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the ES�xreen <br />CITV Of <br />�verett <br />259-8745 <br />'"� C''�NSTRUCTION <br />PERMIT <br />�� <br />��: <br />PERMIT NO. �� 5 J u <br />❑ DEMOLITION ❑ COMBINATION C� BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWMEP MAILADDfiESS CITY 21P PHONE <br />Keith and Jodv Edwards 6720 Willow Rd Everett Wn 98203 347-3996 <br />{qLNITEGt OR DESIGNER MAIL ADORESS CITY ZIP PHONE <br />GENERALCONTRACTOR MAIIRODPE55 CITV 21P PMONE LILtrvJ[� <br />owner <br />MECH�NICaLCONTRRGTOR MnILI0DRE55 CITV 11P VMONE LICENSE� <br />PLUMBINGCONTR�CTOR MAlIAppRESS CIiY ZIP PIIONE UCENSE• <br />CLASS OF WONN <br />❑ NEW [] ADDITION ❑ ALTERATION ❑ NEPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br />VPLU�TiON OF WORK <br />S 32 200 00 ��, <br />DESGRIBE WOPK - �, <br />Addition <br />HEATSOURCE <br />O ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHEN I <br />ior i9_ o�ocK _ <br />PLUMBING <br />TYPE OF FIXTURE OR ITEM <br />WATER CLOSET �TOILET� <br />BATHTUB <br />LAVATORV (WASH DASIN� <br />SHOWER <br />KITCMEN SINK 8 �ISP. <br />DISHWASHER <br />LAUNDRYTRAV <br />CLOTHES WASNER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />POOF DRAINS — RAINLEnDERS <br />SINK �SERVICE — BAR. ETC.� <br />SUBTOTAL <br />PERMIT <br />TOTIIL FEE <br />iRONTSETB/CN FEARSETORCM <br />USE20NE LOTAFEA <br />TYPE OF LONST. OGCUPnNCY GR� <br />sK[ oF �toc. No oF sroRlEs <br />FIRE SPRINNLERS REOUIRED ❑ VES � 1 <br />APPLICATION�CC UY PLANSCM[CKC[ <br />S.H. <br />u <br />B.E. <br />FEE <br />� <br />f <br />S <br />sioE se*oncK <br />_ ` <br />VACRNT SITE <br />] YES X NO <br />NO OF pW[LUNG UNITS <br />1 <br />MA% OCC LOnO <br />—�UA <br />nrrn ron issunnce nr <br />B.E. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE S�.iv1E TO 6E TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS ANL� ORDINANCES <br />GOVERNING THIS TYPE OF WOHK WILL BE C�MPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE C�RANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE HUTHORITY TO <br />VIOLATE OR CANCEI THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAN' REGULATING CONSTRUCTION OR <br />THE PERFORMANCE Of i;ONSTRUCTION. <br />SIGNATURCOFCON111nCTOfi.AUTl10R12��/GENi.ORqIYNER �ATE <br />X <br />TVPE OF EOUIPMENT <br />A/C — A�HN�LG UNIT$ — H P. <br />(±EFPIGERAT104 UNITS — NP. EA. <br />BOILEPS—BTU/HP. <br />GAS FIflED A�C. UNITS — B TL. <br />FORCED AIR SYSTEMS — 0 T.0 <br />WAII HEATEFS — B T.U. <br />UNIT HEATERS —0 T.U. <br />EVAPORATIVE COOLERg <br />CLOTHFSORVERS <br />VENTILATION PAN <br />qnNGEHCOD <br />WATER HEATE(i <br />WOODSTOVE <br />McTAL PIREPLACE 8 CHIMNEV <br />FIREPLACEINSERT <br />HEAT PUMP <br />GAS VIPING <br />E%HAUSTFAN <br />SUBTOTAL <br />PERMIT <br />PLAN CHECK NL <br />88/19596 <br />BUILDING <br />PLUMBItJG <br />MECHANICAL <br />INVESTIGATIONFEEld71 C <br />P _ <br />STATE BUILDING SURCHAHG <br />STATEENfRGVSURCHARGE <br />DRIVEWAY PERMIT <br />TOTAL <br />M EA. <br />Ai <br />M <br />FEE <br />76,05 <br />5 <br />Sec.304�e) <br />< <br />FEE <br />95343 <br />WHEN PROPLRI.V V�LIDATEO QN THIS SPACE) THIS IS YOUR PERMIT <br />%�L, ... i . ,. <br />5� <br />