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► <br /> the Evcrgreen - �� f"'"-�1����U CT I O N � - - q n <br /> CITY OF ` J <br /> everett p����T PERMITNQ:= I �U� � <br /> 259 -8745 <br /> ❑ DEMOLITION ❑ COMBINATIl1N C� BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNEF AIAILADORE55 CITY ZtP PHONE <br /> LAUREL JACOBS 8628 Fobe� Road Snohomish WA 98290 568-0192 <br /> ARCHITECTORDES�GNER IAAILA90RE55 CrtY 2iP PHONE <br /> GENER�LCONTRACTOR MAILAODPESS QTY 21P PHONE IICENSE+ <br /> MECMA:JICALCONTRAGTOR MAILADORESS • CITY ZIP PMONE LICENSE� <br /> PLUMBINGCONTRALiOP MAILAODRE55 QTY ZIP PHONF LICENSE• <br /> CLA55OF WOFN <br /> ❑ NEW ❑ ADOITION ❑ ALTERATION [{7 REPAIR ❑ DEMOLITfUN ❑ BUILDING RELOCATION <br /> VALUATiON OF WORK <br /> S ��00.0� <br /> DESCFIBE WORN <br /> Reroof <br /> Henrsounee <br /> ❑ ELECTRICITY ❑ GAS ❑ WOOOSTOVE fl OTHER <br /> PPOPOSE�USE OF�UiLOtNG <br /> Single family residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE gqME TO BE TRUE AND <br /> LEGAI.�ESCPIPTiONOFPRpaEFTY�5HOW6ELOWORATTACMFOURCOPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> �or_e�ocK _ ov 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 TD <br /> VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br /> STATE OR/L�CAL LAW REGULATING CONSTRUCTION OR <br /> THE PERFdRW1ANCE OF COf�STRUCTION. <br /> JOBADDiVE55 SiGNATUR O C�NTRACTUR. UTlIOryz¢OAGENT,Oi01VNE(1 DFT[ . <br /> 1201 - 44th St. X iJ,,f,� ���._ ���� <br /> PLUMB!NG MECHANICAL � <br /> / <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TVPE OF E�UIPMENT FEE <br /> WATEFl CLOSET�TOILET) A�C—ARINDLG UNITS—H P. <br /> tlFTHTUO REFFIGERATION UNITS—H.P.EA. <br /> LAVATORY(WASH BASIN) BOILERS—BSL/H P. <br /> SHOWEfi GAS FIRED A C.VNITS—o.T.U. <br /> Y�TCHEN SINK 8�ISP. FORCED AIR SYSTEMS—B T.L'. W EA. <br /> OISHWASHER WALLHEATER$—B.T.U. M <br /> LAUNDRY TaAY UNIT HEATERS—BS.U. M <br /> CLOiHES WASHER EVAPORATIVE COOLERS <br /> URINAL CLOTHESORVERS <br /> DRINKING FOUNTAIN VENTILATION FAN <br /> FLOOR�f7AIN RANGE HOOD � <br /> �ACKFLOWPREVEN�ERS WATEflHEATEF • t� <br /> ROOFDPAINS—RAINLEAOERS WOO�STOVE <br /> SINK�SERVICE—BAR,ETCJ METAL FIREPLACE 8 CHIMN <br /> FIREPLACEINSEFT ' � <br /> HEATPUMP <br /> GAS PIPING ` � ' <br /> EXHAUSTFAN <br /> SUBTOTAL S SUBTOTAL <br /> PERMIT S PERMIT <br /> TOTALFEE 5 TOTALFEE <br /> FRorvrSEiBnCK REaq SErBnck SIDE$ETBFCK P�AN CNECK NUMBER FEE RECEIPT NO. <br /> USE20NE LOTAREA yqCANTSiTE <br /> ❑ves ❑No FEES VALUATION FEE <br /> TYPEOFCONST OCCUPANCYGROUP NOOFOWELIINGIINITS BUILDING S <br /> PLUMF3ING <br /> SIZE OFOLOG NO OF STORIES �IA% OCC LOAO <br /> MECHANICAL <br /> INVES7IGATION fEE Sec.904�e) <br /> FIRE SPPINKLERS REOUIRED ❑VES ❑NO <br /> STATE BUILDING SUFiCHARGE <br /> STATEENERGYSURCHARGE <br /> APPLIC4TION4CL.�Y �LANSCNECHCDOv �FPRFGRISSUANCEDY <br /> DRIVEVlAY PERMIT <br /> TOTAL 26 50 <br /> — PEHMIT VALIOATION <br /> WHEN PFOPERLV YALIDATED(W THIS SPACE)THIS IS YOUR PER�NT <br /> � <br /> �� <br /> � <br /> �� <br /> [� <br />