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Ihr firrrxn��v�n <br />ciT�� o� <br />everett <br />259-8810 <br />❑ DEMOLITION <br />: WilEfi <br />Dujardin Dev. <br />ii:r�nr�r <br />4ROUTECt OR DESIGY[R <br />UFNER4Lf.ONiR�LLOR <br />Owner <br />lqP1ANIUl. CONLI1TCi011 <br />PIUAIBINO CONiqA(:tOR <br />' r�ONSTRUCTION --� <br />PEF��IIIIT PERMITNO. �6��� <br />K] COMBINATION ❑ DUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />�.ini�nppR[sti ['ilv :J� P��N:C <br />PO box 5308 Ev erett, WA 98206 334-SOld <br />ur,i�nDnnFss r:nr :o� r��orrt <br />�n/'L ROOfiE55 f.I1Y IIP PMONE <br />f,1A550i WORN <br />y[3 NEW ❑ ADDITION <br />CONTFACT PRICE OF WORK' $ 54 � 160 <br />ncscmoewonre.Nosounneroor•cEiHvoiv�n <br />New ronstruction 11605F <br />1.1ML l�ODNE :$ <br />1.1AIL ROO�EiS <br />MAiL nOOf16!: <br />❑ ALTERATION ❑ REPAIR <br />CITY Z�P <br />CIiY IIP <br />Clir bP <br />❑ DEMOLITION <br />P��ONE IiCENiE • <br />DUJI�RD204IA <br />winr�c uc[�+sr • <br />nHONF L10EN$E � <br />❑ BUILDING RELOCATION <br />f.ONi�Q PCPSON WO i`MONC NO If OTME� TNAN Rp0"E <br />/ <br />BLDG 4437.00 <br />rnovosco us[ or nu�io�r+c <br />Single Family M�CH 490.00 <br />imn�ocsenirnoNo�rno�en.r,srowociowonnrreonouncowes � • <br />Df'iVW'1 5�0.00 <br />iot �� mocx — ar -- <br />IJATER 5130.00 <br />c <br />SEWE� $30.00 <br />�onnnon�ss - • <br />_.. ...., _. .... CHEG( 51406.50 <br />PLUMBING <br />NO. TYPE OF FI%TURE OR ITEM <br />WnTER CLOSET �TOILET) <br />AATNTUB <br />LAVATOPY �1VASH BASIN) _ <br />SHOWER <br />NITCHEN SINK 6 DISP <br />DISHWASHEP <br />LAUNDIIV TRAV <br />CLOTNES WASHER <br />URINAI <br />DRINNING FOUNiAIN <br />fLOORORAIN <br />BACKF�OW PREVENTEf75 <br />PG�F DRAINS — RAINLEADERS <br />SINK ISERVICE — �AR. ETC 1 <br />rHnhTSEtB�CK <br />20 <br />USEdONE <br />R-1 <br />1 r q Of CONS'RUf,11pN PI I RV4Pi F <br />V–N <br />s�ac oc moc <br />1160 + 490 Gar <br />I�CCIIPpNCr l Onp <br />N/A <br />�1f n!;OII fOP Sf'NI11N1F115 <br />M•PLICATION ACf, flV <br />SUB TOT�L <br />PERMIT <br />TOTAL FEE <br />qenns[in>cx <br />IOiAP[I. <br />f <br />f <br />MECHANICAL <br />FEE NO. TYPE OF EOUIPMENT <br />A�C — A�MNDLG UNITS — H P <br />fORCED AIR SYSTEMS — � T U M EA <br />UhITHEATERS�-BTU M <br />CL0T/1r5 DRYEflS <br />� VENTILAiIONfnN _ <br />RANGEMOOD <br />WnTER HEAiER <br />WOODSTOVE <br />MF.TAL fIR[PIACE h CMIMNEV <br />FIREFLACE INSERT <br />NEnT PUMP <br />cns ririNc <br />CkHAUST �AN <br />nf tilq�nfx PLAN CHECK NUM[I[R <br />5 91/26430 <br />�LnN1 Si1F <br />res u r+o <br />FEES <br />SUBTOTAL <br />PERMIT <br />TOTAI FEE <br />FEE <br />B asic <br />iv�7 a� caNStxUcnoN <ctU>i ,,,,,, ,' No a� uxn urvrnNrts BJILDING <br />V-N R-3 1 pLUMPING <br />NO 0( STORiEti IinSfA�b�� <br />1 ❑ YES � NO MECHANICAL <br />iinfGN�WrcI[n5RE00 ��1�6��ri.iAiitnliGN OTHER <br />❑ VES xp NO 2$ <br />STATt [iUILOING SUf7CHAPGH <br />_ STATEENERGVSURCHqRGE <br />nNsnrrnininrr CITY OF EVERETT <br />LOCAL SALES �'�'A"c wonKs <br />J�i TAX CODE IS rorn� <br />— ---- 3105 _.. __ WHEN PROPERLY VF <br />$ 54,1G0 <br />THIS IS <br />PECEIP7 NO <br />P[HMITS El(PIRE IF WORK IS NOT COMMFNCED WITHIN ��' A� <br />nl�l:-., � i.. ��'t - <br />1B0 DAYS OR CEASES FOR MORE T�iAN 180 DAYS. <br />