VALUATION OF WORK <br /> 51�800. <br /> DESCRIBE WORN <br /> Build and install fireplace insert <br /> NEATSOURCE <br /> ❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br /> PROPOSED USE OF BUIIDING <br /> single family residence I HEREBY CER7IFY THAT I HAVE READ AND EXAMINED 7HIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGRLDESCRIPTIONOFPROPERTYISNOWBELOWORATTACHFOURCOPIE51 CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> lOT�6LOLK _OF WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br /> PERMIT DOES NGT 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 CONSTHUCTION. <br /> JOBADORE55 5 1URf OF ONTRALTOR,AUTN i EO 1 �OWNER DRTE <br /> 4720 Mermont P1 Sept. 4, 198 <br /> PLUMBING M HANICAL <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET�iOILET) A/C—AMNDLG UNITS—HP. <br /> BATHTUB REFRIGERATION UNITS—M.P.EA. <br /> LAVATORY(WASH BASIN) BOILE(iS—BSU./H.P. <br /> SHUWER GAS FIHE�AD.UNITS—B.T.U. <br /> KITCMEN SINK 8 DISP. FORCE�AIR SVSTEMS—B.T.U. M EA. <br /> DISHWASHER WALLHEATERS—B,T.U. M <br /> LAUNDRV TRAY UNIT HEATERS—�.T.U. M <br /> CLOTHES WASHEf7 EVAPORATIVE COOLERS <br /> URINAL CLOTHESDRYERS <br /> ORINKING FOUNTAIN VENTILATION fAN <br /> FLOOR DRAIN RANGE NOOD <br /> BACKFLOW PREVENTERS WATER HEATER <br /> ROOF ORAINS—RAINLEADERS WOOD STOVE <br /> SINK(SERVICE—BAR.ETC.) METAL PIREPLACE 8 CHIMNEV <br /> j FIREPLACE INSERT 3O OO <br /> HEATPUMP <br /> GAS FIPING <br /> E%HAUSTFAN <br /> SUB TOTAL S SUB TOTAL 30 00 <br /> PENMIT f PERMIT — � <br /> TOTALFEE f TOTALFEE <br /> FRONT$ETBACK REAR SEiBnCK SiDE SETBncK P�AN CHECK NUMBER FEE RECEIPT NO. <br /> USEZONE IOTAPEA yp�qNT51TE FEE <br /> ❑res ❑No FEES VALUATION <br /> TYPEOFCONST. OCCUPANCYGROUP NOOFpWE�IINGUNITS BUILDING 5 <br /> PLUMBING i �ilJ�-%-�.� �.���•.� �� . . <br /> 512E Of BLDG. NO OF SiORIES MA% OCC LOA� <br /> MECHANICAL ' 30 00 <br /> INVESTIGATION FEE .; Sec.304(e) �. <br /> FIRE SPRINKLERS REOUIRED ❑YES NJ STATE BUILDING SUFiCNARGE '-' -- � � -'` <br /> STATEENERGYgURCMARGE <br /> APV�IGRTION RCC.BY VLANS CMEGNED DY APPR FOR ISSUANCE OY <br /> DRIVEWAY PERMIT <br /> M.M. TOTAL 30 00 <br /> PERMIT VALIOATION <br /> WH[N PROPE(iLV VALIDATED�IN THIS SPACE�TNIS IS VOUR PERMIT O <br /> �D <br /> N <br /> � <br /> � <br /> i., <br /> I <br />