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C�1 v pi <br />ever�tt <br />GTY HALL Y59�B715 <br />J <br />PERN6IT PERMII'N0. 15�56 <br />EVERETT, WA 982M � COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMpING <br />OWNEN MAIL ApDRE55 GITY ZiP PMONE <br />John Jorda�i 18900 - llth Avenue NE S?attle WA 9b155 364-6626 <br />APLMIiEC' OR OESIGN[R MAIL ApD9E55 LItV nn cunuc <br />GENERALGONiR�C�OR MAILAOOR[55 LiiY YP PNONE LICENSE� <br />EVERETT BUILDERS INC 5606 EVERGRFEN WAY EVERETT WA 98203 353-7161 <br />MEGHANICRL CONTRqCTOR MAIL R�URE55 CITY ZiP PMONE IICENSE � <br />223-01 EVENEB301PH <br />PLUMBING CONTRALTpR MRI� ADDRCSS CIIV ZIV PHONE ULENSE / <br />Cl�SS OF WORK � �� — -- <br />❑ NEW ❑ ADDITIOt� I� ALTERATION ❑ qEPAIfl ❑ DEMOLITIGN ❑ FENCE ❑ SIGN ❑ W000 STOVFIFIREPLACE INSEPT <br />f 28%5,�� <br />)ESCRIBE N"IRR <br />Reroof - composttion <br />�RJPOSED US[ OF BIIILOING <br />Residence <br />.EGRL �ESLNIPiION OF PROPEHTY �SNOW 9ELOW OR RTTACN FOUR GOPIES� <br />�or_e�ocn_oF_ _ <br />Lots 8& 9 Blk 8 Beverely Park <br />ioenooRess -- <br />7708 Beverly 81vd <br />PLUMBING <br />N0. TYPE OF FI%iURF OR ITEM FEE <br />WATER CLOuET (TOC ET <br />BATHTUB <br />LAVATORV(WASM BASIRI <br />SMOWcR <br />KITCH[N SINh 8 DISP. <br />LAUNDRYTRAV <br />CLOTHESWASHER <br />WA7ER HEATEF <br />URIt7AL <br />DpINKING FOUNiAIN <br />FLOOR DRAIN <br />VACUUM BREANERS <br />ROOF DRAINS — RAINLEA�ERS <br />SINK (SENVICE — BAR, ETQ) <br />sueTorn� <br />PENMI7 <br />TUTAL FEE <br />STORIES <br />FIRE <br />APPHOVNLS <br />1. ENVIRUNMENTAI. CMECK LIST <br />2. OUILOING PLANS <br />3. FIRE 11YDRANT <br />d. FIRE FROTECTION SYSTEM <br />5. CRAOING <br />6. DRAI�:AGE <br />7.ENVIRONMENTALIMPACT$TATEM'cN7 <br />B.MEALTN DISTRIC7 <br />stg <br />�f <br />REAR YARD S <br />VACANT SITE <br />VES NO <br />NO. OI. OWEL <br />M�x. oca �o <br />FIRE SPRINKL <br />REOUIRED <br />YES NO <br />8Y IAPPR.FORISSUANCE BY <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THF SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS C? L4WS AND OHDINANCES <br />GOVERNING THIS 1'YPE UF W'�K WiLL BE COMaLIED WITH <br />WHETHER SPECIFIED HEREIN'1R NOT. iHE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORIlY TO VIOLATE <br />OR CANI:EL THE PROVISIGNS OF ANY OTHER STPTE GR <br />LOCAL L.AW REGULATING CONSTRUCTION OR THE <br />PERFOR(�IANCE OF CONSTRUCTION. <br />SIGNlJIIRNQF CONTR�QT�i JR Al1iHOR12E� A4L`It DFTE <br />X <br />MECHANICAL <br />NU. TYPE OF EOUIPMENT <br />AIR COND. 11NRS — H.P. EA. <br />PEFRIGERATION UNITS — H.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE <br />FORCED AIH SVSTEMS — B.T.U. <br />WALL HEATF.RS — B.T.U. <br />UNIT MEATERS — B.T.U. <br />EVAPORATIVE COOLERS _ <br />CLO7HES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />AIR HAN�LING UNIT — <br />S70VE — WOCU <br />METAL FIR°PL10E d CHIMNEV <br />FIREPLACE INSE�IT <br />HEAT PUMP <br />BUILDING <br />PLUMBING <br />MGCMANICAL <br />OTMER <br />PENALTV <br />8/5/85 <br />EA. <br />M EA. <br />M <br />M <br />QF.M. <br />SUBTOTAL f <br />f'ERMIT t <br />TGTAL FEE S <br />PLAIJ CHECK FEE <br />FEE RECEIPT N0. <br />VALUATION FEE <br />f <br />38150 <br />TOTAL � � 38 � 50 <br />7ENMIT VALIDATION <br />WHEN PROPERLY VALIDA7ED QN TMIS SPACE) THIS IS YOUF,PEqMl7 (D� <br />�i <br />N <br />� <br />.� <br />l�DDRESS FILL <br />z <br />0 <br />-� <br />c'� <br />m <br />� <br />1� <br />1/� 2 <br />m <br />co <br />mo <br />c'> <br />--i c <br />O 3 <br />m <br />S —ZI <br />m <br />� <br />O Z <br />C <br />D —/ <br />rx <br />«. .. <br />< y <br />O .�v <br />�1 Y <br />3 <br />-i m <br />S <br />m .-. <br />N <br />or <br />c� m <br />C N <br />m� <br />� r <br />• f�l <br />a <br />� <br />1 <br />S <br />n <br />z <br />1 <br />x <br />N <br />Z <br />O <br />-�i <br />�. <br />C'f <br />m <br />