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ihrLlcrr�reen CONSTRUCTIO � . <br /> �.�„ or i <br /> everett PERMIT PERMtTNO. 1514 �J <br /> CITV MALL 259-07�5 <br /> EVERETT.WA 98201 [� COMBINATION ❑ BUILDIN(3 Q'i MECHANICAL ❑ PLUMBING <br /> OWNEA MeIL�DORL55 UTV ZIP PNONE <br /> Art Johnson 111] E Casino Rd Everett 98204 252-3938 <br /> ARCMITECL OR OESIGNEA M11L�Of)NE55 GTY IiP PHONE <br /> OENEReI CONTR�LiOR M�i��ODRElS C�*V 2i� PNONE LICENSE� <br /> Valley Natural Gas 519 S.E. Everett h1a11 Way Everett 98204 355-7730 VN.LENG153LD <br /> MECM�NIC�L CONiR�CTOR MMl�ODRE55 ��1� ��r PHONE LiC[NSE I <br /> PLUMBING CONiR�CTOR Ms�� �D�NESS CITY ZiP PIIOHE L�GENSE� <br /> C1�5$OF WORM <br /> �NEW ❑ ADDITION ❑ �LTERATION O REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVE/FIREPLACE INSEFT <br /> V1lU�TIONOF WONK <br /> { <br /> DESCRIBE WORI( <br /> PROPOSED USE OF BUILDINO <br /> I HEREBY CEFTIFY THAT I HAVE READ AND EXAMINED THIS � <br /> APPLICATION AND KNOW THF SAME TO BE TRUE AND <br /> LEO�l0E9tNIPT10N OF PNOVEHTY�SNOW BELOW OR�1TI1CH FOUR GOPIESI CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES m <br /> �or_eiocK_oc GOVERNING THIS TYP'_OF WORK WILL BE COMPLIED WITH .. <br /> WHETHER SPECIFIED HEREIN OR NOT.THE GFANTING OF A <br /> PERMIT DOES NOT PFESUME TO GIVE AUTHORITY TO VIOLATE � T <br /> OR CANCEL THE PRCUVISIONS OF ANY OTMER STATE OR � � <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE � _ <br /> PERFORMANCE OF CONSTRUCTION. �^ <br /> JOB�DOHESS SIGN�T RE OF CONTP�CTOR O JTMORIZED AGEN7 OAtE C� <br /> 1111 E Casino Road x _ _ m <br /> --�c <br /> PLUMBINO MEC ANICAL �� <br /> N0. TYPE OP FU(TURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE _ � -=1 <br /> WATER CLOSET�TOILEn AIR COND. UNITS- M.P. EP. "" <br /> O = <br /> BFTMTUB REFRIGERATION UNITS - H.P.EA Cy <br /> LAVATOHY p"�qSH BASIN� BOILFRS- M.P. EA. r � <br /> 2 <br /> �..� 'r <br /> SMOWER GAS FIRED A.C.UNITS- TONNAQE ER. K N <br /> NITCHFN SINN A OISP FORCED AIR SYSTEMS - B.T.U. M EA. �A <br /> �ISMWASHER WALL HEATERS- BT.U. M <br /> UUNDFV TPAY UNIT HEATERS- B T.U. _ M = <br /> CLOTHES WASMER EVAPONATIVE COOLERS .___ ._ m N <br /> WATER NERTEH CLOTHES ORYEflS � r <br /> URINAL VEN7ILATION FAN <br /> - C v1 <br /> DRINKING FOUNTAIN RAN.E HOOD �N <br /> FLOOR DRAIN AIR HANDLIND UNIT QF.M. �� <br /> VACUUM BNEAI(ERS STOVE -WOOD ' my <br /> ROOF DR�INS- RAINLE�DER9 METAL FIREPLAGE 8 CHIMNEV _ A <br /> SINK(SERVICE- B�R,ETC.) FIREPLACE INSERT = <br /> MEA7 PUMP ' <br /> 1 anversion urner, 6 00 = <br /> 1 Gas i i � <br /> x <br /> .» <br /> — �n <br /> 8UB TOTAL f SUB TOTAL f = <br /> -- O <br /> PEPMIT f FERMIT t M <br /> TOTAL FEE f TOTAL FEE t n <br /> m <br /> SIDE VAHD SETB�GN STNEET SEidACK REAR YARD SETBACN PLAN CMECK NUMBER PLRN CMECN FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SI1E ' -'— <br /> YES NO FEES VALUATION FEE _ <br /> TYPE OF CONST. OCCUPpNCY OFOUP NO.OF DWELLING UNI'S <br /> BUILDING t <br /> SI2E OF BlD(i. NO.OF STORIES MA%. OCC. LOAD <br /> PLUMBING <br /> FIRE 2011E BASEMENT FIRE SPRINNLERS MECHANICAL ZO SO <br /> REOUIREO <br /> VES NO <br /> AFPNOV11L8 BY D�TE �TMER <br /> 1.ENVIRONMENTAL CHECK L15T pENALTY U B C <br /> _ - SEC 7071e� <br /> 2.BUILDING PLANS � <br /> J.FIREMYDRANT TOTAL ZO SO <br /> � FIRE PROTECTION SVSTEM VERMIT V�LID�TION <br /> S.ORA�ING WME�PROPERLV VALIDRTEO pN THIS SPACE�TMIS IS YOUR PERMIi (,O <br /> �' <br /> B.DRAINAGE <br /> �"'� <br /> 7.ENVIRGNMENTAL IMPACT STATEMENi � <br /> 8 HEALTM DISTRICT y--+ <br /> APPLICATION ACC. BY PUNS CMECNED BY APPR. FOR ISSU�NCE BY <br /> M.M. e.w, <br /> ADDRE55 fllE <br /> I <br />