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IhPLl'rr�i�en � CONSTRUCTIO ' , <br /> '. t � <br /> everett PERMIT PERMIT NO. ^ � �r �' � <br /> GTV HALL 259 B7a5 <br /> EVERE1T,VtA98201 � COMBINATION ❑ BUILDING �f; MECHANICAL U PLUMBING <br /> OWNEA MAILRDDRES$ GiY ZIV PMONE <br />' Cindy Richard 1620 Colby Avenue Everett 90201 339-3638 <br /> �RGMi�EGT ON DESiGNER MR4 AODAE55 C.lr LF VnONE <br /> CaENERAL GONTPACTOH MRIL AODRES$ GTY ZIP PNONE LIGE�4E� <br /> MEGNRNICAL CQNTPAGTOR M�IL RDDRE55 GTY ZIP PMONE LIGEN6F.• <br /> Valley Natural Gas 11323 Highway 99 Everett 98204 355-7730 <br /> PLUMBING GONTPAGTOiI MAIL ADDRESS CITY ZIP FnONE L�GENSE� <br /> CLASS OF WORN <br />�� ❑NEW � ADDITION ❑ ALTERATION ❑REPAIR O DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVE/FIREPLAGE INSERT <br /> V�LUATION OF WOPR <br /> I� f <br /> OESGNiBE WORN <br />` PROPoSED USE OF BUILDING Z I <br />� I HEREBY CERTIFY THAT I HAVE READ AND EXAMiNED Tf11S o <br /> APPLICATION ANO KNOW THE SAME TO 8E TRUE AND � <br /> LEGRL�ESCRIPf10NOFPROPENTY�SMOWBELOWOP�TT�CHiOURCOPIES� CORRECT. ALL PFOVISIONS OF LAWS AND ORDINANCES r' <br /> m <br /> GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH •• <br /> ior_e�ocK_oF WHETHER SPECtFiED HL'REIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE ,:� T <br /> OR CANCEL THE PROVI;IONS OF ANY OTHER STATE OR � � <br /> LOCAL LAW REGULATlNG CONSTRUCtIGN OR THE �m I <br /> PERFORMANCE OF CONSTRUCTION. o <br /> dOB RODAESS SIGNATURE OF CONTRFCTO R�UTMORIZE�AGENT DATE C � <br /> X 12�3�85 �� � <br /> O 3 <br /> PLUMBING ME ANICAL �Z <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE _ '� <br /> m <br /> WATEHCLOSETITOILEn A�R GOND. UNITS— H.P EA. _ Q z <br /> BATHTUB REFRIGERATION UNITS— N.P. EA D ,_.� <br /> LAVATORV(WASM BASIN� BOILERS— H.P.EA. .,r,� � � <br /> SHOWER GAS FIRED AA. UNITS—TONNAGE[A. K � <br /> KITCNEN SINK 8 DISR FORCED AIR SVST[td5— B.T.U. M EA. � <br /> DISHWASMER WALL MEATERS— B.T.U. M1i O m <br /> LAUN�RV TRAV _ UNIT MEAiEflS— B.T.U. M m M <br /> CLOTHES WASHER EVAPORATIVE COOLERS N <br /> WATE(iHEATER CLOTNES DFYERS p m <br /> URINAL VENTILA710N FAN C N <br /> FANGE HODD 3 N ' <br /> DRINKING FUUNTAIN Z � <br /> FLOOR DRAIN AI? MANDLING UNIi — C.F.M. �m <br /> VACUUM BREAKERS STOVE —WOOD q <br /> ROOF DRFINS— HAINLEAOEHS METAL FIAEPLACE M1 CHIMNEV p <br /> SINK(SEFVICE — BAR, ETC.� FIREPLACE�NSEflT p <br /> HEAT PUMP Z <br /> �IIYE2510ri�llLII '""� <br /> 2 <br /> � � <br /> N <br /> Pi ' <br /> SUB TOTAL f SUBTOTAL f p <br /> PERMIT S PERMIT S QQ.� �,., <br /> TOTAL FEE S TOTAL FEE f 11O m <br /> SIDE YARD SETBAGK STREEi SFTBACK REAR VARD SETBACK PLAN CHECK NUMBER PLAN CNECK FEE <br /> FEE PECEIPT NO. <br /> USE ZOHE LOT AREH VACANT S!TE <br /> �. .YES ..NO FEES VALUA710N FEE <br /> TYPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING 11N1T5 � <br /> CUILOING S <br /> SIZE OF BLDG. NO.OF STORIES MA%.OCQ LOAD <br /> PLUM8ING <br /> FlREZONE BASEMENT FIRESPRINHLERS MECHANICAL Z]. OO <br /> REOUIFED <br /> YES NO <br /> APPROVALS BY UAiE OTMER <br /> 1. ENVIRONMENTAL CHECK LIST PENAI.TV U B C. <br /> SEC.307 Ia1 <br /> 2.BUILDING PLANS TOTAL 21 OO <br /> 3.FIRE HYDRANT <br /> 4.FIRE PROTECTION SVSTEM VERMIi VALIDATION <br /> 5.GRADING WMEN PROPERLY VALIDATED pN THI6 SPpC�I TMIS�J.�/�Y�U�1 P(�F�iIT � <br /> t l iis � U I UU <br /> 6.DRAINAGE <br /> r- <br /> 7.ENVIRONMENTAL IMPACT STATEMENT (J, <br /> B.HEALTH DISTRICT ` ' " � p � <br /> APPLIGATION ACC.BY PLANS CHECKED BY AP�F.POR ISSUANCE BY � � �� I��:�_.E I P�1 � ' <br /> . � �.i�� ���} �� <br /> � <br /> ' L-��i Ol <br /> ;�.GDRESS FlLE <br /> t� <br />