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� <br />theEvergr OF � ���T�UCT18�1� � . <br />everett P�RMIi P�RMITNQ:_ � U�U� ! <br />259-8745 <br />❑ DEMOLITION L�COMBIhAT10N ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING O SIGN � <br />OWNF.R M�ILADDRESS CITV ZIP PNOY.E �� <br />tdeluT. & Smith P.O. Box 592 Y Lk Stevens, WA 98258 653-2025 <br />/PCMITECiORJE5IGNER MAll.AO�F[:5 CITY ZIP PMONE � <br />MNL ADORESS <br />h1i:uLUh1180P7 �i <br />CITV ZIP PHONE IIfENSE� I <br />Same <br />MECNAN�C�L CONTRACiOR MAI�AU�liE55 CIT'! ZIP PHONE LICENSE n <br />PIUM�ING CONTRACI OR <br />CLA55OF WOFK <br />�9JEW ❑ ADDITION <br />bIqIL <br />ZIP CHONE LICENSE x <br />❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCpTION <br />5 43,000.00 <br />OESCRIDE WORN <br />New Single fmaily residence Basic kll'o <br />I1EAT SOURCE <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />le familv residence <br />LOT 1$ pLOCK _ <br />doonooaess <br />PLUMBING <br />VJATEFi CLOSET (TOILET� <br />BATHTUB <br />LAVATORY (1VASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISHWASHER <br />LAUNDRYTRAV <br />CLOTHES WASHER <br />URINAL <br />DRINi;ING FOUNTAIN <br />FL009 DRAIN <br />BACKFLOW PREVENTERS <br />ROOF OflAINS — RAINLEADERS <br />SINK (SERVICE — BAR, E7'CJ <br />SUBTOTAL <br />PERMIT <br />TOTALFEE <br />ViSEi�ACH <br />V-N R-3 <br />SiZEOFOLOG NOOFSTORIES <br />1120+528GA: 1 <br />APPLICATIONP.CC �Y <br />PLANS <br />FEE <br />1 <br />VACANT SITE <br />❑YES LIHO <br />NO OF DW[LLING UNITS <br />1 <br />N/A <br />�neuxx�liuR.�sn� <br />M.h7. I B.E. I L.0 <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRU[ AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHEFl SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PE�MIT DOES NOT PRESUME TO GIVE AUTHORITY TO <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION C�rt <br />THE PERFORMANCE OF CONSTRUCTION. <br />SIGNAT��U{{�EE� Of� CONTq�tCTOR. �UTHCRIZED �GENT, OR OWNER ,DATE � <br />X /f� ��'� �`!' i / '�i':" r.il %/���i i% <br />� <br />MECHANICAL <br />NO. T��PE OF EOUIPMENT FEE <br />A�C — A�HNDLG UNITS — H P. <br />flEFRIGEflATION UNITS — I I P. EA. <br />BOILERS — B.T.0 /HP. <br />GAS FIFiED AC. UNITS — 8.'LU. <br />FORCED NR SVSTEMS — B T.0 M EA. <br />WALL HLATERS — BS.0 M <br />UNIT HEATERS — B.T.U. M11 <br />EVP.PORATIVECOOLERS <br />], CLOTHES DRVERS S O <br />Z VENTILATIONFAN OO <br />1 RANGEHOOD ( SQ <br />1 WATER IiEATER � S O <br />WOODS70VE <br />htETAL FIqEPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />GAS PIPING - <br />EXHAUSTFAN .____..__ <br />SUB <br />PLAN CHECK NUM�EF7 F ----' - R EIPT NO. <br />87/18861 b 0�1�3�81856 � 90357 <br />BUILOING 3���000� �ug_ <br />���� 0 e� � �69 00 <br />PLUM6ING F: ��'��{ $.rj� 45 00 <br />MECHANICAL E SRCH 'S1 .00 <br />8 50 <br />INVESTIGATION FEE C�i304(q�iSS .nQ <br />STA7E BUILDING SURCHARGE 3 S <br />STATE ENERGV SURCHARGE 15 00 <br />DRIVEWAV PERMIT <br />TOTAL 4 8 1 0 0 <br />PE(7MIT VALIDATION <br />l"Jlif_N FfiOVERLY VAl!DATLD (IN TFIIS SPACE) THIS IS VOIIR PEI7M111T <br />'T�' <br />�� <br />a�0 <br />� <br />