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u� � <br />cin oF <br />everett <br />259-8745 <br />�"` C�NSTRUCTION <br />PERMIT <br />,..., r� <br />PERMIT NO. 19945 <br />❑ DEMOLITIOh ❑ COMBINATION ❑ BUILDING Q MECHANICAL -❑ PLUMBING ❑ SIGN <br />OWNEi MMLPDDRE55 LITY UP VHONE <br />A1 Liebelt 5222 Wetmore Ave. Ecerel:t.. WA 90203 353-6375 <br />I1ACH-TELTONDESIGNER MnIIPO�RE55 CITY ZIP M10NE <br />GENERAL CONTRRCTOR MRIL ADORESS CITY 2iP PHON[ LICENSE � <br />AIECNAMC�LCONiRRLTOR MPRN�DPE55 CiTY ZIP P�WNE LiCENS[� <br />Owrter <br />PWMBINGCONTRnCTOR MAILAODRE55 CITY 21P VMONE LICENSEr <br />CLRSS OF WORN <br />❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING HELOCATION <br />W W RTION or wonR <br />{ <br />OESCRIttE W�RK <br />Puttin in woodburner movin stove in basement <br />MEATSOURCE <br />O ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER _ <br />LOT _ OLOCN _ <br />PLUMBING <br />TYPE OF FII <br />WATER CLOSET (TGILF <br />BATHTI:d <br />LAVATORYIWASH BA'_ <br />SHOWER <br />KITCHEN $INK 8 DISP. <br />OISHWASHER <br />LAUNDRVTRAV <br />CLOTHES WASHER <br />YING FOUNTAIN <br />q DNAIN <br />:FLOW PREVENTERS <br />° ORAINS — RAINLEADERS <br />�SERVICE — BAR, ETC.� <br />CONST <br />o�oc <br />S.H. <br />I HtREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL Pr70VISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TVPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO <br />VIO�ATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />THE PERFORMANCE OF CONSTRUCTION. <br />SiGNATUR[ O�'CONi `IOR�i� �Oni2'0 /GENT.OR OWN[P � D E <br />X ( ' / <br />MECMANICAL <br />FEE NO. TYPEOFEOUIP6IENT <br />A/C — A�NNDLG UNITS — H P <br />REFRIGERATION UNITS — H P. EA. <br />�OLLERS -- 0 TL %N P <br />G�SFiPEDAC UMTS—BTU. <br />FORCCD AIR SYSTEMS — 0 T U. M EA. <br />WALLHEAIERS—BTU M <br />UNI1H[ATENS—OTU M <br />EVAPORATIVE COOLERS <br />CLOTHES OF�ERS <br />VENTILATION FAN <br />RANGENOOD <br />WATERHEAIER � <br />WOODSTOVE <br />METAI FIREPLACE 8 CHIMNEY <br />FIREPLACEINSGRT <br />HEAT PUMP <br />GAS PIPING <br />E%NAUSTFAN <br />SUBTOTAL S <br />PERMIT f <br />TOTAL FEE f <br />REARSFTOFCN SIpESEIB<CN <br />LOT RREF ypGFNT SITE <br />❑rEs ❑rvo <br />OCCUPANCYGROUP NOOFOWELLINGUNI <br />NO OF STORI[5 MA% OCC LOFD <br />' REOUIPED ❑ YES ❑ NO <br />[iY PLRNS CMECNEOOV APPR FOR ISSUANCE <br />SUB TOTAL <br />PERMIT <br />TOTALFEE <br />. NUMOER FEF <br />FEES VALU <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />INVESTIGATION FEE <br />STATE �UILDING SURCIIARG <br />STATEENERGVSURCNARGE <br />DRIVEWAV PERMIT <br />E <br />Sec.30a(e) <br />FEE <br />TOTAL I I <br />PERMIT YALIOATION <br />WHEN PROPERLV VAUDATED �W TNIS SPACE) THIS IS �OUR PERMIT <br />F�'i'll� . .: 1 � C <br />3G100 <br />L�]I � 1 <br />