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!hc E�ergrcrn <br />CiTY OF <br />everett <br />259-8745 <br />�` C �NSTRUCTION �� <br />PERMIT <br />� <br />PERMITNQ:- � �UO� <br />❑ DEMOLITION ❑ COMBINATION � BUIIDING ❑ McCHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER M�IlAOURESS CITY ZIP PHONE <br />Fred Ochsner P.O. Box 55303 Seattle, WA 98155 339-0428 <br />ARCNITECiOR0E51GNER AIAILI.IJ�PE55 GtY ZIP PNONE <br />Self <br />GENENnLCONTRACIOR AIAILADDRESS CITY 21P PMONE LICENSE� <br />Self <br />MECHnNICALCONTRAQOR AIAILADDf1E55 CIiY ZIP PIIONE LILENSE• <br />Self <br />PLUI.I�INGCONTRACTOfI I.'�'Lr10CRE55 CITY 2iP PHONE LICENSC• <br />Self <br />c�nss or wonK <br />❑ NEW ❑ AUDITION ❑ ALTERATION �7 REPAIR O DEMOLITION ❑ BUILDING RELOCATION <br />V4WATION OF WORN <br />$ .�.2�0��.�� <br />pE5CRi0E N'ORK <br />Repair fire damage <br />MEATSOURC[ <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />IEG�L <br />lOT <br />Home <br />iCRIPTION OF Pf10PEPTY �SHC:J �ELO W OB PTTFCH FOUR COP <br />18 Town of Lowell. N <br />_ �LOCN _ OF <br />lot 9 and all of lot 10 <br />JO�ADORE55 <br />2?16 52nd St. <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />Z WATER CLOSET (TCILET� <br />1 BATMTUB <br />Z I AVATORY (1VASH �ASINI <br />] SHOWER <br />], KITCMEN SINK 8 DISP. <br />OISHWASMER <br />LAUNDRYTRAV <br />1 CLOTNES WASHER <br />URINAL <br />DFINKING FOUNTAIN <br />ROOH DRAIN <br />BACKF.JW PPEVENTFRS <br />ROOF C9AIN5 - RAINLEAOERS <br />SINK �SER�'�CE - L?R ETCJ <br />SUBTOTAL f <br />PERMIT 5 <br />TOTALFEE 5 <br />I HEREBY CFRTIFY THAT I HAVE READ AND EXAMINED TIiIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND OfiDINANCES <br />of GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THF GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHFR <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />TI1E PERFORMANCE OF CONSTRUCTION. <br />ti�f.r1A� [ Of CpyT�M'�i0�; TIIO'IZwD AGENT. Ofi 015NER //� OATF <br />X i ��� 9 �� <br />MECHANICAL <br />FEE NO. TYPE OF EOUIPMENT <br />LO OO A�C—A�HNDLGUNITS--HP <br />S OO REFRIGEflnTION UNITS — H P. EA <br />ZO OO OOILERS—�TU�HP. <br />,j Q� GASFlPEDAC UNITS—�TL <br />�'j DO FOPCED A�R SYSiEMS — A' U M EA <br />WALL HEATERS — BJ U. M <br />UNITHEATERS—OTL M <br />S OO [VAPORATIVECOOLERS <br />CLOTHESCR�LRS <br />VENTILATION FAN <br />RANGEHOOD <br />WFTEH IiEATER • <br />1V000 STJVE <br />METM RI7EPLA�E 8 CHIMNEV <br />FIRtPLACE IN$Efli <br />HEATPUMP <br />GFS PIPING <br />EXIIAUST FAN <br />v:""�•` •••,•`� VACANTSIiE <br />❑YES ❑NO <br />TVPE OF LONST OCCUPANCV GOOUP NO OF OK'ELLING UNITS <br />SIZEOFOLDG NOOFSTORIES Mn%OCCLOAD <br />FIRE SPRINKLEPS REOUIRED ❑ VES ❑ NO <br />�PPIIC�IIONPCC PV PLRNSCMEGKEOOV APPR IOflI55UdNCEOY <br />S.H. L.C. <br />PLAN C4ECH NUh7�ER <br />�UILDING <br />PLUM�ING <br />MECHANICAL <br />INVESTIGATION FEE <br />STA7E �UILDING SUI <br />FEE <br />SUBTOTAL f <br />PEPMR � � S� � <br />TOTALFEE �9 <br />fEE � RECEIPTNO. <br />VALUATION FEE <br />n2����.�� 135 <br />Sec.304�e) <br />STATEENERGYSURCHARGE <br />ORIVEWAV PERWIT <br />TOTAL I I 1 <br />PERMIT VALIDATION <br />WMEN PNOPERLY VALIOATEO (W TIIIS SPACE) TNIS lti VOUq PERMIT <br />