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`�� �` C'7NSTRUCTION � "� c <br />everett PERMIT PERMITNO. � 841 u <br />259-8745 <br />❑ DEMOLITION ❑ COMBIN.4TION � BUILDING ❑ MECHANICAL ❑ PLUMBING G SIGN <br />OWNER MPILA�DRE55 CITY ZIP PHONE <br />(:arrol D. Petersen 9222 7th Ave. Everett 98208 355-5266 <br />ARCMITECTORDESIGNEP �AAILADDRE55 CITY ZIP PHONE <br />GENENALCONTPACTOR MFILADDBE55 CRV ZIP PMONE LICENSE• <br />Verlyn Baker Const. 150 llth St. Dayton OR (503)864-3195 �� � J V r/_ � n���� <br />CITY <br />LICENSE � <br />PLUMBINGCONTRAGTOR MAILFUOPE55 LItY ZiP PMONE LiCENSEr <br />:LASS OF WORN <br />L�NEW ❑ ADDITION ❑ AL�ERATION ❑ REPAIH <br />S 9100.00 <br />DESCRIBE WORK <br />= Construct metal pole garage <br />MEATSOUflCE <br />❑ ELECTRICITY CJ GAS ❑ WOODSTGVE <br />Do..o..o�. � wc nc ni ii� niur. <br />Garage <br />lOT _ BIOCK __ OF_ <br />Sae Attached <br />9222 7th Ave. <br />PLUMBING <br />NO. I-- <br />WATER CLOSET ;TOILET) <br />BATHTUB <br />LAVATORV�WASH BASIN� <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISHWASHEF <br />LAUNORYTRAV <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF �RAiNS - RAINLEi <br />SINK (SERVICE - BAR, El <br />20' <br />USCZONE <br />SIZE OF �LDG <br />qPPLiCATiON ACL DY <br />S.H. <br />FOUR <br />❑ DEMOLITION <br />❑ OTHER <br />❑ BUILDING HELOCATION <br />I HERFBY 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 W7RK WILL BE COMPLIED WITH <br />WHETHER SPECIFIEC HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOl' PRESUME TO GIVE AUTHORITY TO <br />VIOLATF. OR CANCEL THE FROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />THEPERFORMANCEOF ON'�N. <br />SIGNATUR/E O�MTfl9LjfOfi, J O P ENT. �R OWNER DATE <br />X �/iw/� /ii� i�/_ G��v.,• _ '?-_�O 'Gy <br />OR ITEM FEE NO. TYPE OF EOUIPMENT <br />/'S - A�HNDLG UNITS - HP. <br />PErRIGERATION UNITS - H.P. EA. <br />BOILFRS - B T U/H P. <br />GAS FIRED A�Q UNITS - B T.0 <br />FORCED AIH SYSTEMS - 8 TL. M EA <br />WALLHEAiEHS-BT.U. A1 <br />UNIT NEATERS - �.T U. �� <br />EVAPORATIVECOOLERS 1 <br />CLOTHESDRYEqS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER HEATER <br />�S WOOD STOVE <br />METP.L FIflEPL4CE d CHIMNEY <br />FIREPLACEINSERT <br />HEAiPUMP <br />GAS PIPING <br />E%HAUSTFAN <br />SUBTOTAL <br />PENMIT <br />TOTA! FEE <br />OCCIiPANCY OROUP <br />M-1 <br />NO OF STOFIES <br />1 <br />) ❑ VES �PNO <br />PLANS CNECNE� �V <br />B.E. <br />6' <br />VFL/ Nf SITE <br />]YES �INO <br />NO OF OWELLING UNIiS <br />� <br />MA% OCC I.OAO <br />6 <br />narn ron <br />L.C. <br />ev <br />SUBTOTAL <br />PENMIT <br />TOTALFEE <br />FEE <br />416 I,.76,q5. - <br />FEE <br />BUILDING 5��8$:�9];QQ.Q <br />PLUMBING -"' - � �'���' <br />MECHANICAL i �,�:i.., _- <br />INVESTIGATION FEE SeC. 3041e) <br />STATE BUILDING SURCHARGE <br />STA7EENERGVSURCHARGE <br />DAIVEWAY PERMIT <br />TOTAI <br />PENMIT VALIDATION <br />WHEN PROPERLY VALIDATED pN THIS SPACE) THIS IS VOUR PERMIT <br />,_.;tS., , _ <br />r' <br />117IOU <br />5� <br />120� 50 <br />