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the Eueigreen <br />CITY OF <br />ever�tt <br />259-8745 <br />'�` C�NSTRUCTIO!'J �; '" � <br />PERMIT PERMIT NQ:- �090� <br />Ll DEFAOLITION ❑ COMBINATION [� BUILDING ❑ MECi1ANICAL ❑ PLUMBING ❑ SIGN <br />OIVNER MRIL qOD(i[SS CITY y y ZIP PNJNE <br />John M. Haugen 2107 33rd St. Ev�rett 98201 339-1518 <br />ARCMITECTOROEiIGNER MRILAOOFESS CITY ZIP PHCNE <br />GENERAL CONTRACTOR MAIL AODRESS CITV ZIP PHONE LICENSE � <br />6.vner <br />MECHqNICPLCONTRFCTOR MAILApDRE55 CITY IiP PHONE IICENSE• <br />PLUMBING CONTRAC70R AIAII ApDRESS CITY 21P PHONE LIG[NSE + <br />GLASS OF WOAN <br />❑ NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ UEMOLITION ❑ BUILDING RELOCATION <br />VALUATIGN OF WORN <br />S ienn nn <br />Foundation for silc� �toraqe for resin <br />HEATSOUPCE <br />❑ ELECTRICITV ❑ fiAS ❑ WOODSTOVE ❑ OTHER <br />LOT _ OLOLK _ <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET �TOILC-T) <br />BATHTUB <br />LAVATORV�WASH BASIN) <br />SHOwER <br />KITCHEN SINK 8 DISP. <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOF DRAIN <br />BACKfLOW PREVtMTE(i5 <br />ROOF DRAlIJS — RAINLE .�EFS <br />SINK ISEFVICE — FAR. ETC 1 <br />USE20NE <br />C-1 <br />TYPE OF CONST <br />SIZE OF pLDG. <br />N/A <br />FIRE Sr^RINKLERS R <br />pPPLICRTION ACC. BY <br />S.H.W <br />SU9TOTAL <br />PERMIT <br />TOTAL FEE <br />REAPSETpACN <br />LOT r1REA <br />OCCUPANCYGROUP <br />B-7 <br />NO.OF STOPoES <br />N/A <br />� ❑ YES C}NO <br />PLPNS CHECN[D OY <br />J.W. <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 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 PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTFUCTION OR <br />THE PERFORMANCE OF CONSTRUCTION. <br />SIGN/TUREOFCONiAAGTOR.AUTMORI EUAGENT OR NER OATE <br />X C Q.��.-,�.-. `, �� � l t� i9 �Y <br />MECHAN�CAL <br />FEE NO. TYPE OF EQUIPMENT <br />A/C — A/HNDLG UNITS -- H. P. <br />REFRIGEFATION UNII'S — H.P. EA. <br />BOILERS — B T.0 /H F <br />GAS FIRED A.C. UNITS — BSL. <br />PORCED AI!i SVSTEMS —� B.T.U. M EA. <br />WALLHEATEFS—B.T.U. M <br />UNITHEATERS—B.T.U. M <br />EVAPORATIVECOOLERS <br />^ CLOTHESDRVERS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER hcATER � <br />WOOOSTOVE <br />METAL FIREPLACE 8 CHIMNEV <br />FIREPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />EXMAUSTFAN <br />-_� 86/20909 <br />VACANT SITE <br />❑YES CYND <br />NO OF DWELLING UNITS <br />� <br />MAN.00C. L04p <br />N/A <br />J.W. <br />FEES <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />INVESTIGATION FEE <br />SUBTOTAL S <br />PEHMIT S <br />TO'7AL FEE <br />iF�iieise iz:� r��f <br />22/75 133 <br />CHECf; .3 .50 <br />Sec.304(e) <br />FEE <br />STATE BUIIDING SURCHAHGE <br />STATEENERGYSURCHARGE <br />DRIVEWAY PEFMIT <br />TOTAL <br />PEpM1T VALIDATION <br />WHEN PROPERLV VNLIDATED pN iHIS SPACE) THIS IS VOUR PERMIT <br />AUDf1L".Sc Ill_E <br />� <br />�:� <br />�i <br />0 <br />rn <br />0 <br />c�.� <br />