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`���" `�' C�NSTRUCTION � `�`` - p <br />CITY OF <br />ever ett PERMIT PERMITNQ _� o��� <br />❑ DEMOLI710N ❑ COMBINATION ❑ BUILDING C]2 MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNEfl MAILAD�FESS CITY ZIP PMONE <br />J.D. Ivans 5301 33rd Ave. W. Everett 98203 355-4191 <br />ARCHITECT OR OESIGNER MAIL ADDRESS CITV 21P PHONE <br />GENERAL CONTNACTOR MAIL ADDRE55 GTY 21P PMONE IILENSE r <br />MEGMANICALWNTPACTOR MAILADDRE55 CItY ZIV PHONE LICENSE• <br />Valley Nat. Gas 11323 Hwy 99 Everett 98204 355-7730 <br />PWMBINGCONTRACTOR MAILADORESS CITY ZIP PHONE LICENSE� <br />CLASS OF WORN <br />❑ NEW ❑ ADDITION ❑ ALTEHATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br />VALUATION OF WORN <br />S <br />Install beiler�water heater <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTNER <br />LOT _ OLOCK <br />5301 33frd Avenue W <br />PLUMBING <br />NO. I— <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORV�WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 OISP. <br />DISHWASHEfl <br />�AUNDRYTRAV <br />CLOTHES WASHER <br />URINAL <br />DFINKING FOIINTAIN <br />FLOOR DRAIN <br />BACK6LOW PREVENTERS <br />ROOF ORAINS — RAINLEAnERS <br />SINK (SERVICE -- OAR, ETCJ <br />TYPE OF CONST. <br />FYM� <br />ACC. DY <br />SUB TOTAL <br />�ERMIT <br />TOTAL FEE <br />f1EAR SETBACN <br />LOT AREA <br />Occuanucrcaour <br />NO UF STORIES <br />) ❑ YES ❑ NO <br />FLANS CHECKEO OY <br />VACANi JITE <br />❑YES ❑NO <br />MA% OLC LOAD <br />APPR FOR ISSUFNCE 9Y <br />L.C. <br />I 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 COti7PLIED 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 PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />THE PERFORMANCE OF CONSTRUCTION. <br />SIGN/+TUREOFCONTPPCTOR. TIIORIZE�AG[NT.OROWN[R DATE <br />TYPE OF E�UIPMENT <br />NC — A/HNDLG UNITS — H P. <br />RErRIGERATION UNITS — H P. EA. <br />BOILEflS — B T.U./HP. <br />GAS FIRED A�C. UNITS — BSL. <br />FORCED AIR SYSTEMS — B T.U. M EA. <br />WALLHEATERS—B.T.U. M <br />UNITHEATERS—B.T.U. h1 <br />EVAPORATIVE COOLERS <br />CLOTHES ORVERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER � <br />WOOD S70VE <br />METAL FIflEPLACE 8 CHIMNEV <br />fIREPLACEINSERT <br />HEATPUMP <br />FEE <br />GAS PIPING . . . -'' I'� '. . ,.. . . . <br />E%HAUSTFAN � <br />SUe TOTAL <br />PERMIT-�'- � <br />TOTAL FEE <br />pECEIPT NO. <br />FEES VALUATION FEE <br />BUILDING S <br />PWMBING <br />MECHANICAL 33 50 <br />INVESTIGATION FEE Sec.304�e) <br />STATE BUILDING SURCHAFGE <br />STATEENERGYSURCHARGE <br />DRIVEWAY PERMIT <br />TO7AL 33 50 <br />PEPMIT VALIDATION <br />WHEN PROPERLV VALIDATED �IN THIS SPACE) THIS 15 VOUR PERMIT <br />Af�[,i i:[t3 i'1 E <br />