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Niel����rreirr�� - CONSTRUCT10• 1 <br /> r,n� <n <br /> evei'�tt PERMIT PERM�T No. 1�� 39 <br /> CITY HALL 25&tlir;, <br /> eveaerr,wnsezoi � COMBINATION L] BUILDING �y( MECHANICAL �_� PLUMBING <br /> OWNER MAIL AODRE55 CIiY ZIP PMONE <br /> Lola Hall 306 Alder Everett 96201 <br /> ARCHITEGT OR OESIGNER MnIL AD�RESS Ci I� ZIP PNONE <br /> GENERALCONTRACTOR MAILRODRE55 GITY 21F PHONE �iGENSEY <br /> A1ECM4NICAL CONTRACfOfl MAIL r1DORESS CITY ZIP PHONE LICENSE X <br /> Natural Gas Equipment Co. Inc. 1625 East Marine View Drive 98201 258-2441 <br /> PLUMBING CONTNAGTOR MAIL AODRESS CRY TIP PHONE LIGENSE V <br /> CLAS$OF WOFK <br /> ❑NEW ❑ ADDITION ❑ ALTERATION ❑REPAIR ❑ DEMOLITION ❑ FEN�E ❑ SIGN ❑ WOOD STOVEIFIREPLAC£INSERT <br /> VALUATION OF WORN <br /> S <br /> �ESCHIBE WORK <br /> PPOPOSED USE Ci BUILDING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> �ecn�oescnirnoNocPaovERTv�sNo��ee�owoea�acHFouacoaies� APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> CORRECT. ALL PROVISIONS OF LAW5 AND ORDINANCES <br /> �o*__e�ocK_oc__ GOVERNING THIS TYPe OF WORK Wr,LL BE COMPLIED WITH <br /> - WHF?;;�h SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br /> — G:4 CANCEL TFfE PROVISIONS OF ANY OTHER STATE OR <br /> LOGAL LAW REGULATING CONSTRUCTION OR THE <br /> ._ . __ PEr�FORMANCE OF CONSTfiUCTION. <br /> JOB ADORESS SIGNATURE OF ONT OR OF A RIZE�AGEFT DATE <br /> 306 Alder SXititlC Street X ' 1/31/84 <br /> PLUMBING MECHANICAL <br /> NO. TVPE OF FI%TURE OH ITEM � FEE NC � � <br /> __, T••" �- �aairiwEHr _ FEE <br /> _ WATERCLOSET�TOII.ETI � �� AIR COND. UNITS,- H.P.EA. <br /> � HniHTU� � REFRIGERATION UNITS- H.P. EA. <br /> LAVATORV�WASH BASIN) BOILERS - H.P. EA � <br /> SHOWEF GAS FIRED A.C. UNITS-TONNACaE EA. <br /> KITCHEN SINKB DISP. FORCED AIR SYSTEMS- B.T.U. M EA. <br /> DISMWASHER � ], WALL HEATERS- B.T.U. M E OO <br /> LAUNORYTRAY UNIT HEATERS- B.T.U. M <br /> CLOTHES WASHER EVFPOPATNE COOLERS � � <br /> WATER HEATER CLOTHES DRYEFS <br /> URINAL VENTILATION FAN <br /> DHINKfNG FOUNTAIN RANGE F100D <br /> FLOOR DRAIN AIfl M^NDLING UN17- QF.M. <br /> VACUUM BREAKERS STOVc-WOOD <br /> ROOF DRAINS- RAINLEADERS METAL FIREPL.ICE&GHIMIWEY <br /> SINK(SEFVICE- BAR, ETCJ FIREPLACE INSERT � <br /> HEAT PUMP <br /> 2 Wa�.�r Eieater i 4 50 <br /> SUB TOTAL f SUA TOTAL f ].O SO <br /> PERMIT $ � PHP.MIT 7� ].O OO <br /> TOTAL FEE S TOTAL FEE S <br /> SIDE VARD SETB4CK STREET SETBACK REAF YAR�S€TBACK PLAN CMECK NUMBER FL4N CHECK FEE <br /> FEE HECEIPT NQ. <br /> USE ZONE LOT AREA VACANT SITE - �---- <br /> � �.-]YES NO FEES VAlUAT10N FEE _ <br /> TVPE OP CONST. OCCUPANGV CaROUP NO.OF DWELLINP UNITS � <br /> BUILDING � <br /> SIZE OF BLDG NO. OF STOAIES MAX.OCC LOF� �- — <br /> PWMBING � <br /> FIREZONE BASEMENT F�RE,`.FniNkLERS <br /> RE�UIRED MECHANICAL � � � 2� ,0 <br /> �.:.YES �_NO — — <br /> APPpOVAIS BY DATE OTHER <br /> 1.ENVIRONMENTAL CHECK LIST PENAL?Y � U�B.C. <br /> 2.BUILDING PLANS � , SFA.?::31a) <br /> 3.FIREHYDRANT YC��AL ZO SO <br /> +,.fIHE PROTECTION SVSiEM VERMIT VALIDATION <br /> 5.GRADMG _ W 4EN PflOPERLV VALIDATED(IN THFS�p�C�)THIS��O}1f�PfRM17_�Q] <br /> 8.DRAINAGE ! L 7 L U 7 U a�; <br /> 7.ENVIRONMENTALIMPACTSTqTEMENT � <br /> B.HEALTHDISTRICT . . � - ��� - ,_���� <br /> APPLICATION ACC.8Y PLANS CHECKED BV AFPR. FOR ISSUANCE BV � � ' " ` ' ' <br /> �.� �.� <br /> . . . :J <br /> - 7 iu 61 <br /> ADDRESS FILE <br />