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� <br /> ,,,, , ,�,.,<.�.,, ^(`WSTRtJCTlO� <br /> a,��oF r <br /> everett PERMIT pERM1T NO. 1OO5T <br /> GITY HALL 259�BiA5 <br /> eveae� �i.�H �szo� ❑ COMBINATION ❑ BUILDING � MECHANICAL ❑ PLUMBING <br /> Jt:qt�i MmtnCU�LLs Gc� , r.�.q� <br /> �T.�PHEN P J�NSEN 1426 COLBY RV�RETT 98201 258-9035 __ <br /> <+�����ICTnqDES�GHE9 V<il/.DD�I55 (:�Jv ]�N uHOqE <br /> 6(4luhlCO/atan�;Ga M>iLhDDNC55 Ci.-v ZiP �'�fUNt LIGENSC� <br /> Self <br /> L'i c:ii4Nic4l Co�fiN�CTOQ M��L AOUNESs uir ilv in�pryE ��Ny. r <br /> �'WI.I�INGCONfqnCtOR M41�ADpRF`5 CRY ZI> PHONE lCUl6E� <br /> �.;V.SS DF WORK <br /> QIXEW CADDITION ❑AUERATION ❑REPAIP ❑OEMOLITION ❑FENCE ❑61GN ❑GARRGE <br /> v>W RTiON OF WJRY. <br /> S <br /> OCSCA�BC WORn <br /> Installation of insert in existing chimney <br /> �AO�OSEG USC GF BUiLD�NG <br /> Residence I HEREBY CERTlf-v THAT I HAVE READ AND EXAMWED THI;; ai' <br /> ��r:,'.�otsrmm�ovor �nor�Fr.�;Howeuowoannna�rouncores� PLICATION ANfI M,NOVJ THE SAME TO 8E TRUE AIJD CGRPL�,;� <br /> ALL PROVISIONS OF U+WS AND ORDINANCES GOVERNING i�i!5� <br /> .�� ei�x�_��� TYPE CF WORK 'NILL BE COMPLIED WI7H WHETHER SPECIFirli <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES N0� <br /> PRESUME TO GWE AUTHORIIY TO VIOLATE OR CAM1iCEL TNF FPG <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULtii!I�.'�-; <br /> CC�NSTRUC;iION OFl THE PERFOR6IANCE OP CO!JSTRUCTIG�a <br /> niflApfl�FG$ �tl, . �ql.'J �� -r .,SYi .� . <br /> 1926 Colby X 12/3/81 <br /> FLUMBINO MECNANI AL <br /> NO. TYPE OF FUCTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FE[ <br /> WATF_R CLOSET fTOILEn AIP COIJU U��liS—H P EA I <br /> OATHTUB ' REFNIGCFATION UNIT$—H P EA � _ <br /> LAVATORY(WASH BASIN) �1�4EFS—H.P @q. I <br /> SHOWBP Gng pIRED AC.UNITS—TONNAOE EA <br /> KITCHE�I SINY,8 D�SP. FOACE�Alfl Sv5TEM5—B 7L M Eh � <br /> DISHWASMER WALL NEA1pR5—B 7.0 M J <br /> LhUNCHv TRAY UNIT{1EpT[R$—B T U M _ � <br /> CIOTNES WASHER EVAPORATIVE fApLERS <br /> WATF:R HEATER CLOTH[5 DRVF.RS <br /> URINAL V[NTILATION FAIJ � <br /> DR�NKING FOUNTAIN A�NGE HUO� j <br /> fLOOP DRAIN AIR MANDI!!JG UNIt _ _ Qi.M � <br /> VACUUM OREAKERS ��`v✓L ; <br /> PC�f ORAIN6—RAINLF.ADERS Ul inL r iqi�P.A('f R r�aIMNF': 'I <br /> SINK ISERVIC[—BP.R.ETC 1 P..1J�C0 �n_G'S.._�".f— __{ �� <br /> I <br /> 1 . _ 1 <br /> SUBTOTAL SUBTOTAL f �_�SD_ ,� <br /> PERMIT t PEPMIT 3_�Q__ �A- <br /> TOTAL FEE i 70TAL FEE f d <br /> ;iDC Y,:9D bE1FiACk S i taCE i SCTBAGk REAR YPR�SETAAGf. PL�+N GHEGN NUMBEF PLFN CH[CN F[E � <br /> FEE RECEIFT NG. � <br /> USF ZONE LOT pH[� �ACANT SITE — � <br /> L1YE5 GNO FEES VALUATION FEE <br /> TYPE Of CONST. OCC'JPANGY GROUP N0.OF DWELUNG UNI7S � <br /> �UILDING { <br /> SIZE OF BLDO. NO OF 6TORI[5 MA%.OCG.IOAD - --- I <br /> PWMBING — I + <br /> 1 IRE ZONL ONSEMENT FIRE SPRINKLEPS � I <br /> REOUIRED MECHANICAL <br /> rrres ❑wo _ 17_i 50_ <br /> l�VFpOVALS BY DATE OTHER � <br /> ENVIpONb1f:NTAICHECKLIST pE��A��y UBL � I <br /> ? BUILUING PlANS __ SEC 303�a) � _ ' <br /> 3 FIREHYDRANT TOTAL I.�I �SO <br /> < FIRE PROTECiION SVSTEM PERMIT VALIOATION I <br /> WHC4 PRUPCRLY VAI�O�.�EI���N TN6 SPA=L'1H15�€VVUF f'L,4MiT <br /> 5 6RADING . . � <br /> q. DRAIHr1GE � � <br /> '. ENVIRONMENTAI IMPACT STATEMENT O <br /> C HERLTH DIS7RiCT � f <br /> — c-� <br /> n�l'I.�C+�1t0[J kCC Ifv PLANFGHECKED BY APP« FV� i'iSU/•NCL HV I <br /> _--_ li <br /> 1 <br />