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`��"'�" �'` f�NSTRUCTION �~ '`' <br />��n oF <br />everet�� PERMIT PERMITNQ. �0403 <br />259-8745 <br />❑ �EMOLIT"'.� ❑ COMBINATION ❑ BUILDING �MECHANICAL '� PLUMBING ❑ SIGN <br />OWNER MML400�[55 CITY ZIP PHONE <br />Bernard E. VanBeek 7112 Yew St. Everett 98203 353-9261 <br />nRC11rtECT OR 0[SIGNER MAII AOORC55 CITY 21P PHONE <br />GENERAL CONTR�GTOR MPIL R��RES$ dTY ZIP �ONE LILENSE � <br />MECMRNICRL CONTRRCiOR MRIL RDDRESS QTY 21P PNONE UCENSE � <br />Owner <br />PWMBING LONTIIACTOR MAII A�ORE55 QTV ZIP PHONE LICENSE • <br />CUSS OF WOPK <br />❑ NEW ❑ ADDITION <br />S <br />❑ AITERATION ❑ HEPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br />Wood Stove Installation <br />HENTSOURCE <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />Residence <br />LOT _ BLOf.N _ OF. <br />7112 Yew Street <br />PLUMBING <br />TYPE <br />klqi <br />TYPE OF FII <br />WATEF CLOSEi (TOILI <br />BATHTUB <br />LAVATORY (WASf11fA; <br />SHOWER <br />KITCHEN SINN 8 OISP. <br />DISHWASHER <br />LAUNDRVTRAV <br />GDTHES WASHER <br />{ING POUN'AIN <br />R DRAIN <br />IFLOW PREVENTERS <br />� DRAINS — RAINLEADERS <br />�SERVICE — f3AR, ETC � <br />�CG �Y <br />SUBTOTAL <br />PERMIT <br />TOT�LFEE <br />NO <br />PLANS CHECNE� 6Y <br />I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CUFRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TVPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SFECIFIED 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 LAW REGULATING CONSTRUCTION OR <br />THE PERFORMANCE OF CONSTRUCTION. <br />SIGNn� [ OF CONiRAC1CR �UT110�12[D fA.ENi OR OWNER DATE <br />z %5..�.,..�,.,2� �' • (/a--l�e.—d�✓ G�v.:. S' Y� <br />MECHANICAL <br />FEE NO. TYPE OF EOUIPMENT <br />MC — �iHNDLG UNITS — H P. <br />REFRIGERATION UNITS — ii P. EA. <br />BOIIERS — BS.UJH P <br />GAS FlRED A C. UNITS — B T U <br />FORCED AIR SVSTEMS — B TU. M EA. <br />WALLHEATERS—BTU M <br />UNITNEATERS—(1TL. O�r�OS�� E <br />EVAPORATIVE COOLERS � <br />CLOTNESDRVERS IIOOOGO4O3 <br />VENTILATION FAN MECN <br />RANGEHOOD CHECK <br />WATERHEATEP � <br />1 WOODSiOVE <br />METAL FIREPLACE d CHIMNEY <br />FIREPLACEINSERT <br />HEATPUMP <br />GAS PIPING <br />EXHAUSTFAN <br />T SITE <br />❑ No <br />DWELLING UIJITS <br />CC LOnD <br />ron issunr�ce or <br />SUBTOTAL <br />PEHMIT <br />TOTALFEE <br />PLAN CHECK NUM�Efl <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />INVESTIGATION FEE <br />STATE BUILDING SURCHARG <br />STATEENERGYSURCHAFGE <br />DfiIVEWAV PERMIT <br />FEE <br />�EE FECEIPTNO. <br />VALUATION FEE <br />S <br />30 <br />.iec.304(e) <br />TOTAL I I 30 <br />PEPMIT VALIDATION <br />WHEN PROPERLV VALIDATEO �IN THIS SPACE) THIS IS YOUR PERMI' <br />,, t <br />M <br />O <br />d' <br />O <br />N <br />