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r <br />. � <br />!he !_'Prr(rpPn <br />c,.v <br />everett <br />C17Y MALL 259�87d5 <br />EVERETT, 1NA 98201 <br />� "ONSTRUCTIOf� <br />PERMIT <br />❑ COMBINATION ❑ BUILDING � MECHANICAL <br />PERMIT NO. 12823 <br />❑ PLUMBING <br />OWNEF MAILApDRES: [ITY $IP YtlpNE <br />Robert Falkner 2927 Broadway Llrerett 98201 <br />ARLMrtECT OP DESIGNER MAIL AOORE55 GIiY ZIP PHONE <br />GENEflALCANTRACTOR MAILAODPESS qTY ZIP PMONE LILENC'1 <br />MWMANILqL CONTRAQOR MAIL ROORESS LITr 21P PHONE LILENSE I <br />Natural Gas Equipment 1625 East Marine View Drive Everett 98201 258-2441 <br />PWMHING GONiRAGtOR MAI� AOONE55 CITY ZIP PMONE LICENSE Y <br />O NEW O ADDITION ❑ ALTEPATION ❑ qEPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOO� Srpy�rFIREPLACE INSERT <br />s <br />LOT_BLOLK_OF <br />ioe aogn��� Broadway <br />PLUMBING <br />NO. TYPE OF F <br />WATER CLOSET (TOI <br />BATNTUB <br />LAVATORV(WASMBASIN) <br />SMOWER <br />KITCMEN SINK 8 DISP. <br />DISMWASHER <br />LAUN�RVTRAY <br />CLOTHES WASMER <br />K'ATGR HEATER <br />URINAL <br />�HINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREANERS <br />ROOF DHAINS — RAINLEADERS <br />SINK (SERVICF. — BAR, ETC.� <br />PEHMIT <br />TOTAL FEE <br />EETSETPACK <br />NO. OF STORIES <br />APPROVALS <br />1. ENVIRONMENTAI CMECK LIST <br />2. BUILDING PLANS <br />3. FIRE HYDfiANT <br />4. FIFE PFOTECTION SYSiEM <br />S.GRFDING <br />7.ENVIRONMENTALIMPAGTSTATEMENT <br />B. MEALTH DIS7PIC7 <br />f <br />f <br />S <br />:.VES � �.NO <br />FEE <br />DATE <br />BV IAPPR.PORISSUANCE BV <br />I HEREBY CERTIFY THAT I HAlE READ AND E�(AMINED THIS <br />APPLICATION AND KNOW TI1E SAME TO BE TRUi AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINF,NCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTIOh OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />XGNnTURE OF� RA � R�(jq/ UtHO^2 J GENT � DR � / <br />X %t /0�I/� 12 14 83 <br />MECHANICAL <br />N0. TYPE OF EOUIPMENi <br />AIR COND. UNI1S -- HP. EA. <br />REFflIGERATION UNITS — H.P. EA. <br />BOILERS — M.P. EA. <br />GAS FIRE� A.C. UNITS — TONNAGE EA. <br />FORCED AIR SYSTENS — B.T.U. M EA. <br />WALL H.ATERS — R.T.U. M <br />UNIT NE�TERS — B. i.11. M <br />_VAPORATIVE COOLEfiS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEMOOD <br />AIR HANDLING UNIT — C.F.M. <br />S70VE — WOOD <br />METAL FIREPLACE d CHIMNEV <br />FIREPLACE INSERT <br />HEAT PUMP <br />BUILDING <br />PLUMBING <br />MEGHANICAL <br />OTHER <br />PENALTV <br />TOTAL <br />FEE <br />SL'B TOTAL f Q <br />PENMIT f lO <br />TOTALFEE S 14 <br />PLAN CMEGK FEE <br />FEE RECEIPt N0. <br />VALUATION FEE <br />E <br />U.B.G. <br />SEC. 303 <br />PERMIT VALIDA710N <br />WHEN PROPERLY VALIDATED pN TH� $V(�C�E) TNI��Y�U(i P�V�AIT ('�] <br />4�s � u �; <br />� r, <br />�� <br />1`: J R REC:EIFT • � <br />i <br />; ,<,��,, ou <br />I 3 u=C � ; <br />ADDRESS f-ILE <br />