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theFuerk�cen �� NSTRUCTION -� <br />CITY OF <br />���erett ����I� PERMITNA. 2035� <br />259-8%45 <br />❑ DEMOLITION C� COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWN:R !-0NLAO�RESS CITY ZIP PIIONE <br />Melum & Smith P.O. Box 592 �k�������ns 98z58 653-2025 <br />ARCNITECTOROESIGNEii IAAILADORE55 CITY ZIP PHONE <br />G[NEf1AL CONTHACTOfi <br />Owner <br />MECMANiCnLCONTRACiOF <br />PWNDING CONTR�CTOP <br />MNL r1DDRE55 <br />MIdL <br />CiTY )iP FHONE <br />MELUMC180P7 <br />CIiY ZIP I'HONE <br />M <br />�ICENSE • <br />Z�P P�iONE LICENSEy <br />CLASS OF WOBN <br />�l NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br />VAWATION OP WORK <br />5 40,500.00 <br />oescniee w�nK . <br />New single family residence Basic 1120 <br />IIFAT SOUFCE <br />❑ ELECTRICITV ❑ GAS ❑ WOODSTOVE � OTHER <br />Single <br />I.OT �_ OLOCH _ OF <br />Si7f8! residence <br />10902 8A[ 9th Dr. SE <br />PLUMBING <br />NO. TYPE OF FI%TURE OR <br />2 WATER CLOSET (TOILET) <br />Z BATHTU� <br />z LAVATORY (\VASH BASIN) <br />SHOWER <br />1 KITCHEN SINK 8 DISP. <br />D151'.NlASHER <br />L.IUNDRV TRAY <br />CLOTHi?S WASHER <br />C 41NAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTERS <br />ROOF DRAINS – RAINLEADERS <br />SINK (SEflVICE – BAR. ETC.) <br />V–N <br />s¢e or e�oc <br />iiio <br />APPLIC�TION�CC pv <br />SUBTOTAL <br />PEHMI7 <br />TOTAL FEE <br />OCCUPANCYGF <br />R-1 <br />NO OP STORIES <br />1 <br />CL�NS CHEGNEO fiY <br />FEE <br />sine <br />V�CANitiR[ <br />[]jYES ❑NO <br />NO Of �WELLINGIINITS <br />1 <br />mna occ iono <br />N/A <br />Al'PH f Ofl ItitiU/�Nf C 11Y <br />b1.M. I J.W. I J.47. <br />I HEREBY C=RTIFY 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 WO�K WILL BE COMPLIED WITH <br />WHETHER S�'ECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES N7T PRESUME TO GIVE AUTHORITY TO <br />VIOLATE GR Ci NCEL THE PROVISIONS OF ANY O7HER <br />STATE OP LOCAL LAW REGULATING CONSTRUCTION OR <br />THE PERF�RMANCE OF CONSTRUCTION. <br />SIGNPT iqE OF C0IJTPACTOR, 4UTIIORIZEp AGENT. OR 01'iNER pAiE—/�x,/ <br />X�77��//J'�-'G=:�J'�1 C%/S / GJ v <br />^7 <br />MECHANICAL <br />NO. TYPE OF EOUIPMENT FEE <br />NC – A/HNDLG UNITS – H P. <br />REFRIGERATION UNRS – hi P. EA. <br />�OILEAS – B T U.�HP. <br />GAS FIHED A.C. UNITS – B.T.U. <br />FORCED AIfl SYSTEMS – � i U. M EA. <br />VJALL HEATERS – �S.U. M <br />UNIT HEATEflS – B T.0 M <br />EVAPORFTIVC-COOLERS <br />CLOTHES DRVEflS <br />VENTILATION FAN <br />RANGEHOOD <br />WATER FIEATER <br />IVOOD STOVE <br />M[TAL FIREPLACE R GMIMNEV <br />FIPEPLACEINSERT 08/OS/88 11= <br />HEAT PUh1P � <br />GASPIPING tt00005464 <br />E%HAUST FAN I.I�TCR R <br />SUB <br />.AN GHECK NUM�ER FE�OOOGO.CS4 RECEIPT NO. <br />68/1a856 �ic �: b•� <br />FEES V TION FEE <br />•.��— <br />BUILDING S 3.SO <br />PLUM1181NG E SRCH � �S.O�] <br />MECHANICAL CHECf; 415�B.Q0 <br />INVESTIGATION FEE Sec. 304�e) <br />STATE BUILDING SURCHApGE <br />STnTEENEFGYSURCHARGE <br />DflIVEWAVPERMIT ZO OO <br />TOTAL 468 f10 <br />PERMIT VALIDATION <br />N'HEN PROPER! Y VALID�T[t] �IN TI115 SPACE) THIS IS VOU�i P[�ih11T <br />�'��J <br />,AJ <br />^� <br />\��•�� <br />1. V <br />