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"��.. ^� C"�'NSTRUCTION - -- C <br /> everett PERMIT PERMITNQ:= �0�� `� <br /> 259 -8745 <br /> ❑ DEMOLITION ❑ COMBINATION �l BUILDING ❑ MECHANICAL O PLUMBING ❑ SIGN <br /> OWNER MAiIRDDRE55 CItY ZIP PMONE <br /> Ross Johnson 1001 Rockefeller Everett 96201 258-4050 <br /> ARCHITECTORDESIGNER MRILAOORESS CITY 21P t'MONE <br /> 6ENERAICONTRACTOR MAILAODRESS QTY ZIP �MONE 4CENSE• <br /> Dale Hoff 5015 37th NE Seattle 98105 525-2720 HOFFJC�0145 <br /> MECNRNIC/LGONTRACTOR MAILApDRE55 CITY Z1P PMONE UCENSE� <br /> FLUMBMG GONTMCTOR MAIL PODRESS CITY 21P PHONE LILENSE� <br /> CL�SS OF WORN <br /> ❑ NEW ❑ �DDITION ❑ ALTERATION C�REPAIH ❑ DEMOLITION L� BUILDING RELOCATION <br /> VALUATION OF WORN <br /> 5 450�.a� <br /> oescaiee woaK <br /> Reroof <br /> ME/TSOURCE <br /> O ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br /> �oroseo use or euao�r+c <br /> I HEREBY CERTIF .' fHAT I HAVE READ AND EXAMINED THIS <br /> SkR APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGALDESCRIPTIONOiPROPERTY!SMOWBELOWORATTALNfOURCOPIES� CORRFCT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> GOVERNING THIS TYPE OF WORK WILL BE COMPIIED WITH <br /> ior_eiocK _oF WHETHER SPECIFIED HFREIN 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 R�ORE55 SIGNA7UPE OF CONiRACTOR.AUTNOPiZED AGENT.OR OWNER OATE <br /> 1 1 C 1 � <br /> PLUMbING MECHANICAL <br /> NO. TVPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT �E <br /> WATER CLOSET�701LET� A/C—A/HNDLG UNITS—HP. <br /> BATHTUB REFHIGERATION UNITS—HP.EA. <br /> LAVATORV(WASH BASIN) BOILERS—B.T.U./H P. <br /> SHOWER GAS FlRED A�G UNITS—B T.U. <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS—8.T U. M EA. <br /> DISHWASHER WALL HEATERS—B T U. M <br /> LAUNDRVIfiAV UNITHEATERS—BS.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> URINAL CLOTHESORYERS <br /> DRINKING FOUNTAIN V[VTILATION FAN <br /> FLOOR DRAIN RANCE HOOD <br /> BACKFLOW PAEVENTERS WATER NEATER � <br /> ROOF DRAINS—RAINLEADE95 WOOD STOVE <br /> SINK�SERVICE--9AR,ETCJ METAL FIREPLACE 8 CHIMNEV <br /> FIREPLACEINSERT <br /> HEAT PUMP <br /> GAS PIPING <br /> I E%HAUSTFAN <br /> i <br /> SUBTOTIIL f SUBTOTAL <br /> PERMIT S PERMIT <br /> I TOTALFEE S TOTALFEE $ <br /> FhONTSETOACK nEARSEiBnCK Slo[SETOnCrc PLANCHECKNUMBER L - � <br /> � <br /> USE20NE IOTRPEA yqCANT5ITE <br /> ❑ves ❑r+o FEES ATION FEE _ <br /> TVPEOPCONSI OCCUPANCVG110UP NOOFOWRLINGUNITS �UILDING V •� <br /> PLUMBING <br /> 512E OP pIDG NO OF STORiES MA% OCC LOAD <br /> MECHANICAL CHECIi S�S.S�� <br /> IN�ESTIGATION FEE Set 30d�e) <br /> FIRE SPRINKLERS REOUIREO O YES NO STATE BUILDING SURCHARGE <br /> S7ATEENERGVSURCHARGE <br /> APPLIC4TIONRCCIIY PL4NSGNECN[OOY APPRfOBI55U�NGE�Y <br /> �RIVEWAI'PERMI7 <br /> S.H. TOTAL �s so <br /> — PEflMITVALIDATION <br /> WHEN PROPERLV vqLIDATED(IN THIS SPACE)THIS IS YOUR PERMIT <br /> �..�� <br /> r� <br /> Q� <br /> � <br /> N <br /> , , E:.. . . .. <br />