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e�� <br />ciTv oF <br />everett <br />259-8745 <br />�'ONSTRUCTION � <br />PERMIT <br />PERMIT NQ: _ •� � `� U � <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OYMER MAII AODPE55 CITV ZIP PHONE <br />Brad, Boe 6007 Rockefeller �erett 98203 <br />♦qCHITEGT OR OESIGNEP MAIL AODRESS CITY 21P PMONE <br />GENER�ICONTRACTOR MMLAGJRE55 CITY ZIP PMONE IICENSE� <br />$tOLTl�S ODIISYSUCC10Il <br />MECHPNICALCONTRRCiOR MRILROORESS dTV ZIP PMONE UCENSE� <br />RUMBINGCONTRACiOR MAll4D�RE55 CITY ZIP PMONE LICENSE• <br />Trakar Plwnbin 2923 Silver Crest Dr. Bothell 98012 337-1717 <br />C1A550F WORN TRIiICA*�1S4LP <br />❑ NEW �l ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br />V�LU�TION OF WORK <br />S <br />Remodel and ac.dition <br />HEAT;AURCE <br />❑ ELECTliICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />residence <br />�or _ e�x� _ <br />JOB <br />PLUMBING <br />TYPE OF FO(TUHE OI <br />WATER CLOSET (TOIIET) <br />BATHTUB <br />LAVATORY�WASH BASIN� <br />SMOWER <br />NITCMEN SINK 8 DISP. <br />DISHWASHER <br />LAUNORVTRAY <br />CLOTHES WASNER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR OHAIN <br />BACKFLOW PPEVENTERS <br />ROOF DRAINS - RAINLEADEPS <br />SINK ISERVICE - BAR. ETC.) <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED 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 />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />THE PERFORMANCE OnF' CONSTRUCTION. <br />SIGNAt F CO R!�(O�THO�REO RGENT, OR 0\YNER OATE <br />X /� .L�,.,�— /!— /7—R6 <br />MECHANICAL <br />�TEM FEE NO. TYPE OF EOUIPMENT <br />A/C - AMNDLG UNITS - H P. <br />REFRIGERATION UNITS - H.P. EA. <br />BOILEqS - BS U.MP. <br />GAS FIRED A�C. UNITS - 8.T U. <br />FORCED AIR SVSTEMS - B i.U. M EA. <br />WALLHEATERS-BT.U. M <br />UNIThiATERS-B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTMES DRVERS <br />VENTIIATION FAN <br />P.ANGEHOOD <br />WATER HEATEF • <br />WOOD STOVE <br />METAL FIREPLACE 8 CHIMNEV <br />FIPEPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />E%HAUSTFAN <br />SUBTOTAL f <br />PERMIT f <br />TOTA�FEE S <br />Si0E5[fOACN PLAN <br />VPGANT SITE <br />❑YES ❑NO <br />OCCIIPFNCY GROUP NO OF OWELLING UNITS <br />NO.OF $TORIES MA% OCC LOAp <br />' REOUIHE� ❑ YES � NO <br />pY PLRNSCMECNEOOY APPNGONISSU�NCE�Y <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />INVESTIGATION FEE <br />STATE BUILDING SU <br />SUBTOTAL <br />PER <br />TOT , <br />�CH 4 :� <br />CHECI; 45 .50 <br />VALUATION <br />S <br />Sec.904�e) <br />STA7EENERGVSURCHARGE <br />DRIVEWAY PERMIT <br />TOTAL � � <br />PERMIT V�LID�TION <br />WHEN PROPERLY VALICATED (IN THIS SPACE) THIS IS VOUR PERMIT <br />(lill I'ESS FII E <br />