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tne Euerbn•een <br />CITY OF <br />eve��tt <br />259-8745 <br />C �IV�TRUCTlOM <br />PERNiIT <br />PERMITNO: � ���� <br />❑ DEMOLITION � COMBINAT�JN ❑ BUILDING ❑ MECHANICAL '❑ PLUMBING ❑ SIGN <br />OWNER M/ILAODRESS CIiY ZIP PHON[ <br />4elum � Smith P.O. Box 592 Lake Stevens, Wa y8258 653-2025 <br />ARCNII .BTORD[SIGNER h1AiLnD�fi[SS QtV LIP PHON[ <br />GENERRI : JNlPNCiOR lANLADDRE55 CITY ZIP PHONE UCENSEx <br />MELUM180P7 <br />MECIIANIC/LCONTRA(:TOfI MAILqDOPE55 CITY ZIP PMOVE LIC[NSH' <br />PWM1IPINGCONiRNCTOH AtAILApDRE55 CITY ZIP PHONE �ICENSEu <br />CLASS OF WOPK <br />k�CNEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BIIILDING RELOCATION <br />VALUATION OF WOPN <br />s 44,500.00 <br />oescniee �voHK — <br />Single family residence - Basic 17.49 <br />HEhT50URCE <br />❑ ELECTRICITY ❑ GAS ❑ SYOODSTOVE ❑ OTHER <br />Single family residence <br />3 Larson Place <br />ior _ etocK _ nr <br />1U914 9th Dr. SE <br />PLUMBING <br />NO. <br />1 <br />1 <br />E <br />W�.TER CLOS[T ITOILET) <br />BATHTUB <br />LAVATORV�WASHBASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISHWl�SHER <br />IAUPIDRV TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR OR�IN <br />BACKFLOW FREVENTERS <br />ROOF DRAINS — RAINLEACERS <br />SINK (SERVICE — BAR, ETC � <br />2� <br />USEZONE <br />R-1 <br />TYPE OF CONST <br />BSiSW V-N <br />SIZE OF OLDG <br />FIRE SPRINKLERS F <br />nrri.icnrior�ncc or <br />S.H. <br />SUBTOTAL <br />PERMIT <br />TOTAL FEE <br />"l0 <br />FEE <br />� <br />5 <br />S <br />sios sETnncrc <br />6 <br />CNNi Srt[ <br />VES ❑NO <br />R-3 1 <br />NO OF STOR�ES MAX OCC LOAD <br />1 N/A <br />� <br />fiY I l�Pf'fi <br />I HEAEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICA"ON AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVER.VING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME �O GIVE AUTHORITY TO <br />VIOLATE OR CANCEL THE PF,OVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGI-LATING CONSTRUCTION OR <br />THE PERFORMANCE OF CONS�fRUCTION. <br />SiGN�rtUq[ OF CONTR�CTOF. nUT�iORiZ[0 AGENT, OR OIYNER DATE <br />X ��-„ ,� �y���, s�.3�:� � <br />— e , <br />MECHANICAL <br />NO. TYPE OF EOUIPMENT FEE <br />10 00 n,�c - n-tiNo�c uNits - H.a. <br />IO OO F7EFRIGERATION UNITS — H.P. EA <br />IO OO BOILERS — 8 T.0 /HP. <br />GAS FIPEO A�C. UNITS — BS U. <br />S OO FORCED AIR SYSTEMS -- � TL. M EA. <br />S OO VlALL HEATERS — B T.U. M <br />UNIT HEATER$ — BSL. M <br />S OO EVAPORATIVECOOLERS <br />1 CLOTHESORYER$ <br />2 VEN7ILATION FAN <br />], RANGEHOOD <br />1 WATER 11EATER � <br />WOOD STOVE <br />]. METAL FIfiEPLACE 8 CHIMNEV <br />RREPLACEINSERT <br />HEATPUMP <br />GAS PIPING <br />EXHALISTFAN <br />❑V <br />SUBTOTAL <br />PEHMIT <br />TOTALFEE <br />RECEIPT NO. <br />88Jf 87/18660 � Basi� <br />BUILDING � �F4'� <br />PLUMBING I A00019965 <br />MECHANICAL <br />INVESTIGATION FEE I �{�j8.304(e) $S�.SO <br />STATEBUILDINGSURCHARGFI � ......�, ..{- .,.. 3I SO <br />STATE ENERGV SURCHARGE I �h:UW�I �:'p.00 15I 00 <br />DflIVEWAYPERMIT � ,,,,�.�„ „�, ,,,, 2OI 00 <br />B.E. ITOTAL I ft00026654 524I 00 <br />PERMITVALIDATION ��F� '.�'•" <br />WHF:N PROPEHLV VALIDATLD �IN TBI'�PP��) TM��'OYQQ� PERMIT <br />1171-5 G65p.DD � <br />CIILCI; ;�=55„+.�JO � <br />� <br />� <br />� <br />