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`��' ('7NSTRUCTION � 7 <br />eV� a�_�ia PERMIT PERMITNO. � 9O 1 O <br />❑ DEMOLITION ❑ COM8INATION ❑ BUILDING k7 MECHANICAL ❑ PLUMBING ❑ 816N <br />Q�Eq MAIL RODHE55 GITY ZIP PHONE <br />Dan Nordetrom 8426 Xavier Way Everett, WA 98206 347-1338 <br />ARCMRECTORDESIGNEP MRILAOORE55 CITY Z�P PMONE <br />6ENERAL CONTRACTOP M�R �OURE55 LitY ZiP PHONE IICENSE � <br />MECMANIC�LCONTR�CTOR M�ILADORESS C�TY 21P PNONE LICENSE� <br />Owner <br />PLUMDINGCANiAALTOR MRRAODRE55 CITV 21P PHONE LICENSE� <br />CLASS JF WOPR <br />� NEW ❑ ADDITION � ALTERATON ❑ REPAIR <br />VALUATION OF WORK <br />{ 1z00.00 <br />UESCRIBE WORK <br />Install fireplace insert <br />HE�TSOURCE <br />❑ e�crniarr ❑ c�s ❑ w000srove <br />Residential <br />lOT _ BLOCN _ <br />8426 Xavier Way <br />F'LUMBING <br />TYPE OF FI%Tl <br />WATER CLOSET (TUILET� <br />BATHTUB <br />LAVATORY�WASH BASIN� <br />SHOWER <br />KITCMEN SINK 8 OISP. <br />OISHWASHER <br />LAUNDRYTRAV <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />BACKFLOW PREVENTERS <br />FOOF DRAINS — RAINLEADERS <br />SINK (SEPVICE — BAR. ETC.� <br />BUBTOTAL <br />VERMIT <br />TOTALFEE <br />CON$T. OCCUPRNGY4NO <br />g�p(�.. NO.OFSTOiik'S <br />�R1Ni(LERS REOUIPED ❑ VES ❑ N <br />1TION�CC BY PL/NSCMECKEO <br />S.H. <br />❑ DEMOLITION <br />❑ on�en <br />O BUILDINO RELOCATON <br />1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHE7HER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL I.AW REGULATING CONSTRUCTION OR <br />THC PERFORMANCE OF CONSTRUCTION. <br />SIGN T RE Of CQNT LtOP. RUTHORiZED RGENT.OR OWNER DATE <br />z �.�a�...�.�-� (1 ���.- � o -30-87 <br />MECHANICAL <br />A/C — A/HNOLG UNITS — HP. <br />NEFRIGERATION UNITS — M P. EA. <br />BOILERS — B.T.U./H P. <br />GAS FIRED A C. UNITS — B T.U. <br />FOFCED AIR SYSTEMS — B.T.U. M EA. <br />WALLHEATERS—B.T.U. M <br />UNITHEATERS—BT.U. M <br />CLOTHESDRYERS <br />VENTILATIOIv FAN <br />RANGEHOOD <br />WATER MEATER <br />WOODSTOVE <br />METAL FIREPLACE 6 CNIMNEV <br />FIREPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />E%HAUSTFAN <br />SUB TOTIIL <br />PERMIT <br />TOTALFEE <br />VACANT SITE <br />❑VES ❑NO <br />NOOFOWFLUNGUNITS BUILDING <br />MR% <br />pPPR FCR ISSURNCE �Y <br />PLUMBING <br />MECHANICAL <br />INVESTIGATION FEE <br />STATE BUILDING SURCHARG <br />STA7E ENEtiGY SURCHARGE <br />DRIVEWPV PERMIT <br />'EE RECEIPT NO. <br />VALUATION FE <br />$ <br />''-�'$eCi'304(el:_:;', � __J,-''�Q <br />9: J'�;11': IJ i i� <br />— �_, <br />TOTAL � I <br />PEflMIT VALIDATON <br />WMEN PROPERLV VALIOATED �1N THIS SPACE) THIS IS YOUR PERMIT <br />AU��R�'S Flt � <br />