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`�E �"� C-�71�STRUCTION �� C <br />everett PERMIT PERMITNQ. � �� �`� <br />� zS�r -8�/ � <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING I� MECHANICAL �� PLUMBING ❑ SIGN <br />OW`!E!i M/ILRODRE55 CITV ZIP ��ONE <br />Ron Cole 4302 S. 3rd Ave Everett, WA 98204 259-0783 <br />PPCHITECTORDESIGNER MAILPDORE55 CITY LIP PHONE <br />GENEN/.LCONiRACTOR MAIL�DDRE55 CITV ZIP PMONE UCENSE• <br />Natural Gas Equipment 1G35 E Marine View Dr. Everett, WA 258-2441 NATURGE321K9 <br />MECHRNiCr. :ONLRACTOf1 MAILF�DHE55 LITY ZIP PHONE LICENSE• <br />CONTPnCTOR <br />;LASSOF WORN <br />❑ NEW ❑ ADDITION <br />�A W AiION Of WOHN <br />S <br />Wall gas furnace and g <br />IEAT 5011RCE <br />❑ ELECTRICITY ❑ GAS <br />residence <br />L DESCRIFTION OF <br />ior _ awcK _ o� <br />Q ALTERATION <br />•.uater heater <br />4302 S 3rd Ave <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET ITOIIET� <br />onnarue <br />LAVATORV�WASH OASIN� <br />SMOWER <br />ri1TCHEN SINK 6 DISP. <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHEI7 <br />URINAL <br />DAINKING FOUNTAIN <br />ROOf7 �RAIN <br />�ACKPLOW PPEVENTERS <br />ROOF DfiA1N5 — RAIM_EADER� <br />SINN �SERVICE — �Afi. ETC � <br />SUBTOTAI <br />PERMIT <br />TOTALFEE <br />fRONT <br />TYPE OF GONST. <br />SiZE oF OLOG � no of <br />nrrucnnor+ncc ov <br />M.M. <br />O flEPAIR ❑ DEMOLI7!ON <br />G WOODSTOVE ❑ OTHER <br />ZIP PNONE lIC[NS[ • <br />❑ BUILDING RELOCATION <br />I HEREBY CERTIFY THAT I liAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE S�ME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF �AWS AND C�DINANCES <br />GOVERNING THIS TYPE OF WORK WILL OE COnn�LIEO 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 />STA'i E OR LUCAL LAW REGULATING CONSTRUCTION OP <br />THE PERFORMANCE OF CONSTRUCTION. <br />si�_;Hntun ur,Cr�inncton.niirr�or+izEonccN*,onowHFn onrE <br />x K� l�ivJ,�� 1� -.�0-87 <br />MECHANICAI. <br />NO. TYPE OF EOUIPMCN'f FEE <br />A.0 — NIINDLG UNITS � H P <br />REFRIGEf7ATION UNITS — H P. EA <br />ooi�ens - o.r u -�i r <br />GAS �IllED A C. UNITS — E1.T.0 <br />FORCED AIR SYSTEMS -- [i T U. M EA <br />W�LLHEnTERS—OTU M <br />UNIi HEATERS — 0 T U. M <br />EVAPOMT�VG COOLERS <br />CLOTNESDRY[RS <br />VENTILATION FAN <br />RANGEHOOD <br />WATERHEATEfl � <br />WOOD STOVE <br />METAL FlREPIAC[ A CHIMNEV <br />FINEPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />E%HAUSTPAN <br />S SUBTOTAL <br />s PENMIT <br />s TOTALFEE <br />SiOE SErUnCrc PLAtJ CNECK NUMf3Eq FEE I P.ECEIPT NO. <br />VAC�NT SIT[ <br />pr[5 ❑r+o <br />GROUP NOOfOWELUNGUNITS <br />ES MA% OCC LOAD <br />] NO <br />Heoev nvrn�onissunHceov <br />FEES VALUA710N _FEE <br />BUILDING � <br />PLUMBING <br />MECHANICAL <br />INVESTIGATION FEE Sea 304�e) <br />STATE BUILDING SURCHARGE <br />STATEENERGYSURCHAqGE <br />DRIVEWAV PERMIT <br />TOTAL <br />PENMIT VALIDATION <br />WHEN PROPGRI.Y VALIDATED (IN THIS SPACE) THI515 VOUR PERMIT <br />30 � 50 <br />30 � 50 <br />