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"�E"�" C- �iVSTRUCTION /�C <br />��T, a� <br />everett PERMIT PERMIT NQ: _ � �O`�`� <br />��xXx�ic�x� 259-6800 <br />❑ DEMOLITION O COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />�yyryEq MAILAD�RE55 GTV ZIP PHONE <br />Robert Groenig 5320 S 4th Ave Everett, WA 98203 252-7685 <br />MCHiTECTOPDLIGNER MRILAODRE55 CITY IiP P110N[ <br />GENERPICONTRRCTOP MFILPDORES$ CITY Z�P i'HONE UCENSE• <br />Self <br />MECMRNICRLCONTRRCTOR MRILAO�R[SS QTY Z�P PHONC LICENSE� <br />PWMBINGCONTRRCTOR M�IILROORE55 CIiY ZIP I�MONL LICENSE• <br />❑ NEW ❑ ADDITION <br />�ALURTIO'!Of WORN <br />5 665.00 <br />>Escnm[ woarc <br />Re-roof <br />❑ ELECTRICITY <br />•sovoseo use oF ou <br />Single fan <br />66 <br />LOT _ BLOCN _ <br />❑ GAS <br />❑ ALTERATION � REPAIR <br />CJ WOODSTOVE <br />residence <br />Earr �sr�ow eciow oa nrrncn roua coaiesi <br />gasani Lowell View Tracts <br />,oiLnppqes.S. 9th Ave <br />S.ilU <br />PLUMBING <br />TYPE OF FIXTURE OH ITEM <br />WATER CLOSE? �TOILET� <br />pATHTUB <br />LAVATOFY�WASN BASIN� <br />$HOWER <br />KITCHEN SINK 8 DISP. <br />OISHW�SMER <br />IAUhDFYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DHAIN <br />�ACNFLOW PREVENTERS <br />ROOi DRAINS — FiA�NLEADERS <br />$INK �SERVICE — BAA. ETC � <br />SUBTOTAL <br />PEPMIT <br />TOTRL FEE <br />iRONT5Ei0ACK PERRSEIDPCK <br />USE 20NE LOT nHErl <br />TVPEOFCONST OCCLIP4NCYGROUv <br />SIZEO�ALDG i�00F5TORiES <br />FIRE SPRINKLEA$ REOUIRED ❑ �ES ❑ NO <br />APPLIL4TIONnCC Ov PtANSCHECeED�V <br />M.M. <br />O DEMOLITION <br />❑ OTHER <br />❑ BUILOING flELOCATION <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />P.PPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVEHNING THIS Tl"PE OF WORK WIIL BE COMPLIED WITH <br />WHETHER SPECIFIED HEPEIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTI�ORITY TO <br />VIOLATE OR CANCEL THF PROVISIONS OF ANY OTHEfi <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />TH�FREORMANCE O CONSTRUCTION. <br />X Nq� ��R�R. i IORIiE� � OWNEli OAi[ <br />� 9/15/87 <br />�[ SETO>CN P�AN <br />CnNT SrtE <br />YE$ ❑ NO <br />NO OF DWEIIiNG 11NR5 <br />M1+A% OCC LOn� <br />nrrn wn �ssunNce nr <br />TYPE OF EOUIF�IE <br />A: C— NHNDLG UNITS — H P <br />RFFRIGER4TION UNITS — H P. EA <br />BOILERS — US U MP. <br />GAS FIREO A C. UNITS — B.TL. <br />FORCED AIR SVSTEMS — B T U <br />WALL HEATERS — 0 T U <br />UNIT HEATEPS — � T.0 <br />EVAPORATIVE COOLERS <br />CLOTIIES �fiV[!i5 <br />VENTIIATION FAN <br />RANGEHOOD <br />WATERHEATER • <br />WOODSTOVE <br />METAL FlRE�'LACE B CNIMNE� <br />FlREPLACEINSERT <br />I1EAT PUMP <br />GAS PIPING <br />E%11AUST FAN <br />SUBTOTAL <br />PENMIT <br />TOTALF[E <br />FEE <br />M EA <br />M <br />M <br />ree <br />�UILDING I$ 665.00 I 19I �0 <br />PLUMBING <br />MECHANICAL <br />INVCSTIGATION FEE <br />STATEOUILDINGSURCHARGEI ijOOU1BO4S I SISO <br />STATEENERGYSURCNARGE <br />DRNEWAVPERMIT � LI�cCI� ���).�� <br />TOTAI I I 20I50 <br />PERMIT VALI�qTION <br />WH[N PROPERLV VAUDFT[U �IN THIS SPAGE) TMIS IS YOUR PERMIT <br />�7 <br />� <br />�— <br />� <br />�— <br />i��'�.�.._.i.: � ; � <br />