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d�e�ergreen <br /> CITYOF � (�NSTRUCTION �y� °"" <br /> everett PEI'1�IIIT PERMITNO. 1929� <br /> 259 - 8745 <br /> ❑ DEMOLITION ❑ COMBINATION fyCl BU1�91NG ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNEN MAILAOORESS CITV ZIP PHONE <br /> Hope Lutheran Brethren Chu.rch 11329 - 26th Ave SE Everett, wA 337-HOPE <br /> ARCMITECTOPDESIGNER MAILAODRESS CITV ZIP PHONE <br /> GENERAICONTHALTOR MAILFOORESS CITY ZIP PHONE LICENSEM <br /> owner <br /> MECHANICFLCONTRACTOP MAIL?OORE55 CITY 21P PMONE IICENSEu <br /> GLUMBING CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE• <br /> CLNSS OF WORK <br /> ❑ NEW ❑ ADDITION Q;ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCq710N <br /> VRLUATION OF WORK � <br /> a 656.00 <br /> DESCRIBE WORK . <br /> ,�nstall door, remove and install new wall <br /> HEATSOURCE <br /> ❑ ELECTRICITV ❑ GAS ❑ WOODSTOVE ❑ OTHEH <br /> PROPOSE�U5�OF BUILDiNG <br /> Church I HF9EBY CERTIFY THAT i HAVE RFAD AND EXAMINED THIS <br /> AF. _ICATION AND KNOW THE SAME TO BE TRUE AN7 <br /> LEGALDESCRIPTIONOFVROPERTY�SHOWBELOWORATTAGMFOUqCOPIES� CORRECT. AL� PFOVISIONS OF LAWS AND ORDINANCES <br /> �oT_o�ocK _ oc 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 GIVF AUTHORITY TO <br />�;r- '� - VIOLATE OR CANCEL THE PROVISION� OF ANY OTHER <br /> i`;-,.� . STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br /> THE PERFORMANCE OF CONSTRUCTION. <br />" JOBADDfiE55 SIGNr1TURE0FCONTRACTOR.AUTHORIZEOAGENT.OROWNER OATE <br /> 11329 - 26th Ave SE . X / ,�y <br /> PLUMBING MECHANICAL � <br /> NO. TYPE OF FI%TURE OR ITEM FEE NO. TY�PE OF EOUIPMENT FEE <br /> WATER CLOSET(TOIIET) A/C—A/HNDLG UNITS—H.P. <br /> BATHTUB REFRIGERATION UNITS—H.P.EA. <br /> LAVATORY(WASH BASIN) 801LERS—B.T.U./H.P. <br /> SHCWER GAS�rRED A�C.UNITS—B.LU. <br /> KITCHEN SIN✓8 DISP. FORCED AIR SYSTEMS—B.T.U. M EA. <br /> �iSHWASHER WALLHEATERS—B.T.U. M <br /> �AUNDRVTRAV UNITHEATERS—BT.U. M <br /> I CLOTHES WASHER � EVAPONATIVE COOLERS <br /> URINAL CLOTHES DRYERS <br /> DRINHING FOUNTAIN VENTILATION FAN <br /> FLOOR DRAIN RANGE HOOD <br /> BP.CKFLOW PREVENTERS WATER HEATER <br /> ROOF DRAINS—RAINLEAUERS VlOUD STOVE <br /> SINK(SERVICE—BAR,ETCJ METAL FIREPLACE 5 CHIMNEY <br /> FIREPLACEINSERT <br /> HEAT PUMP <br /> GAS PIPING <br /> E%HAUSTFAN <br /> SUB TOTAL S SUBTOTAL <br /> � PENMIT S _ PENMIT 3 <br /> TOTALFEE S TOTALFEE <br /> FROr�TSETBnCK REARSETBACK SioESEieaCK FLANCHECKNUMBER FEE RECEIPTNO. <br /> 87/19294 12.35 93847 � ' <br /> USE ZONE lOT AREA V�CANT SITE <br /> R-3A ❑ves �7r+o FEES VALUATION FEE ' <br /> TYPEOFCONST. OCCUPANCYGflOUP NOOFOWELLINGUNITS BUIL�IN('a 5 656�.00 � 19 �0 � <br /> V—N A-3 � PLUMBING <br /> SRE OF BL�G NO.OF STOBIES MAX.OCC.LOFO <br /> 1648 alt 1 6$ MECHANICAL <br /> INVESTIGATION FEE $ec:304(e) � ,.._ � <br /> FIRE SPHINKLEFS REOUIREO ❑VES NO . . <br /> STATE BUILDING SURCHARGE ' �- 3 50 <br /> ST�TEENERGVSURCHARGE <br /> APPLICATION ACC BY PLANS CMECKED OV APPR FOB ISSUANCE DY <br /> DRIVEWAY PERMIT <br /> M.M. Bf L.C. IOTAL 22.SQ :4 $� <br /> PERMIT VAIIDATION <br /> WHEN PflOPERLV VALIDATED pN THIS SPACE)THIS IS YOUR PERMIT <br /> �' <br /> �� <br /> N <br /> � <br /> � <br /> . .,,,,lc:;,. F:Lt <br />