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��� <br />GTV OF <br />everett <br />259-8745 <br />❑ DEMOLITION <br />�iy� C�NSTRUCTION �- ��` <br />PERMIT PERMIT NO. 2� 5( S <br />❑ COMBINATION ❑ BUILDING C� MECHANICAI � PLUMBING ❑ SIGN <br />Bill i�he� 8115 Xavier Way Everett 98203 353-8810 <br />AftC11rtECTORDlSIGNER MAIIFODPESS CITY ZIP PHONE <br />GENERAL CONTFPCTOR MAIL RDORE55 CITY 21P PMONE LICENSE • <br />MEC�bWIULCONiRRGTOR MAILAODRE55 CITY ZIP PIIONE UCENS[w <br />Qistom Gas Service 22329 57th Ave. SE Bothell 98021 =USTOGS231P6 <br />PWM6INGCOHTRRCTOR MRILPLORE55 CiTV Z�V PHONE LILENSE� <br />:USS Oi WORN <br />� NEW � AUDITIOi� <br />�AWITIONOF WURK <br />S <br />(� ALTERATION ❑ 11EPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br />Install conversion burner and gas piping -- <br />11E>T $OURCk <br />O ELECTRICITY ❑ GAS ❑ WOODSTOYE ❑ OTHER <br />SFR <br />LOT �_ BLOCR �� <br />8115 ](avier <br />PLUMBING <br />TYPE OF <br />SIZE <br />TYPE OF FIXTL <br />WATEF CLOSET �TOILLT� <br />BATHTUB <br />LAVATORY �Y/ASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISHWASHER <br />LAUNDRYTRAY <br />URINAL <br />FLOOR <br />ROOF DRAINS — RAINLEAOERS <br />SINK �SERVICE — BAR. ETC.� <br />SUBTOTAL <br />PERMIT <br />TOT11L FEE <br />rn� <br />FIRE SPRINKLERS REOUIRED ❑ VES ❑ 40 <br />Vr1f.ANT SITE <br />❑YCS ❑NO <br />NO OF UWELLi <br />occ �ono <br />APPIICATIONAGG OY PlNNSi��[CNE�OY APPR FOR <br />S.H. <br />I HEREBY CERTIFY THAT I HAVE READ AND E%AMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PFOVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE 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 />VIOLATE OR CANCEL THE PFlOVISIONS OF ANY OTHER <br />STATE LOCAL LAW REGULATING CONSTRUCTION OR <br />THI�/ .ORMANCE OF CONSTRU ION. <br />SIG TU OFCONTRnCTOA.AUT1101112E T.OROWNEli DATE �p <br />Y .� i a C %% / �O. � _ rC11�c..- � � '�J'� �Y <br />TYPE OF EOUIPMENT <br />MC �- A/HNDLG UNITS — H P. <br />REFRIGERATION UNITS —liP. EA. <br />OOILEflS — � T.U. H P. <br />GAS FIRED A L UNITS — B.T.U. <br />FORCED AIR SYSTEMS — B T.U. M EA <br />WAILHEATERS—BTU M <br />JNITHEATERS—[1TU. M <br />EVAPOPATIVE COOLE85 <br />CLOTHES OR1'ERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />WOODSTOVE <br />METAL FIREPLACE 8 CHIMIJEV <br />FIREPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />E%HAUSTFAN <br />PERMIT / <br />TOT S <br />NUMBER G R EIVTNO. <br />CHECf: 42 �.00 <br />recc VALl1AT10N FEE <br />BUILDING <br />PLUh181NG <br />MECHANI�:AL <br />INVES7IGATION FEE <br />S7ATE BUILDING SURCHAfiG <br />ST�7EENERGYSURGHARGE <br />DRIVEWAY PERMIT <br />Sec.304�e) <br />TOTAL � I <br />vERMIT VAIIDATION <br />WHEN PROPERLV VALIDATED �IN THIS SPACE) iHIS IS YOUR PEIiMIT <br />;.;;�� :.s< r� <br />291 00 <br />