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'"''F�` ���""�'"T �'ONSTRUCTIOI"� - ^ q <br /> everett PERMIT PERMIT NQ. �0405 <br /> 259 - 8745 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING �MECHANICAL '� PLUMBING ❑ SIGN <br /> FIAIL 41)R��CS: <br /> cnr zm rHor+c <br /> OWNCR 252—Q7O9 <br /> Nevy 9aldassi 1621 Rucker Avenue Everett 98201 <br /> TRbal[Ci OR DCSICNCfi MNl/DORR$ <br /> crtv zir nw�+c <br /> Gf.NCReL CONTR�CI OIl Mnil AOON[55 <br /> C11V I.II• Iq10NE UGENSE� <br /> MPIlA�I111C55 CIIY ZIP PHONE LICENSE• <br /> uccr��Nic�i cor�roncron 355-7730 <br /> Valley Natural Gas 11323 Highway 99 Everett 98204 <br /> atv :��• rr�onE ucer+se� <br /> Mu�uoiNe coNtnnctoa nun nenncss VALLSNG153LI <br /> i;ustt oF wonK <br /> ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ NEPAIR ❑ DEMOLITION ❑ BUILDING RELOCA <br /> vnwnnoN o�wonn <br /> S <br /> o[:.cnme wonK <br /> Install furnace/water heater <br /> NEAi50URCC <br /> ❑ ELECTRICITY ❑ 6115 ❑ WOODSTOVE ❑ OTHER _ <br /> vaaroscous�ovounort+c I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> SFR APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> «e•ioacnivrio�ormorcn•riswwee�oworu**nc��ra�ncor�esr CORRECT. ALL PROVISIONS OF LA1N5 AND ORDINANCES <br /> GOVERNING THIS TYPE OF WORK WILL BE CUMPLIED WITH <br /> ior_eiocn _or WHET!icR SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br /> PERMIT UOES NOT PRESUME TO GIVE AUTHORITY TO <br /> VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br /> STATE OH LOCAL LAW REGULATING CONSTRUCTION OR <br /> THE PERFORMANCE OF CCNSTRUCTION. <br /> SIGNAT PE Of O R� T ..RUIHORILED PGENT.O�OWNER �^DAtE� <br /> JO��DGAE55 y � 6 <br /> 1621 Rucker Avenue �` � <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIl(TURE OR ITEM <br /> FEE NO. TYPE OF EOUIPMENT FEE <br /> AiC—AiMNDLG UNIiS—H P <br /> WATER CLOSET�TOILET� <br /> REFRIGERATION UNITS—H P.EA. <br /> BATMTUB <br /> DOILERS —�T U/H P <br /> LAVATORY�WASH BASIN� <br /> GASFlREDAC UNITS—OTL. <br /> SMOWEN <br /> KITCMEN SINN 8 DISP 1 FONCED AIR SVSTEMS—B T U. M EA. 9 <br /> WALLHEATERS—BT.0 M <br /> DISMWASHER -- - � <br /> UNIT 11EATERS—B T U <br /> LAUNDRY TRAY <br /> EVAPORAI i:E CCOLERS <br /> CLOTHES WASMER CLOTNES DRYERS <br /> UPINAL <br /> VENTILATION FAN _ <br /> DRINNING FOUNTAIN <br /> qANGEHOOD � <br /> FLOOR DRAIN (� SO <br /> � 1 WATERHEATER � — <br /> BACNFLOW PREVENiERS <br /> WOODSiOVE - <br /> ROOF DRAINS—RAIYIEADERS METAL FIREPLACE 8 LHIh1NE� <br /> i <br /> SINK ISEHVICI—BAR.ETC I � <br /> � FlREPLACEINSERT — <br /> HFATPUMP — <br /> GAS PIPING , — <br /> _ E%H!UST FAN - <br /> SUBTOTl1' 3 ZS SO <br /> � SUB TOT�L f PERMIT ZS OO <br /> PEpMiT = <br /> f TOT�LFEE <br /> TOTIIL PEE RECEIPT NO. <br /> T� SETOnCN REnRS[lOnLn Si0[5[tol.Ch PLANCHECKNUMBER FEE <br /> usem�+E ���AREA �>cnNrsrte FEES VALUATION FEE <br /> uYes ❑�a b <br /> TYPE Of CONST OCCU�ANCV GAOUP NO Of O�4ELLM4 U��iT�+ <br /> OUII.DING <br /> PLUMCIING <br /> size or airc no or stoaies Mna oce.�ono 30 50 <br /> MECMANICAL _ <br /> INVESTIGATION FEE SeC.304(e) <br /> FIRE SPqINNLk�15 NEOUIRED ❑�ES NO STATE OUILOING SURCHARGE <br /> STATE ENEPGV SUf7C1�ARGE <br /> PLANSCN[CN[DOY APPNFOPIti511ANC[0Y <br /> ���+ii�i�ir�nCc Or DRIVEWAV PERMIT <br /> 30 50 <br /> TOTAL <br /> PERMIT VALIOATION <br /> WHEk PIiOPERLV VALIOATEU(IN THIS SPACE)7NIS IS YOUR PEflMII' Sl, <br /> 0 <br /> �� <br /> 0 <br /> N <br /> �, ; � <br />