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thr Fwrr*rsrn <br />,: <br />everett <br />259-8745 <br />� C-'`1NSTRUCTION <br />PERMIT <br />PERMIT NO. I � U � � <br />❑ DEMOUTION i. i COMBSNATION ❑ BUILDING ..J MECMANICI�L C� PWMBING i3 SIGN <br />n•NNfP NAII AO[]RFS• .• [I{' � M�INf <br />Kentucky RYYKI(d Fried r`�,ick.en 4131 kucker Ave. iVerett, WA 98201 <br />•RCMrtFCT[mOFS�ONfn v�LL�pOnf".•:, r��.tv ]�r rrexJf <br />6ENERM CON1RI�f,�Oq M/11 �OpRf.55 GnY ZIP P�q�K tIf,FNSI � <br />Mever Sian Co 16B9 Hwy 99 � Mt Vern WA ornrr,tcvcncnaa�nT <br />MErN/�NIUlCON1Rl1CTOR M�II �DfIRF55 CITY ZIV VNONE LIC.F�ISf • <br />PIUMIIIMGCON�R�C1pp M�II�D�JNf$q CRV Ilf` PHtHIF UCFNtiF• <br />CL�950f W(MF <br />❑ NE�Y i] ADOITION <br />vu w no.� n� wanr <br />3 500.00 <br />Gd ALTER�TION ❑ REPAIR <br />oF5cA�9e wonn <br />Change face in existi.ng pole sign. <br />NERT SOUtiCf <br />❑ ELECTRICITY ❑ GAS ❑ WOOD6TOVE <br />RE6tdUidllt <br />�.,� —._... —. Or <br />4131 Rucker Ave. <br />PLUMSING <br />NO. TYPE Of FIKTURE OR ITEM <br />WaTER Cl OSET iTOILETI <br />BATHTUB <br />IAVATORVIWASM BASIN� <br />SHOwER <br />NITCMEN $INK 6 DISO. <br />DISHWASMER <br />LAUNDRVTRlV <br />CIOTHES WFSHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRFIN <br />BACNFLOW PREVENTER$ <br />ROOF ORAWS – RAINLEApERS <br />SINN (SEA VICE – BAR. ETC 1 <br />OF CONST <br />SIZE Oi BLDG <br />qP�LICPTION <br />S.H <br />SUB TOTAI <br />VERMIT <br />TOT�IFEE <br />�R tiETP�C�'� <br />❑ DEMOLITION <br />❑ OTHER <br />O BUILDING PELOCIITION <br />I HEREBV CERTIFV THAT I HAVE READ AND EX.AMINED THIS <br />APPUCATION A1JD KNOW THE SAME TO BE TRUE AND <br />CORRECT ALL PROVISIONS OF LAWS AND OfiDINANCES <br />GOVERNING THIS TYPE OP WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE F�UTHORITY TO <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATIn'G CONSTFUCTION OR <br />THE P[ ORMA�E OF CONSTRUCTION. <br />briNn'.i� t6CO./(1�iP/. iOR i.11i��ORIT[b!�<iENT OPpWNEn f/ f`I.S( <br />� �l. _����-OL <br />FEE Nd. TVPE OF EOUIPMENT <br />A C A�HNDI , VN�TS – M P <br />AEfRIG[RATIOP: UNiTS �� M P EA <br />BOI�[�S� 97U'�P <br />GASRPEDnC UNITS-87U <br />FORCEDAIRSYSTEMS–BTU MEA <br />WALI MEATERS – 8 T U M <br />UNITHE/TERS–BTU M <br />EVAPORFTIV[ COOLERS <br />CIOTHESDRYEFS <br />VEN7ILATION FAN <br />RANGFNOO�J <br />WATEPHLATER � <br />WOODSTOV[ <br />IdETAL ��REPLACE 6 CHIMNEY <br />FIREP�ACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />E%HAUSTFFN <br />L�O[ SEiFfaCK P�AN GMEGK NUM[ <br />vncnNt si*E FEES <br />❑YCS ❑NO <br />NO O�DWELLI <br />JO O! STORIES MA% <br />❑ VES '� NO <br />PLhNSCNECNED[iV PP� <br />B.E. <br />BUILDING <br />PW�dBING <br />MECHANICAL <br />INVESTIGATION FEE <br />STATE BUILDING SU <br />SUB TOTA� <br />PERMIT <br />TOTALFEE <br />FEE <br />GTATEENERGVSURCHARGE <br />roqissuANCEnr <br />DRIVEVJAV PEiiM1T <br />5 rJ��.O� <br />Sec 30d(c� <br />B.E. ITOTAL I I <br />PERMIT VALIDRTON <br />\M191EN PROP[�LV VALIDATEO (IN THIS SPACEI TNIS 6 VOUR PE(iMIT <br />5 <br />5 <br />�7 <br />N <br />C.� <br />O� <br />� <br />