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u� � <br />CITV OF <br />everett <br />259-8745 <br />'`' t'"`�NSTRUCTION � <br />PERMIT <br />^. <br />PERMIT NQ: .19 6 4 3 <br />❑ DEMOLITION ❑ COMBINATION 8] BUILDING ❑ MECHANICAL '1_1 PLUMBING ❑ SIGN <br />OMMER MAILAOORE55 CITY ZIP PMONE <br />Chris/Barbara Bly 2401 Mukilteo Blvd Evezett 98203 347-2362 <br />RRGIIRECTORDESIGNER MAILApDRESS CITY ZIP PMONE <br />GENERAL WNTNAGTOR AIAIL AODRESS CITY ZIP PMONE LICENSE � <br />8iixaxiui Silverlake Const. Inc. P.O. Box 5145 Everett 98206 252-1131 SILVECI161MS <br />MECHPNICAICONTRRCTON MAILAODRE55 QTY ZIP PMONE UCENSE� <br />PIUMBING CONiRRGTOR MAIL /.DDf1E55 CITY ZIP PHONE LICENSE � <br />CLASS OF WOPK <br />O NEW � �C l�DDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br />VALU}�A�TI�O�N� �OF WO�RN <br />'+W�CAi6167C ZZ160� <br />DESCNIBE WOf1N <br />Kitchen/Master bedroom addiiton and remodel <br />NEPTSOURCE <br />� ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />residence <br />lq e,,,,,,, 2 „� Plat of Darlington <br />4170-0012-014-0204 <br />teo Blvd <br />PLUMBING <br />NO. TYPE OF FIXTI <br />1 WATER CLOSET (TOILET� <br />BATHTUB <br />1 LAVATORV (WASH BASIN <br />1 SHOWER <br />1 KITCHEN SINK 8 �ISP. <br />1 DISMWASHER <br />LAUN�RY T(iAV <br />URINAL <br />DRINKING FOUNTAIN <br />FLGCR DRAIN <br />BACNFLOW PREVENTERS <br />ROC1F DRAIN3 — RAINLEAUERS <br />SINN �SERVICE — BAR. ETCJ <br />25' <br />R-S <br />EOFC <br />V-N <br />FEE <br />SUBTOTAL S 3O OO <br />VERMIT S — <br />TOTAL FEE f 3O OO <br />CR SETBRCN SIOE SETORCK <br />25� %�� <br />f FREA yqCRNT §I�TE <br />!B�OOOSf ❑yE5 CJNO <br />CUPANCY GROUP NO OF DWELLING UNITS <br />R-3 1 <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNO�Y THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPIIED 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 />STAT OR LOCAL LAW REGULATING CONSTflUCTION OR <br />TH FORMANCE OF CONSTRUCTION. <br />SIG qE jIF CON]Rf�CTOIif�LLiNOR�ED AG`ENT, OR OWNE i � O��/� � <br />X cw'[ln /� 1� � <br />MECHANICAL <br />A/C — A/HNOLG UNITS — MP. <br />REFRIGEPATION UNITS — H P. 1 <br />BOILERS — B.T.U./H.P. <br />GAS FIRED A.C. UNITS — B.T.U. <br />FORCEO AIR SYSTEMS — B.T.U. <br />WALL HEATERS — B T.U. <br />UNIT HEATERS —BS.U. <br />EVAPOFATIVECOOLERS <br />CLOTHESDRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER H.ATCR • <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEATPUMP <br />GAS PIPING <br />EXHALIST FAN <br />88/19643 <br />eui�oiNc 21,600 <br />PLUMBING <br />SIZE OF BLOG NO OF STORIES Mrt% OCC. LOAO <br />525 addition 1 MECHANICAL <br />PPPLICATION ACC OV <br />Sti <br />CNECKEDOY <br />Be <br />APPfl FURISSUANCE OY <br />Be <br />�CC <br />M EA. <br />M <br />M <br />SUBTOTAL f <br />PERMIT 3 — — <br />TOTALFEE f ZZ �� <br />FEE RECEIPTNO. <br />176.4 95367 <br />VALUATtON FEE <br />5 26ti0fi0c <br />30 00 <br />22 00 <br />INVESTIGATION FEE <br />STATE BUILDING SURCHARCa <br />STA7EENERGYSURCHARGE <br />DRIVEWAY PERMIT <br />TOTAL <br />Sec.30S�e) <br />26 <br />PERMIT VRLIDATION <br />WHEN PROPERLV VALIDATED pN THIS SPACE) TMIS IS YOUR PERMIT <br />,,, , I�,Fr_.� ��i.E <br />� <br />M <br />d' <br />CO <br />� <br />� <br />