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�� <br />cin oF <br />everett <br />259-8745 <br />C'`'JNSTRUCTION - <br />PERMIT PERMITNO. � �J92 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING �{7 MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MAILAOORE55 CITV ZIP PHONE <br />Willard Rawlins 22419 - 78th W. Edmonds 98020 776-8979 <br />qRCHrtECTORDE5IGNER MAILRDURE55 GITY 21P %10RE <br />GENERNL CONiRACTOR MAIL AODRESS LITY 21P PHONE LICENSE • <br />M'_LMANIC�L CCNTFnCiOR MRIL ROORESS CITY 21P PHONE LiLENSE • <br />PWMOINGCONTRRLTOR �/�LADDRE55 CITY ZiP PIIONE LICENSE� <br />:LASS OF WORK <br />❑ NEW ❑ ADDITION ❑ ALTEHATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br />S <br />DESCRIBE WORN � <br />Fireplace insert installation <br />� ELECTHICITY ❑ GAS <br />�ROVCSE� b5E Of DUILU W G <br />Single family residence ( <br />.EGRL �ESCNiPT10N OF PROPERTY �SNOW OELOY <br />LOT _ BLOCN _ Of <br />�oo nooaess <br />3701 Rockefeller <br />PLUMBING <br />NO. TYPE Of- FIXTI <br />WATER CLOSET (TOILET� <br />OATlITUB <br />LAVATORV �WASH �ASIN) <br />SH(1WER <br />'JTCHEN SINK 8 DISP. <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTMES WASIIER <br />URINAL <br />DRINHING FOUNTAIN <br />FLOOR DRAIN <br />ROOF �RAINS — RnINLEADERS <br />SINK �SERVICE — �AR. ETCJ <br />TYPE <br />SIZE OF �LDG <br />SUBTOTAL <br />PERMIT <br />T OCCUPANCYGROUP <br />NO OF STORiES <br />LEPC REOUIRED ❑ VES ❑ NO <br />�CCl3Y PlANSCHECNEO�Y <br />M.M. <br />❑ WOODSTOVE ❑ OTHER <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AN� <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK W�LL BE COMPLIED WITH <br />WHETHER SPEC�FIED 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�'S`F CONSTRUC IDN. <br />SIG�` �"�'OF C� dnCT04} AUtH E� AGENi OR 1YNER CAT[ <br />i� //�i//'P%� ��,til 12/23/8 <br />MECHANICAL <br />FEE NO. TVPE OF EOUIPI <br />NC — A�HNOLG UNITS — H P. <br />REPRIGERATION UNITS — HP. E <br />DOILERS — B T.UM.P. <br />GAS FIRED A�C. UNITS — BS.U. <br />FORCED AIR SYSTEMS — OS.U. <br />WALL HEATERS — D.T.U. <br />UNIT HEATERS — B T.0 <br />EVAPORATIVC COOLERS <br />CLOTMESDRVERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER 11EATER <br />j WOODSTOVE <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />S <br />f <br />f <br />VACANTSITE <br />❑ves ❑rvo <br />NO OF DWELL�NG UNITS <br />LOAD <br />qPPR iOR ISSUANC[ DY <br />SUBTOTAL <br />PERMIT <br />TOTALFEE <br />�LAN CNECKNUMBER FEE <br />FEES V U <br />BUILDING S <br />PLUMBING <br />MECHANICAL <br />;� ; <br />INVESTIGA710N FEE <br />STATE OUILDING SURCHARGI <br />STA7EENERGYSUHCHARGE <br />DRIVEWAY PERMIT <br />TOTAL <br />M En <br />M <br />M <br />SeC.304�e) <br />FEE <br />NO. <br />:1'J <br />PERMIT VALIDATICIN / <br />WHEN PROPEliLV VALIDATED pN TNISuSiAC�E1,rHIS IS VOUR PERMIT <br />NU U / Y �� <br />11EL'H �?O.UO O7 <br />-.C�7F�T(,�� k <br />L�• <br />� <br />