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tAe Everqrron <br />I <br />���, �,� <br />�verett <br />CITY HALL'S9Fi)4!i <br />_ �CON�TRUCTION <br />PERMOT <br />i.vrnerr.wn �,aao, COM[31NP.TIOfV • BUILDING • MECHANICAL • PLUMBING <br />t�1VNEH MAILADUHESS IIP PIIUNE <br />Wayne V. Jensen Box 104 Mu}:ilteo Heights 98275 355-6682 <br />AIiCHITECT Ufl DG51(iN[li h1AIL ADDF2ESS PHUD.L <br />LICENSE NO. <br />G[NERAL CONi(iACTOR MNL ADURESS <br />Same <br />Atf.CHI�NICAL CONTRACTOR MAIL ADDRESS <br />LUM <br />❑ COM6INATION <br />[�DUI�DING [�PLUM�ING [�tdECHANICAL <br />/ALUATION OF WORK <br />5 IrJ�0�0.�0 <br />�65CRIBE WORK — <br />L <br />JE NS F.0 253N0 <br />NE LICENtiI <br />NE LICENSI <br />❑NEw OnuuiTic�tv OnirtnnrioN ❑�Evn�n <br />❑D@A10�_ISH ❑F@NCL ❑SIGN ❑SWIM�b11N6 POOL <br />construct 22'xl6' Garage and replumU and rewire 'd <br />single fami <br />LEGALDESCRIPTIpN1 <br />FOV q COPIESI <br />L0T4 . f3�OCK_ <br />resi ence <br />residence f.7ECHANICAL <br />HOPE9TV ISHOW BELC'""`^ "���^�� TYPE OF ENERGY <br />oF Shore Acres <br />JOBADORESS - <br />3111 Mukilteo Blvd. <br />PLUMBING <br />TURE <br />- level <br />U'�S ❑LLEC. <br />NO. TYPE OF EQUIPMENT _ FEE <br />AIR COND UNITS-I1.P. EA. � � <br />REFRIGERATION VNITS H.P, EA. T <br />60�LERS� H.R [A._- - � <br />FOFCED AIR SYSTEMS-B.T.'J. MEA. <br />I <br />SPACE fL WALL HEATLFS - p.T.U. <br />UNITIIEAT[N$ 11.1'.U. � <br />EVAPOftATIVECOULER$ <br />1 CLOTHESORYECS_ .. � �,� <br />V'_NTILf+TION FAN -OTSL4__ <br />_2_ _ _ ____'_ <br />(_/�NGE HOOU � <br />, nIH_ HI�NDLING UNIT-- C.F.M. -T- <br />__--. � <br />WATEfl HEATER T <br />FAC. UUILT FIREPLACE & CHIMNEY � <br />1 <br />GAS. SVSTEM NO OP OUTL[TS -�- <br />_ ___ ___ SU� TOTAL 5 '� � Q� <br />�ERMIT 5 <br />_" ________ __--_ TOTAL FE[ 5 � Q_ <br />THIS PGHMIT UECUYI[S NUI.L AND VOIp IF WORK OR CONSTRUC <br />IION AU111bHIZ@D IS NOT COMMENC[D WITHIN 120 DAYS, OR IF <br />CON;TFlUC�:ON OR 1Yf1RK I$ SUSPENDED OR l�[iANDONED FOR !� <br />P[RIOD OI° 720 DAYS /�T 11NV TIME AFTER 1NOPK IS C0�IMENC[U. <br />I Hffl[Iiv CEIiIIFV THAT I IIAVE PGAU AND E%�1MINED TNIS AP <br />PLICATI(1N AND KNOW TIIG :AM@ TO UE TI1VE AND CORRECT. ALL <br />PROVISIpN$ OP LAW; ANO ORDINANCBS GOVERNING THIS TYVE <br />DF WORK WILL pE COh1PLIED Wlil� WH[T�iBR SPLCIFIED H[RFfIN <br />O(i NOT, THk GRANTINL3 OF l� P[qp11T UOES NOi 1'H[SUME TO <br />(:IV[ 11UTIlORITV TO VIOLM-E OR CANCGL TH[ PFIOVISIONS OF <br />ANV OTMfIR STAT[ OH L'JCAL LAW R[GULATING CONSTRUCTION <br />------- -. OIi1HCPLRFOfiMANCEO6CON5iRUCTIOPI. <br />� 1 <br />SU13 TOTAL _2_(1 � 00 � <br />P[RMIT $ -r _c J� ,,G <br />� TOTAL 1-E[ --�- x <br />!'�ATER SEHVICE SIZE ULfJG. SUPPLY 512G siarvnTUrv� r cbNil <br />SIDEVAROSEi4ACK STR[ETSETIIACK REAqVAqDS[TAACKPLANCH[C NV�1fiLR <br />USE 20NE LOT ARGA VACANT SITE �P/G03 <br />❑YG5 ❑rvo FEES <br />SPFCIAL CONOITIONS: <br />' � —y __y� -�_ <br />` .�.:.�- - •�.__ �— <br />�5 ❑NO <br />10/19/78 <br />PLAN CHECK I�E[ <br />�-« IP[CEIPTNO. <br />38.n0 <br />i 33934 <br />VALUATION FE[ <br />ItUILDING 5 LS�OOO.00 <br />�'LUMItING <br />MECHFNICAL <br />OTN[R <br />PENALTY --- — SLC�JO:ifa) <br />TOTAL 99 � 00 <br />---� �v���N i�n'ni•r n��v`v <br />_: �--__ � --___�-- - -__-_ , <br />�--�-- , �4 R RECEPPT <br />-� '---� �__._�'"-'_ _ _ , � <br />,n ;�, --,-; , Pt=t ,1�lr YGt1 ` <br />. <br />nrr 1.nuunL�.H� u �•tn��fCr.iuu� nrrnuvluruniYn�, nv <br />^' � v.c. x.c.��� <br />G -� � 0(:T 78 <br />�' -' .. _--� <br />9 <br />� <br />I � I <br />�o „za�z�5,.��s o��s� OA�,,.�,�,�} , <br />1r <br />YOQiR RE�GCIPTN <br />TE�,�j�lK YOU �; <br />- , ; <br />�= • <br />;;:i_I�oct18 <br />I <br />