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�e E�ergreen <br />��r oF <br />everett <br />259-8745 <br />� C!'�NSTRUCTION <br />PERMIT <br />�, � <br />PERMIT NO. 2 � 4 6 � <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING �I MECHANICAI ❑ PLUMBING ❑ SIGN <br />OWNER MRILpDORESS CITY 21P MON[ <br />Bruce Ostbo 7202 Yew St. Everett 98203 347-078G <br />�PC��rtECTOR0E51GNEl1 MniLnDORES'a CITV 2iP PHONE <br />GENER�LCONTRACTOR MRILApDR[SS CITY ZIV PHONE UCENSE� <br />MECHANIULCONTRRCTOR MRILRODRESS CITY 21P P110NE UCENSE� <br />Valley Nat Gas 11323 Hwy 99 Everett 98204 355-7730 VALLENG153LI <br />PLUMBING LONTRACTOR MAIL AOORCSS CITV ZIP PHON[ IICENSE • <br />❑ NEW ❑ ADDITION k7 ALTERATION ❑ REPAIH <br />�AWATIDN OF WOPK <br />S <br />)ESf,RIBE WORN <br />install furnace and water heater <br />IERTSOURCE <br />❑ ELECTRICITY ❑ G11S ❑ WOODSTOVE <br />8Yo�81[ Single family residence <br />EGFL DESCRIPTION OF 1'ROPERTY �gM�W [iEIOW OR RTinCH FOUP CC <br />lOT _ �LOCN _ OF <br />O�ADDPE55 <br />7202 Yew St. <br />PLUMBING <br />HO. TYPE OF FI%TURE OR ITEM � <br />WATER CLOSET �TOILET� <br />BATMTUB <br />LAVATORY�WASHBASIN <br />SMOWER <br />KITCHEN SINK 8 DISP. <br />OISMWASMER <br />LAUNDRYTRAV <br />CLOTHES WASHER <br />URINAL <br />ORINKING FOUNTAIN <br />FLOOH DRAIN <br />OACKFLOW PREVENTER: <br />FOOF DRAINS — RAINL6 <br />SINK �SERVICE — ���R, E' <br />TYPE OF CONST <br />SREOPULDG <br />�PPLIC�TION nCL DY <br />S.H. <br />❑ DEMOLITION <br />❑ OTHER <br />❑ BUILDING RELOCATION <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAMF TO BE TRUE AND <br />CORRECT. ALL PROVISIONS 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 PFOVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />THE PERFORMANCE OfnCONSTRUCTION. <br />S�GNnTunE U� cONTR/�Toa+iM�ORl2[D 4GENt. OR ONMEP DATE <br />X <br />MECHANICAL <br />FEE NO. TYVEOFEOUIPMENT <br />A'C — AMNDLG UNITS — H P. <br />PEF(iIGERATION UNITS — H P. EA <br />�OILERS — 0.T U MP. <br />GASFIREDnC UNITS—BT.0 <br />FORCED AIN SVSTEMS — B T.U. M EA. <br />WALL HEATERS — BS U M <br />UNIi HEATERS — BS.U. M <br />EVAPORATIV[ COOLERS <br />CLOTHES DRVERS <br />VENTILATION FAN <br />RANGEHOOD <br />1 WATERHEATER <br />WODDSTOVE <br />METAL FIREPLACE 3 CHIMNL� <br />FIREPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />E%MAUSTFAN <br />SUBTOTAL f <br />PERMIT f <br />TOTALFEE S <br />nRSETpACK Slp[SETDACN PLAN <br />i ARER VACANT SITE <br />❑Y6 ❑NO <br />GROUP <br />OF StORIES <br />CHECKE�BY <br />NO OF OWELLWG UNITS <br />MA%.00C IOAD <br />rtPPR FCRISSUANCE�v <br />BUILDING <br />PLUMBING <br />MEC�iANICAL <br />INVESTIGATION FEE <br />STATE OUIIDING SURCHARG <br />STATEENERGYSURCHARGE <br />DRIVEWAY PERMIT <br />TOTAL <br />::11.1. li'SS� <br />CHECf: 91Q7.00 <br />Sec.304(e) <br />7 <br />� , ♦ <br />FEE <br />._....... ----__.. <br />WHEN PROPERLV V4LIDATED QN iHIS SPACE) THIS IS YOUR PERMIT <br />