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���° C'''NSTR�ICT'ION � <br /> everett� P�RIYi�� PERMIT N�. 2� O92 <br /> 2 5 9--�J-�#s � � � <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING �7 MECHANICAL � PLUMBING ❑ SIGN <br /> OWNER fd�ILA0DRE55 CITv ZIP VHONE <br /> Cheryl Ann Provorse 10915 lOth Dr. SE �verett 98208 347-2860 <br /> nnCei*ecronnesiamen i.�an.nooness cirv zia ���or�e <br /> GENERAICONiPnCTOR MNLADOPE55 CITY ZIP VHONE LICENS[� <br /> MECH�NIC4lCONiRqCTOR MMLAODPESS CITY ZIP PHONE LiCENSEx I <br /> Owner <br /> PLUM6iYGCONTRACTOP M�IIADORESS CITY ZIP P��ONE UCENSE� I <br /> CLASS OF 1V0liK I <br /> ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br /> VAWATION OF WORN <br /> 5 I <br /> DESCRIQE N'ORK - <br /> Install woodstove <br /> MEATSOURCE <br /> [I ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br /> PROPOSED USE OF BUIL�ING <br /> SFR I HEREBY GERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME l'O BE TRUE AND <br /> LEGAL�ESCRIPTIONOFPROPERTY�SHOW�ELOWORATTACHFOl1Rf,OPIE51 CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES i <br /> �ur_oioc�c _ oF GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> WHETHER SPECIFIED HEREIN OR NOT. THE GRF,NTIfdG 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 /> TH[ PERFORMANCE OF CONSTRUCTION. <br /> JOD AO�fiE55 SiGNnTURE Of CONTRAGT00.AUTIIORIZE�qGENT.OR OUVNER DATE <br /> io9is ioth nr. sE X <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TVPE OF E�UIPMENT FEE <br /> WATER CLOSET(TOILET� A;C--A�HNDLG UNITS—HP. <br /> BATHTUB REFRIGERATION UNITS—HP.EA. <br /> LAVATORV�WASH�ASIN) BOILERS—B TL/HP. <br /> SHOWER GAS FIilED 0.C.UNITS—BSL. <br /> KITCHEN SINK 8 DISP. fORCEDl.IR SYSTEMS—BS.U. M EA. ' <br /> �ISHWASHEfl WAIL HEATERS—87 U. M i <br /> LAUNORY TRAY UNIT HEATERS—9.TL. M � <br /> CLOTHES WASHER EVAPORATIVE COOLERS 'i <br /> URINAL CLOTHESDRYERS � <br /> DRINKING FOUNTAIN VENTILATION FAN I <br /> FLOOR ORAIN Rl.NGE HOOD I <br /> BACKFLO�N PREVENTERS WATER HEATER � <br /> ROOF DRAWS—RAINLEA�EPS �. WOOD STOVE 3 OO iI <br /> SINK�SERVICE—BAR.ETC.� MET�L FIREPLACE 8 CHIIANEY � <br /> FIREPLACE INSERT �. <br /> HEAT PUMP ', <br /> G�S PIPING I <br /> EXHAUSiFAN <br /> SUBTOTAL S SUBTOTAL 5 3O OO <br /> PEPMIT f PEqM1T 5 <br /> TOTALFEE S TOTALFEE S 3O O <br /> FROIJTSET��CK R[PRS[TBACN SIpEtiLT��CN PLANCHECKNUMBER fHJi4/88 ^�1 �F�Fi'°�bfkf,?'+057 �K:k:K�k: <br /> 1 � <br /> US[ZONE LOi�H[4 <br /> vncnr��sre pEES �N FEE <br /> ❑YES ❑NO <br /> TYPEOFCONST OCCUPFNCYGROUP NOOFDWEICNGUNIiS BUILDING <br /> PLUM�ING <br /> sizeoFo�or, No.oFSTomes Mnx occ �ono <br /> MECHANICAL 3O OO <br /> INVESTIGATION FEE Sec.30d1e) <br /> FIRE SPRINKLERS REOUIRED ❑YES ❑NO I <br /> STATE�L9LUMG SURCHARGE <br /> STATE EN[fiGY SURCHARGE <br /> APPLiC4TiON�CC OY PlANSCMECNEDOV �PPR POl1155URNCE�V <br /> DRIVEWAY P[RMIT <br /> S.fl. TOTAL 30 00 <br /> PEflM1T VALI�ATION <br /> WHEN PIlOP[�LV VALIpAI[D pN TIIIS SPfGE)THIS IS YOUR PERAIIT <br /> �y <br /> �� <br /> 0 <br /> �_ � <br /> �U <br />