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`�� '' t�NSTRUCTION � '' . C <br />everett PERMIT PERMITNQ:_�H`�U� <br />259-8745 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL �] PLUMBING O SIGN <br />ONTIER MRR qDDRE55 CITY 21P PMONE <br />Linda Kane 5107 Woodlawn Everett, WA 98203 <br />APGHITECTORDESIGNER MRILRDDRESS qTY ZIP PHONE <br />MAIL ApDRESS CITY Z:P PMONE UGENSE � <br />MRIIADDRE55 QTY ZIP PMONE LICENSE� <br />PWMBINGCONTRAGTG� M�iLADDR[SS dTY 21P PNONE LIGENSE� <br />�jf,��psy[.j4W'1` G(:OILCt Fmton..S7n QA(15S �71—if1S7 f1LKTFRKtt�,' 1S(1P(` <br />CLASS OF WCRN <br />❑ NEW C� ADDITION ❑ ALTENATION O REPAIH ❑ DEMOLITION O BUILOING RELOCATON <br />URTION OF WORR <br />f 8rJ0.0� <br />CPIBE WORN <br />Rouah in one full bath waste and water <br />MEATSOUPCE <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE <br />PROPOSEO USE OF BUiLDING <br />Single family residence <br />LIiGPL OESLRIFTIOK OF PROPERtt �SNOW BELOW OR qTTACM FOUR COPIES� <br />LOT _ BLOGK _ OF <br />JOBRODRE55 <br />PLUMBING <br />TYPE OF FI%TURE OR I�EM <br />WA7ER CLOSET(TOILET) <br />BRTHTUB <br />LAVATORY�WASM DASIN) <br />KITCHEN SINK 8 DISP. <br />DISMWASNER <br />LAUNDRYTRAY <br />CLOTHES WASMER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR ORAIN <br />BACKFLOW PREVENTERS <br />ROOF �flAINS — RAINLEADERS <br />SINK (SERVICE — BAR. ETC.) <br />USEZONE <br />TYPE OF CONST <br />512E OF BLOG. <br />FIRE SPRINKLERS R <br />APPLILFTIONAGC �Y <br />S.H. <br />SUBTOTAL f <br />PEXMIT { <br />TOTALFEE f <br />REPR SETpACN Si'� <br />lOT AREA <br />OCCUPANGYGROUP <br />NOAF STORIF.S <br />1'LANS CN[CKED OY <br />❑YES ❑NO <br />NO OF DWELti <br />Mq% OCG LOAD <br />APPR FOR ISSUANCE OY <br />❑ OTHER <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APP�ICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS 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 AUTHORITV TO <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />ST9TE-OR-LQCAL LAW RfGl�M71NG CONSTRUCTION OR <br />�FiE PERFORMAt�lCE OF C4SNSTRUC�ION. i <br />MECHRNICAL <br />FEE <br />A/C — A/HNOLG UNITS — H P. <br />REFRIGERATION UNIT$ — HP. EA. <br />BOILERS — D.T.0 /H P. <br />GAS FIRED A�C. UNITS — BSL. <br />FORCED AIR SVSTEMS — B.TU. M EA. <br />WALLHEATERS—BS.U. M <br />UNITHEATEHS—�B.T.U. M <br />EVAPORATI VE COO�EFS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER • <br />WOODSTOVE <br />METAL FIflEPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEATPUMP <br />GAS PIPING <br />EXHAUSTFAN <br />BUB TOTAL <br />PERMIT <br />TOTALFEE <br />FEES VALUATION FEE <br />�UILDING rg<i nn-'.�• -- s �rl�':iiNS, <br />PLUMBING � <br />MECHANICAL ����L'•U]I�JGi <br />it: tli <br />INVESTIGATION FEE !„G�C.�304�e) � t �, �]�i <br />ST�TE BUILDING SURCHARGE <br />S7ATEENERGVSURCHARGE <br />DRIVEWAV PERMI7 <br />TOTAL j <br />PERMIT VALIDATION <br />WHEN PROPERLV VALIDATEO QN THIS SPACE) THI515 VOUR PERMIT <br />AUDRCSS H.� <br />0 <br />. <br />