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'''�� ` '��'A'����" rONSTRUCTION <br /> �,,, �,� <br /> everett PERMIT pERM1T NO. 09624 <br /> ��.�„��� :�,��,.,. <br /> tvtnrn ai�. �;r�; ,� ❑ COMEINATION %� BUILDING ❑ MECHANICAL L� PLUMBING <br /> �`Jlyflr IAAiL AIl[)P1,SS lJlv �l�Ofll <br /> George Edward Packard 2616 Baker Everett 98201 252-3046 <br /> ApI)IIIfCI��.Hl9`:'.��1.1�� MMLNU�RCuS (ilv III' H�UryE <br /> GkNFN�LCANLNALtOP 4Rq�ppRL55 CILY 21P PHONE IIGEN5C1 <br /> Same <br /> MCOInNICAL CANtMC10R M�It A00fiE55 CIiV ZIP PNONE UCENSF� <br /> PWMBINGCONTRACIOR M�IL�OORE55 GITV (IP fv�pNE UCEkSEI <br /> ClA55Of WORN <br /> ❑NEW ❑ADDITION ❑A�TERATION ❑FEPAIR ❑DEMOLI110N ❑PENCE ❑SIGN LJGARAGE <br /> VALU�iION Of WORM -�—_—�--_— <br /> S <br /> DESCRIBE WORK <br /> Install wood burning stove <br /> FROPOSED USE OF BURDiIiG <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP� <br /> �ecr��ocunivnoN or r�rorcarr isiow ee�ow on�r ncN roun cowis — PI.ICATION AND KNOW THE SAME TG BE TRUE AND CORRECL <br /> ALL PRUVISIONS OF LAWS AND ORDINANCES GOVFRNING THIS <br /> �or eiocK_ov TYPE OF VJORK WILL BE COMPLIED WITH WHETHER SPFCIFIED <br /> HERFIN OR NOT. THE GRANTING OF A PEiiM1T DOFS N07 <br /> PFESUME TO GNE AUTHORITY TO VInLATE OR CANCEL THE PRO� <br /> VISIONS OF ANY OTfiER STATE OR LOCAL LAW REGULATING <br /> CONSTRU TION' R THE PEHFORMANCE OF CONST'1UCTION. <br /> JOBADOPESb S�GrvnW� �SON O InAUDI IZEDaaFNI UAik <br /> 2616 Baker X ' ` 8/10/81 <br /> PLUMBINO MECHANI(. <br /> NO. TVPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATER C105[T(TOILET) AIR GONU UNITS --H P kA __ <br /> UA7HTUB REFRIGERAiIUN UNIiS— M P CA <br /> IAVATORV IWASH BASIN� BOIlERS--N P EA <br /> SHOW[P GA$FlR[D AC UNRS--'ONNAGLEA <br /> NITCNEN S�NY 6 DISP FORCED AIR Sv5TEM5—B T U M EA <br /> DISNWASNER WAII.NEATERS—B T U M _ <br /> LAUNDRV TRAY UNIT HE/T[RS —B T U M <br /> CLOTHES WASNER [VAPORAiIVC COOL[RS <br /> W.TER HEdTFP CLOTH[5�RYfRS <br /> UR�NAL VENTILATION fAN <br /> Df11NKINC FOUNTAIN RANGE HOOD __' _ <br /> FLO(:!7 DRAIN l.IR MANULIN3 UNiI C F M <br /> VP^,VUM BREAKIA$ STn�� <br /> ROOF ORAINS— RAINLEAD[RS METAL FlREPInCE 6 CHiMNE v <br /> SINK ISCRVICL —IlAR.ETC 1 <br /> I <br /> BUBTOTAI SUBTOTAL f <br /> PERMIT i PERMIT f <br /> TOTAL FEE f TOTAL FEE f <br /> SIGE 'IARD SETBACN SiREET SCiBAi:h R6A 1 YARD SET�ACR PLAN CHCCK NUM�ER PIAN CHECk f[E <br /> FEE RECNFi NO � <br /> USE ZONE LO7 AREA VAC<Vi$IiE _ <br /> �".vE I INO FEES VALU�TION FEE <br /> TYPE OP fANST OCCUPANCY GROUP NO O'DWELLING UNITS <br /> OUILOING S <br /> SIZE OF BLDG NO UF S10RIf5 MA% GCC lOAO — <br /> PLUMBING <br /> FIREZONE BASFMfM IiNl� 5�91NYLtNS -- <br /> REOUIF:D MECIIANICAL 14 SO <br /> VES 'NO — <br /> 11PPROVALS BY DATE OtH[R <br /> I EhVIRONMENTALCHECKL151 PF.NAIiv UB': <br /> — S6C 3o71w1 <br /> 2 BUILDING PUNS <br /> � FIRE HYDRANT TOT�I 1�I S O <br /> 4 FIIiE PROTEC110N S�STEM PERMIT VALIDATION <br /> N'HEN PqOPE(iLV VAIIDATED IIN IMIS SPACEI TH1515 YOUR P[RMIi <br /> 5 GRADING � � ' I ' .. . � <br /> 6 DRAINPGE CJ <br /> 7 ENVIRONMENTAL IMPACT SIATEMENT � <br /> _ � <br /> B HEALTN DISTRICT <br /> i Q <br /> APPLICATION ACC BY PlANS CHECNED BY APPR FOR ISSUANCE BY . <br /> 1DDR[SS r�ILF <br />