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r- -� <br /> d�e EcerArren �p N ST R U CT l 0� _ <br /> ciiv OF � <br /> QV�rett PERMIT PERMIT NO. 12376 <br /> CITY HALL 259�B7a5 <br /> EVERETT.WAB8201 ❑ COMBINATION �[ BUILDING ❑ MECHANICAL PLUMBING <br /> OWNER A'.aiL ADDRE55 <br /> GTV 21P PMONE � <br /> Elmer A. Richardson 2937 Bond Street Everett 98201 258-4135 <br /> ARCHITEGT OR DESIGNER MFIL ADDRE55 <br /> cirr zir VHONE <br /> ��n, Z�p PMONE LICcNSE/ <br /> GEYEPRL GOHTPAGTOR MAIL ApORE55 <br /> Same ��n. -- Z�p PMONE IILENSE� <br /> MEGMANICRL GONTRRCTOR MAIL AODRESS <br /> � CIiY ZIP PMONE UCENSE� I <br /> PIIIMBING LONTPAGTOR MAIL AODFE55 <br /> CUSS OF WORK <br /> ❑ NEN� ❑ ADDITION Qj(A�TERAiION ❑REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN O WOOD S70VEFIREPLAGE INSER <br /> VFLl1ATION OF WORK <br /> s800. 00 <br /> DESCRIBE WORN <br /> Tennnt Improvement <br /> PROFOSEU USE OF Bl11lDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGAL DESCRIPTION OF PROPEPTV I�MOW BELOW OR ATTACM FOUR GOPIE51 CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> GOVERNING THIS TYPE OF WORK WILL 8E COMPLIED WITH <br /> �or_e�ocrc_oF WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUMETO GIVE AUTHORITY TO VIGLATE <br /> �OCAL LAW H EGU�AITIINGSC�ONSTR CTTIONSOR THE <br /> PERFORMANC CONSTRUCTION. pqTc <br /> SIGNnTURE OF nBTO OR AUiHON12E�AGENT <br /> �oe nooAess �Qy1y, 8 3 0 8 3 <br /> 2937 Bond Street <br /> MECHANICAL <br /> PIUMBING FEE <br /> FEE N0. TYPE OF EOUIPMENT <br /> N0. TYPE OF FIXTURE OR ITEM AIR COND.UNITS— H.P. EA. <br /> WATER GLOSET(TOILET) <br /> REFRIGERATION UNITS— H.P.EA. <br /> BATHTUB <br /> OOILERS— H.P. EA. <br /> LAVAiORY(WASH BASIN) <br /> GAS FIRED A.C.UNITS—TONNAGE EA. <br /> SHOVJER <br /> FORCED AIR SYSTEMS— B.T.U. �+1 <br /> KITCHEN SINK 8 DISP. M <br /> WALL MEATERS— B.T.U. <br /> DISMWASHER M <br /> UNIT HEATERS— B.T.U. <br /> LAUNORYTPAY <br /> EVAPORATIVE COOLERS <br /> CLOTHES WASHER CLOTHES DRYERS <br /> WATEA HEATER <br /> VENTILAiION FAN <br /> URINAL pANGE Ii00D <br /> DRINKING FOUNTAIN G.F.M. <br /> AIR HANDLING UNIT— <br /> FLOOR DRAIN STOVE—WO00 <br /> VAGUUM BREAKERS <br /> METAL FIFEPV.CE 8 CHIMNEY <br /> ROOF DRAINS— RA�NLEADEFS FIREPLACE IIJSERT <br /> SINK(SERVICE— BAR.ETC.) HEAT PUMP <br /> y SUB TOTAL f — <br /> SUBTOTAL f 6 OO pERM1T = <br /> PERMIT S S <br /> TOTAL FEE <br /> TOTAL`EE f PLAN CMECK FEE <br /> :IDEYARDSETO�CK STREETSETBACK REAR YARD SETBACK PLAN CHECK NUMBER FEE RECEIPT NO. <br /> - LOT AREA VAGAN7 SITE FEE� VpLVAT10N FEE <br /> USE ZGf:E �-;YES ��NO <br /> iYPE OF CONST. OCCUPANCY GROUP NO.OF OWELLING UNITS <br /> BUIIDING S 8 10. 1 <br /> SIZE OF eLDG. NO.OF S70RIES MAX.OCC.LOAO pLUMBING 6 00 <br /> � <br /> � c FIRE SPRINKLERS <br /> FIREZONE BASEN_NT REOUIRED MECHANICAL <br /> YES NO <br /> OTHER <br /> �OVALS BV OATE U B.'::. <br /> 1.ENVIFONMENTAL CMEGH LIST PENALTY SEC,307(e) <br /> ax aa <br /> 2.BUILDINGPLANS � TOTAL <br /> ` 7.FIRE HYDRANT pERMIT VALIDAiION � <br /> y d.FIRE PRO � WHEN PPOPERLY VALIDATEO QN T!i'S'S; O E)Th���O I 4�� OMIT _ � <br /> S.GRhDINQ (� � <br /> � .ORAIN � (�J <br /> 7.ENVIflfi Mp�ALIMPAGSSTATEMENT r,,,� I <br /> B.NEAL I ICT � ! <br /> �pPPLICAl`NY�G��B� • P�ANS CHECKED BY APPR.FOR ISSUANCE BY 17 H i�t�I K�YOIU� ' <br /> "'' O rn <br /> c — ! <br /> 3pnuc83 <br /> (�1 ADDRESS fll[ . <br /> . � I, <br /> _ i <br />