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� <br /> theEUCC�YCF (�-7�STR�1C�'ION � ' <br /> e�erett PERMIT PERMITN(?. � � �� � <br /> 259 - 8745 � � <br /> ❑ DEMQUTION ❑ COMBINATION ❑ BUILDING ��i� <br /> Q MECHANICAL ❑ PLUMBING ❑ SIGN I � <br /> OWNER ldAIL AODRE55 CIlY ZIP PMONE � <br /> kacttxxe Lawrence Hurlbert 12223 14th Dr. Se Evezett 337-3054 <br /> ARCHITECTOl10ESIGYEII MAtLF0�f1E55 CRY ZiP PHONE <br /> G[NERFLCONTP�('i0fi p1�ILM�RE55 CITY ZIP PMONE LICENSE• . ��� <br /> K <br /> MECIIANICFi CCNTRPCTOP MAIL 4DDRE55 CITY ZiP PHOIJE LICENSE n <br /> Valley PSatural Gas 2605 t•ScDougal Sverett 98201 259-5492 VALLENG153LI I � <br /> PLUM9INGCONTF4CTOB A1�ILAOOFE^v5 CITY ZIP PHONE IICENSEx <br /> I <br /> CLn55 OF\YORK I . <br /> ❑ NEW ❑ ADDITION [� ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION . '�, <br /> VALIJATION OF WORK . <br /> $ <br /> OESCRi6E VlORK ��, I <br /> Install gas furnace and water heater. i <br /> HEATSOUBCE — �� <br /> ❑ ELECTRfCITY ❑ GAS C WOODSTOVE ❑ OTHER <br /> PROPOSED USE OF�UiLDING I <br /> SFR I HEREBY CERTIFY TNAT I HAVE READ AND EXAA4INED THIS , <br /> APPLICATION 11ND KNOW THE SAME TO BE TRUE AND ' <br /> �ecn�oescair.iaNOFanaPeaTrisNo�veeiowor�arrncr�vouncoaiesi CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES I� <br /> �or_o�acK _ oF GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> WHETHER SPECIFIED HEFEIN OH NOT. THE GRANTING 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 /> THE PERFORMANCE OF CONSTRUCTION. <br /> JO�ApDRE55 SiGN�iF1RE OF CONT TOR�A H F.D AGENT,OR O\YNEP � D(�tE <br /> 12223 14th Dr. SE X ' � ��'((_(�j�1 <br /> le �-, -„� -l�. � l� .' ' f <br /> PLUMBING MECHAP{ICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMEhT FEE <br /> WATER CLOSET�TOILET� A;C—AMN�LG UNITS—H P. <br /> BATHTUB REFqIGERATION UNITS—H.R EA. <br /> LAVATORV�WASH�ASIN� �OILER$—B T.U'H P. <br /> SHOWER GAS FIRED AL.UNITS—�S.U. <br /> KITCHEN SINK 8 DISP. 1 FORCED AIR SYSTEMS—8 T U. M EA. 9 OO <br /> DISHWASHER WALL HEATERS—B TL M <br /> LAUNDRY TRAY UNIT HEATERS--BS.0 A1 <br /> CLOTHES INASHER EVP.POFiATIVE COOI ERS <br /> URINAL CLOTHESDFYERS <br /> �RINKING FOUNTAIN VENTILATION FAN <br /> FLOORDRAW RANGEHOO� <br /> BACKFLOW PREVENTERS 1 WATER HEATER <br /> 6 <br /> ROOF DRAINS—RAINLEADERS WOOD STOVE <br /> SINK(SERVICE—�BAR,ETC.� METAL FIREPIACE 8 CHIMNEV <br /> FIREPIACE INSERT <br /> HEnT PUMP <br /> 2 GA$PIPING � � � 44'i ::�t::i:�.s: <br /> EXHAUSTFAN � <br /> 4il�t�l�?l�ij� <br /> SUBTOTAL _ S SUB�T,QT�1. �,j0. p <br /> PEflMIT 5 PERM�T�� ' a,i <br /> TOTALFEE S TOTALFEE <br /> PnoNi SETOACN P[nR 5[ronCN SiDE SETonCK Pl qN CHECK NUM�ER FEE flECEIPT NO. <br /> USE].ONE LOT�REA <br /> vncnN.srte FEES VALUATION FEE <br /> ❑YES CINO <br /> TYFEOFCONST OCCUPFNCYGROUP NJOFpWE1.LINCUNITi �UILDING S <br /> PLUMBING <br /> Ei2E OF�L�G Il0 OF STOqIES IAA% OCC LOPD <br /> MECHANICAL 3O SC <br /> INVES7IGATION FEE Sec.304�c) <br /> FIRE SPRINKLERS REOIIIRED ❑ YES ❑ NO <br /> STATE�UILDING SURCHARGE <br /> STA7EENERGYSURCHARGE <br /> APPLILATION ACC f3Y PLANSCHECNEO�V qPPR FOR ISSUFNCE pY <br /> DRIV[WAY PERMIT <br /> s.x. roTti� so so <br /> PEflM1T VALIDATION <br /> WIiFN PROPERLY VAf.IDATED�IN THIS SPACE)THIS IS VOUF PERMIT <br /> 0 <br /> �� <br /> �fl <br /> T— <br /> �� <br />