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il <br />` 7heE�crrreen � . <br />�, ����� �� � CONSTRUCTIQ " <br />� e�erett P E R M IT PERMIT NO. 1317 3 <br /> pTY MALL 259�8745 <br /> EVEflETT,WF 98:07 ❑ COMBINATICN ❑ BUILDING C� MECHANICAL ❑ PLUMBING . <br /> - OWNER MAILADDRE55 CITY 21P PMONE � <br />� K s H Printers 1631 Broadway Everett 98201 <br /> nRGHITEGTORDE5ICNER MAILADOAE55 UTY ZIP PHONF <br /> GE�lERAL CONiRAGTOR MAR ADDRE55 CITY 21P VMONE 4CENSE� <br /> Natural Gas Equipment 1624 East Marine View DriVe Evezett 98201 258-2441 <br /> MEGNANICAI GONTRAGTOF MRIL AD�HESS QTY ZIP PNONE L�CENSE F <br /> PLUMBING CANTPAGTOF MAIL ADDRE55 GTY LP PMONE LILENSE N <br /> CLA55 OF WORN <br /> O NEW ❑ADDIT�ON ❑ ALIEMTION O REPAIR ❑ DEMOLITION O FENCE ❑ S�GN ❑ WOOD STOVEIFIPEPLACE INSERi <br /> VALUATION OF WONN <br /> f <br /> DESCFIBE WORK <br /> PROPOSEDUSEOF BUILDINO I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGALDESGHIPTIONOFPROPEflTY�SHOWBELOWORATTALNFOURCOPIES) CORRECT. ALL PROVISIONS OF LAWS AND ORDIIJANCES <br /> GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> LOT_BLOCN_OF WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br /> OR CANCEL THE PROVIStONS OF ANY OTHER STATE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION. <br /> JOB ADDRE55 SiGN T RE OF GONTRACTOR OR AUTMOPIZED AGENT 4/2�84/TE <br /> 1631 Broadway X (1�. ( ': l.l�' <br /> PLUMBING MECH NICAL � <br /> �J. TYPE OF FI%TURE pR ITEM FEE N0. TYPE OF EQUIPMENT FEE <br /> WATERCLOSET�TOILEn AIR COND.UNITS— H.P.EA. <br /> BATHTUB REF{iIGERAt'ION UNITS— H.P. EA. <br /> LAVATORY(WASH BASIN) 1 BOILERS— H.P.EA. S 0 <br /> SHOWER GAS FIRED A.C.UNITS—TONNAGE EA. <br /> KITCHEN SIHH 8 DISP. FORGED Alfl S'/STEMS— B.T.U. M EA. <br /> DISHN/ASHEfl WALL HEATERS— B.T.U. M <br /> LAUNDRY TRAY UNIT HEATERS— B.T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> WATER HEATER CLOTHES DRVERS <br /> URINAL VENTiLATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIF HANOL�NG UNIT— C.F.M. <br /> VACUUM BREAKERS STOVE—WOOD <br /> ROOF DR/+INS— RNINLEAOERS METAL FIREPLACE B CMIMNEY <br /> SIIJK ISERVICE— BAR,ETC.) FItiEPLACE INSERT <br /> HEAT PUMP <br /> SUB TOTAL f SUB TOTAL f 15 00 <br /> PERMIT f PERMIT S _ 10 00 <br /> TOTALFEE S TOTALFEE f 2 <br /> SIDC-VARD SETBACK STREET SETBACK REAR VAR�SETBACK PLAN CHEGK NUMBER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LO7 AREh VAGAN7 SITE FEES VALUATION FEE <br /> _YE3 ::NO <br /> iYPF!OF CONSi. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> BUIL�ING s <br /> ;IZE OF BLDG. NO.OF STORIES MAX.000.LOAD <br /> PLUMBING <br /> FlHE ZONE BAuEMENT PIRESPRINKLERS MECHANICAL ZS OO <br /> REOUIRED <br /> YES NO <br /> APPROVALS BY DATE OTHER <br /> 1. [NVIRONMENTAI CNECl.LIST PENALTV U.B.C. <br /> SEC.3031a1 <br /> 2.BUILOItJG PLANS 2S OO � <br /> tOTAL <br /> 3.FIRE HYDRANT <br /> 4.FIRE PROTECTION SYSTEM PERMIT VALIDATION �' <br /> 5.GRADING WMEN PROPERLY VALIDATED IIN THIS SP7C�)7HIS1S�1'Q41f�PF�i1�1T_(1�- <br /> . 5UL7 UU �-� <br /> 6.DRAINAGE � <br /> 7.E��VI RONMENTAI.IMPACT STATEMENT (Y') <br /> B.HEALTH DISTRICT �. .. . . �,.�� � I F I � <br /> APPLICATION ACC. BV PLANS CHECKED BV APPR.FOR ISSUANCE 8Y ' ' <br /> , , ,_;�, � <br /> � ���,.��.. � . <br /> _ 2 ,, _ <br /> ,:�,� � I <br /> � ADDRESS FILE <br />