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'�� ^ �NSTRUCTION � C C <br /> everett PERMIT PERMITNQ::-� U�O`� <br /> 259 -8745 <br /> �C7 DEMOLITION ❑ COMBINATION C7 BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNEP CdW <br /> MMlAOD9E$5 CITV ZIP PMONE <br /> ynqp�K�4CYCt. 626 - 128th St SW Everett, WA 98204 347-1193 <br /> •RLNITECT OR OESiGNER M�R I�OORE55 GiTY ZiP PMONE <br /> GENERI1lCONTR�GTOH M�iLADDRESS CiTv IIP VMONE LiGENSE• <br /> Brokaw & Co. 626 - 128th St SW Everett, WA 982U4 BROKAC*152N6 <br /> MECH�NILAL LONiP�CTOR MAIL��DRE55 CITY IIP �'MONE LICENSE� <br /> VLbYABING CONTR�LIOH M�il�DDRESS CITY ZIP �ONE LICENSE� <br /> CL�55Oi WORN <br /> B �y/ ❑ ADDITION ❑ ALTERATON ❑ REPAIN ❑ DEMOLITION ❑ BUILDIN/i RELOCATON <br /> V�lU�T10N OF WOPN <br /> s ZIrJLi1000. � <br /> UESLRIBE WOPK <br /> Demolish - <br /> NEATSOURLE <br /> ❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHEH <br /> vnovoseouseoraunoir+c I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br /> APPLICATION AND KNOW THc SAME TO BE TRUE AND <br /> LEG�5LU"EGSGRIPTIONOFPiIOVERTY�SNOWBELOWORATTACHFOUPCOV�E51 CpRRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> Sfy'67 719 Everett, Div H GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> ior_e�oc� _ov WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO <br /> VIOLATE OR CANCEI THE PROVISIONS OF ANY OTHER <br /> STATE R LOCAI LAW REGULATING CONSTRUCTION OR <br /> THE P F(1RMANCE OF CONSTRUC ION. <br /> JOBADDRE55 SIG nT OF NT .AUtHOAi: AG ROWNER �ATE <br /> 3017 Rucker Ave � <br /> PLUMBING MECMANICAL <br /> Np, TYPE OF FI%TURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATEF CLOSET(TOILETI AiC—A/HNDLG UNITS—H P <br /> BATHTUU REFPIGERAT�ON UNITS—M.P.EA. <br /> LAVATORV IWASH BASIN) BOILERS—0 TL/H P. <br /> SHOWEFI GAS FlRED A C.UNITS—B TL <br /> KITCHEN SINK S DISP. fORCED AIR SYSTEMS—BS.U. M EA. <br /> DISHWASHER WALLHEATERS—BT.U. M <br /> IAUNORV TRAY UNIT NEATERS—B TL. M _ <br /> CLOTHES WASHER EVnPORATIVE COOLERS <br /> URINPL CLOTHESORYERS <br /> DRINKINC�FOUNTAIN VENTILATION�AN <br /> FLOOR DRAIN RnNGE HOUD <br /> BACNFLOW PREVENTERS WAiER MEATER • <br /> ROOF DRAINS—RAINLEADERS WOOD STOVE <br /> SINK(SERVICE—BAR,ETCJ METAI.FIREPLACE 8 CHIMNEV <br /> FIREPLACEINSERT <br /> HEAT PUMP <br /> GAS PIPING <br /> EXHAUSTFAN <br /> SUBTOTAL S SUBTOTAL <br /> PEHMIT f PENMIT <br /> TOT�LFEE f TOTALFEE <br /> iPONi5ETB4CK REAPSETBACK Si0E5ET8/CK P1.ANCHECKNUMBF.R FEE RECEIPTNO. <br /> USE ZONC ��T AAEA VACANT SITE <br /> ❑ves ❑r+o FEES VALUATION FEE <br /> TYf'EOFCONST OCCUPANCYGROUP NOOFOWELLINGUNITS OUILDING S —O— <br /> PLUMBING j�/17/O6 10: �AM DOORN;'a5" �K1-fX <br /> SI2EOF�lOG NOOFSTORIES MnR OCC LOnD <br /> MECHANICAL <br /> INVESTIGATION FEE f,���3�«�4S LSS <br /> FIRE SPRINKLERS REOU�RED O�`-S ❑NO STATE BUILDING SURCHARGE � y�L 1 SO <br /> STATEENERGVSURCIIARGE Hppp16905 <br /> RPPi ICRTION PCC t�V PlANS CHECNED E3Y FPPR fOR ISSUANCE OV <br /> DRIVEWAV PERMIT � <br /> TOTAL SEWEF '•`.� 1 50 <br /> M.M. <br /> PENMITYRLID�TION � ' � <br /> WHEN PROPERLY VALIDATED pN T��E)TMIS�Pp�i PERMIT �' <br /> �lil'rJ 4�Jj�7.�4.i � <br /> i;iiECl: 499P i.44 Q� <br /> C.D <br /> � <br /> r�; ���� , �� � ���. _ <br />