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e <br />PERMIT N0. 1 j •' � '— <br />CITY 4ALl 259B7d5 <br />EVERETT. Y/A 99101 �j COMBIkATION C BUILDING ❑ MECHANICAL EJG PLUMBING <br />OWNEP MRIL�DORE55 Cliv .�V PMONE <br />JJiiN DE FORD _5�]�.BEE�h St FvPratt WA 9R7(]'i �53�39Z — <br />♦RCnRECT OR OESIGNER M�il 4DDRE55 Ci�+ ZiN �MONE <br />� GENER,LL GONiRACTON MAIL ��ORE55 GILY ZIP PMONE LICENSE • <br />Same <br />MFCH�NILAL CONTR�GTOR MAR �O�AE55 CITV 21� PHONE IILENSE � <br />L <br />V'.UMBING CONTN�GIOR MPR �D�AE55 GITY ZiP VHONE ULENSE � <br />C1A550f WORN <br />O NiEW ❑ ADDITIGN IQR ALTEHATIOH ❑ REPAIR ❑ DEMOUTION ❑ fENCE ❑ SIGN C) WOOD S�OVBFIREPLACE INSERT <br />V�LU�TION <br />f <br />Altering drainage from plumbing fixtures <br />IiG�L UESCRiP110N OF PPOPERIY ISnOW AELOW OR �I1PCM fOUH GOPIES� <br />�.or 78 BLOCN_OF WeStW00d <br />JOB ADDHE55 <br />� G315 Beech Streel <br />pLUMBINO <br />NO. TYPE OF f'IXTI <br />�7— }�- NATER CLJSET (TOILF.i) <br />7 � BATMTIIB <br />�_ LAVATURY�WASMBA'i1N) __ <br />SHOWER <br />� KITCHEN SINK 6 UISP. ___ <br />DISMWASMER <br />LPUNDRVTRAV <br />�_y —CLOTMES WRSNER _ __ <br />__� WATF.R HEA7fP__ __'_' <br />f URINAL <br />ORINNING FOUNTAIN <br />FLOOR ORAIN <br />— VACl1l1M BREANEHS— _— <br />ROOF ORAINS — RRINLEADERS <br />SINN �SERVICE — BAR. ETC.I <br />SUBTOTAL <br />PERMIT <br />TOTAL FEE <br />NO.OF <br />RPPROVALS <br />1. ENVIRONMENTAL CHECN LISi <br />2. BUILDING PLANS <br />7. FIPE NYOflANT <br />4 FIPEPROTECTIONSYSTEM <br />5 GPAOING <br />fi.D9AINAGE <br />7. ENVIRONMENTAL IMPACT STAt <br />B.MEALTM DISTRICT <br />APPUCATION ACC. BV PIAI <br />s � <br />s _� <br />f <br />EAR VARD SETE <br />AC4NT SITE <br />YES NO <br />10. OF OWEILIN <br />IAk.00C.LOA� <br />APPR FOP <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THI:: <br />APPLICATION AND KMOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS APiD ORDINANCES <br />GOVERhIN3 THIS TYPF OF WORK WILL BL" CO�'�LIFD WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GR.�NTING OF A <br />PERMIT DOES NOT PRESUME TO GIV� AUTHORITV TO VIULATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTFUCTION. <br />SIGNAiURE Of� CO�Vi�TOR �IiJf�i�2E0 �T DnTE <br />IYPE OF EOUIPMENT <br />AIR C lN�. LINITS — MP. EA <br />HEFRIGEFAI'ION I�NITS — M P. LA <br />BOILERS — MP. EA. <br />GAS FIREO ,1.C. UNITS — TONNAGE EA. <br />FORCED AIR SVSiEMS — 9.11!, M EA. <br />WALL MEATERS — B.T.U. M <br />UNIT HEA�f:RS — Bi.J. M <br />EVAPONATIVE COOLEHS <br />CLOTMES DqYERS _ <br />VENTILATION FAN <br />RANGEMOOU <br />Alq MANDLING UNIT — QF.M. <br />STOVE — 1YOOD <br />METAL FIREPLA�E 6 CHIMNEY <br />FIPEPLACE INSERT_ <br />IIEAT PUM� <br />SUB TOTAL f <br />PERMIT f <br />TOTAIFEE 1 <br />( NUTAOER PLAN C <br />�EF. <br />FEE:t _ _ VRLWTION _ <br />BUILDING <br />PLUMp�NG <br />MECMANICAL <br />OTMER <br />PENALTY <br />f <br />U !f C <br />SEC. 909 <br />FEE <br />RECFIPT NO. <br />FEE <br />— TOTAL I I � 3 IQD <br />PERMIT VRLIOATION <br />WNEN PROPERLY VALIOATEO IIN TMI� SPf�CF�I THIS �6.�1�O�fqPqRIt/�T___ x-Qj <br />, J 6 <br />l() <br />— �r <br />M <br />ii 1� <br />ev � <br />„ ,,,��� . � <br />� <br />