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r <br /> 1 <br /> the G crrxrern <br /> e��erett � CONSTRUCTIO; � <br /> PERMIT PERMIT N0. 1193H <br /> CI1Y HALL 2596745 <br /> evEti�-r,wA se2o, � COMBINATION ❑ BUILDING �XJC MECHANICAL ❑ PLUMBING <br /> OWNEP MAILA�OFESS CIiY 2iP GHONE <br /> Jerald Nielson 3130 Broadwa}• Unit #6 Everett 98201 <br /> ARGMRECT OR DESIGNER MlIL�ODRE55 CITY ZIP PMONE <br /> GENERAL GONTP�LiOR MFLL ADDFE55 CITY DV VMONE LIGENSE� <br /> � MEGNANIGAL CONTRACTOR MFII AD�9[55 CITY ZIP PMONE LICENSE� <br /> r Natural Gae Equipment 1611 East Marine Everett 98201 258-2447 � <br /> PLUMBINGWNTHAGTOR MFILApDRE55 V1EW Drive CITY ZiP FMONE LIGENSE� <br /> GUSS OP WOHN <br /> ❑WEW O ADDITION ❑ ALTERATION ❑REPAIR ❑ DEMOLI710N ❑ FENCE O SIGN ❑ WOOD STOVFJFIREPLACE INSERT <br /> VALURTION OF WORK <br /> f <br /> OESCRIBE WORK <br /> PROPJSEO USE Of BUILDI�G <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGALDESGPIPTIONOFPROPERTY�SMOWBELOWORAT7ACNFOURCOPIES) CORRECT. ALl PROVISIONS OF LAWS AND ORDINANCES <br /> LOT_BLOCK_OF <br /> GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH � <br /> WHETHER SPEGIFIED HEREIN OR NOT.THE GRANTING OF A � <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br /> OR CANCEL THE PRUVISION� OF ANY OTHER STPTE OR � <br /> LOCAL LAW REGULA7IiJG CONSTPUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION. <br /> JOB ADDRESS SIGN TU E OF CONTRAGTOR R RUiHOF12ED AGENi DATE <br /> 3130 Broadway X h 4/29/83 <br /> PLUMBING MECHANICAL <br /> N0. TVPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATERCLOSET(TOILEn AIR COND. UNITS— M.P. EA. <br /> BATHTL!B REFFIGEFiAT10N 11NIT5 — H.P.EA. <br /> LAVATOHr'�WASHBASIN) BOILERS — H.P. EA. <br /> SHOWER GAS FIFED A.G. UNITS—TONNAGE EA. <br /> KITCHEN SIIJK 8 DISP. FORCED AIR SVSiEMS — B.T.U. M EA. <br /> DISHWASHER WALL HEAIERS— B.T.U. M <br /> LHUNDRV TRAY UNIT NEATERS— B.T.U. M <br /> CLOTHES WASHER EVAPORATNE COOLEFS _ <br /> WATER HEAT[R CLOTMES DRYERS <br /> URINAL VENI'ILATION FAN <br /> DRINKING fOUNTAIN RAN�E HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT— GF.M. <br /> VACUUM BREAKERS STOVE — WOOD <br /> ROOF DRAINS— RAINLEADERS METAL FlREPLACE 8 CHIMNEY <br /> SINK(SERVICE— BAR, ETC.) FIREPLACE INSEfiT <br /> HEAT PUMP <br /> I _ _ <br /> � _ <br /> SUB TOTAL i SUB TOTRL f 0 <br />�i PERMIT f PERMIT f ZO OO <br /> I <br /> TOTAL FEE f TO7AL FEE f <br /> � SIDE VARD SETBACK STRELT SETOACK REAR YARD SETBACK PLAN CHECN NUMBER PLAN CNECK FEE <br />� FEE RECEIPT NO. <br /> USE ZONE LO7 AREA VACANT SITE <br /> �.�VE$ NO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUP NO.OF OWELLING UNITS <br /> BUILDING s <br /> SIZE OF BLDG. NO.OF S70RIES MA%.OCC. LOAD � <br /> L_ PLUMBING � <br /> FIRE ZONE BASEMENT PIRE SPRINKLERS MECHANICAL SEX g� <br /> REOUIRED <br /> VES NO <br /> 'APPROVALS BY DA7E OTHER <br /> 1. EIJVIRONMENLAL CMECK LIST PENALTV U.B G <br /> SEC.�031a1 p <br /> 2.BUILDINUPLANS TOTAL X�X 7�75 <br />. � 3.FIREHYDRANT <br /> 4.FIRF.PROTECTIONSVSTEM WH NI PROPERLVO ALIOATEDpN TMI$9r�TH15��0}II�P�IAT��� <br /> 5.GRADING <br /> M <br /> 6.DRAINAGE , � ' � <br /> 7.ENVIRUNMENTpLIMPACTSTATLMENT <br /> � " ' �� B.HEALTH DISTRICT YO U R REC E 1 Pt j <br /> :�4-, - APPLICATION ACC. BV PLANs' CHECKED BY APPR.FOR ISSUANCE DY 7}-�qN K YU U <br /> '19 � �83 <br /> . <br /> noi�F�ss rar. <br /> � <br />