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Un� f �,r.ivrrn <br />everett ^ONSTRUCTION <br />PERMIT PERMiT N0. .� �'��' � <br />C�iv lialL 259�B7a5 <br />evEaETr wa sasoi � COMBINATION L�7t BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNEF MAIL AODRf55 C�TY ]��F PHONE -_ <br />Arco Oi'1 Co. 3523 Aroadway _ Everett _ <br />RFGNITECT OP JESIGNEF �/41L hDDRESS CITY ZIP PHONE <br />GENLRIL GONTHPGTOA MAIL ADORESS GItY ZIP PMONE LiCENbF � <br />American Neon P.O. Box 431 Tacoma 98401 627-7446 <br />MECMRNIGAL CONTRAGTOR MAIL 0.0DRE55 CIiV 21P PMONE LICENSF � <br />PLUMBING CONTPAGTOR MAIL AU�RESS <br />PMONE UG[NSL• <br />D �EW O ADDITION ❑ ALTFRATION ❑ REPAIR U DEMOLITION O FENGE QJ61GN ❑ WOGD STOVFJFIR�PLACE INSERT <br />VALUATION GF WOFK <br />i 3����. <br />LOT _ BLOCK _OF __ <br />JOB aDDRE55 <br />�#F3(7tX�WdC+lR9( 851 <br />PLUM8ING <br />TYPE OF FIXTURE OR ITEM <br />WATER CLOSET �TOILEn <br />BATHTUB <br />LAVATORV�WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISH W ASHER <br />LAUNDHYTRAY <br />CLOTHES WASHEF <br />WATER HEATEP <br />UFINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />FOOF DRAINS — RAINLEAOERS <br />SINK �SEiiVICE — BAR, ETC.) <br />SUB TOTAL <br />70TAL FEE <br />ZON[ <br />APPROVALS <br />t. �NVIRONMENTAL CHECK lIST <br />2. BUILDING PLANS <br />3. FIRE MYDRA�T <br />a. FIRE PROiECTION SYSTEM <br />5. GRAUING <br />6.�RAINAG.`. <br />7.ENVIRONMENTAIIMPACTSTATEMENT <br />8, HEALTH DISTRICT <br />APPLICATION ACC. BY PLANS CHECKED BV <br />RF <br />� <br />S <br />S <br />IEAR VARD SETL <br />'ACANT SI7E <br />YEE 1:0 <br />IG. OF DWELLIM <br />qAX. OCQ LOAD <br />BY I DATE <br />N4 <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED TNIS <br />APPLICATION AND KhOW THE SAME TO BE 1'RUE AND <br />CQRRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DCES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAV�' REGULATING CO�!STRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTICN. <br />SIGNATURE OF CONTHPGTOR OR nUTHOF2ED AGENT DPTE <br />X <br />MECHANICAL <br />N0. TYPE OF EOUIPMENT FEE <br />AIR COND. UNITS — H.P. EA. <br />FEFPoGERATION UNITS — H.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIPED A.C. UNITS — TONNAGE EA. <br />FORCED AIR SVSTEMS — B.7.U. M EA. <br />WALL HEATERS — B.T.U. M <br />UNIT HEATERS — B.i.U. M <br />EVPPORATIVE COOLERS <br />CLOTHES DRYERS <br />VEN7ILATION FAIJ <br />RANGEMOOD <br />AIR HANOLING UNIT — C.F.M. <br />STOVE — WOOD <br />METAL FfREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />SUB TOTAL f <br />PERMIT s <br />TOTAL FEE S <br />I NUMBER PLAN CI <br />FEE <br />FEES � VALUATION <br />BUILDING <br />PLUMBING <br />MECMANICAL <br />OTHER <br />?ENALTV <br />53 <br />U B.C. <br />SEC. 303 Ial <br />RECEIPT t�o <br />FEE <br />12 I 00 <br />TOTOL I I 12 I 00 <br />PERMIT VALIDATION <br />VJHEN PROPEFLY VALIDATED pN THIS �yP�nCRE,THIS IS.VOUji ijEF�17 _ �� <br />1 1 � � ( I, <br />1' � ] <br />�. . <br />,. ;.:.:;:IF� , <br />BY ��`� t� Y �: U' <br />i <br />i'dii',:__,. . '�..f_ <br />