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rhe (:1v�rvrn <br />cir, o� <br />everett <br />259-8745 <br />C. NSTRUGTION <br />PERMI� <br />PERM17 NQ: = L�699 <br />O DEMOIITION ❑ COMB�NATION O BUILDING �7 MECHANICAL ❑ PLUMBING ❑ SIGN <br />rnvnoi mm�anon[ss cnr� tir r�wrvE <br />Iarry Iarson 6309 Rockefeller Lberett 353-7259 <br />IOi11tlEC10qPEtiiGNCR AIAII�ODliE55 CI1V ZIP PIION[ <br />G[N[NALCOMOACi011 MAILADDII[$5 CIiV 21P f910N[ LICENSE� <br />MECMAN�CAL r,pNiRqCION �IAiL �OD��C55 CIiY ZIP PIIONE LIClNSE � <br />Valley Natural Gas 11;23 Highway 99 Everett 98204 355-7730 VLALENG153LI <br />1`LUMpiNGCOHLqACTOR A14R�ppf1E::5 CItV ZIP 1'HONE LICENSE• <br />C1A550f p'ORK <br />❑ NEW ❑ ADDITION �-1 ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br />VRWAT10Y Of 1YOBK <br />S <br />OESCPIpE WORN <br />Install furnace and water heater. <br />ME4TSOURC[ <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />Residence <br />LOT _ OLOCN _ <br />H8�6 6309 Fackefeller <br />PLUMBING <br />L4ATER C�OSET �TOILET� <br />BATIITUB <br />LAVATOFV�WASH BASIN� <br />SHOWEA <br />KITC4EN SINK 6 OISP <br />DISHWASHEF <br />LAUNDRYTfiAY <br />CLOTNES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOH DRAIN <br />BACNFLOW PPEVENTERS <br />ROOF DRAINS — RAINLEADERS <br />SINK �SERVICE -- F7AR. ETC � <br />TYPE CF CONST <br />�INx�]] <br />A�'PLIC�I�ON I.CC �Y <br />S.H. <br />SUBTOTAL <br />PERMIT <br />TOTALFEE <br />REARS[TOlCK <br />LOT AHEA <br />OCCUVANCY GRI <br />NO OF SiORiES <br />) ❑ vE5 ❑ P <br />i'LANS CM[CK[f <br />VACANTSRE <br />❑YES ❑NO <br />OCC l0/D <br />ron issunr�cE or <br />t HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CGRRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITFI <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF %� <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITV TO <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />THE PERFORMANCE OF CONSTRUCTION. <br />SI.NI.TU�iP.O� CONTfiAC�I1.AUTMORIZEOAGENT.Of10wNER pATE <br />�.1 <br />MECHANICAL <br />TYPE OF EOUIPMENT <br />AL - A-MNDLG UNITS - H P <br />REfFIGERATION UNITS - HP. EA. <br />�OILERS - �.T.0 /H P. <br />GAS FIRED A C. UNITS - 8 T.0 <br />FORC[D AIR SYSTEMS - 8 T U. M EA <br />WALLHEATC95-�TU M <br />UNITHEATERS-BTU M <br />EVAPURATIVE COOLEtiS <br />CLOTHESDRVERS <br />VENTILATION FAN <br />(7ANGE NpOD <br />WATER HEATER � <br />WOODSTOVE <br />MFTAL FIREPLACE A CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />E%HAUSTFAN <br />SUB 11oWt� <br />p� <br />TOTA <br />PLAN CMECK NUMDER Fry�ry/ <br />lIlLl�f� <br />FEES VALUA <br />�UILDIN(i $ <br />PLUMBING <br />MECHANICAL <br />INVES7IGATION fEE <br />STATE OUILDING SURCHARG <br />S7ATEENERGYSURCHAR,E <br />DRIVEWAV PERMIT <br />Sec.304(:) <br />FEE <br />FEE <br />TOTAL I I <br />PERMIT VALIDATION <br />1l'HfW PROP[RlV VALIDATED QN THIS SPAC[) THIS IS YOUR PERMIT <br />r,'�m.�����': �,��'�! <br />