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`�� �'7NSTRUCTION � �7 <br />everett PERMIT PERMIT NQ� _ � � ( �� <br />259-8745 <br />� DEMOLITION � COMBINATION ❑ BUILDING 0 MECHANICAL ❑ PLUMBING ❑ SIGN <br />OVMER MMLPOOA[55 GrtY 2iP PHONE <br />Kenneth Williams 2601 Virginia Everett 98201 259-3672 <br />ARCHITELT O!1 DESIGNER MRIL nODPESS Crtv IiP MONE <br />GENERALCONTR�LTOR MAILPDDRE55 CITV ZIP 19�ONE LI(ENSE� <br />�u♦ <br />LiCENSE • <br />RUMOING GONTPRCTOR MAIL nDORE55 CITY 21P PHDNE LiLENSE • <br />:USS OF WORN <br />O NEW ❑ ADDITION <br />f <br />DESCRiBE WORK <br />Install wood stove <br />❑ ALTERATION ❑ REPAIR <br />HEATSOURCE <br />❑ ELECTRICITV ❑ GAS 7C] WOODSTOVE <br />Shop <br />LOT _ OLOGN _ <br />Virginia <br />PLUMBING <br />NO. TYPE OF FIXTURE OR <br />WA1ER CLOSET ITaILET� <br />BATHTUB <br />LAVp f ORV � W ASH BASIN) <br />SMO\4ER <br />KITCF'EN SINK 8 DISP. <br />DISHWASHER <br />LAUNCRV TIiAV <br />CLOTHES WASMER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />DACNFLOWi'REVENTERS <br />ROOF DRAINS — RA�NLEADERS <br />SINK �SERVICE — BFR. ETC.) <br />usE <br />TYPE OF <br />S.H. <br />SUBTOTAL <br />PERMIT <br />TOTALFEE <br />PLANS CHECNE� �Y <br />❑ DEMOLITION <br />❑ OTHER <br />❑ BUILDING RELOCATION <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE S�ME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WOHK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HER[IN 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 PEFFORMANCE OF CONSTRUCTION. <br />SIGNnyJRE OF CONTPnCTOR. AUTIIh912[�AGENT.Oii OWNEn _ UATE ^ <br />MECHANICAL <br />FEE NO. TYPE OF EOUIPMENT <br />NC - A/HNDLG UNITS - H P. <br />REFfl13ERAT10N UNITS -NP. EA. <br />�OILERS - � TLIN P. <br />GAS FIPED A C. UNITS - O.T.U. <br />FORCE� AIli SYSTEMS - B TL. M EA. <br />WALL HEAT[RS - U T.U. <br />UNITHEnTERS-iiT.U. M <br />EVAPORATIVE COOLER$ <br />CIOTH[SDRYERS <br />VENTILATION FAN <br />qANGGHOGD <br />WATE(i HEAT[R � <br />1 WOODSTOVE <br />METAL FIHEPLACE A CNIMNEV <br />FIFEPLACEINSERT <br />HEAT PUA1P <br />GAS PI PING <br />E%HAUSTFAN <br />� <br />S <br />S <br />;mesc*ancn <br />VOCANT SIT[ <br />]YES ❑NO <br />Ho or owEuwc ur+irs <br />r.as occ �ono <br />qPPR FOR ISSU�NCE tI� <br />SUBTOTAL <br />PERMIT <br />TOTALFEE <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />INVESTIGATION FEE <br />STATE BUILDING SURCHARG <br />STATEENERGYSURCHARGE <br />ORIVEWAY PERMIT <br />TOTAL <br />� <br />FEE <br />NO. <br />WHEN PR(�!'ERLV VALIOATFD (IN TMIS SPACE) TH1515 YOUR PERMIT <br />i.i;Iti�.;:35 fIL't <br />r <br />N <br />C�- <br />N <br />a--- <br />