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�lir Ercr�rcen C O i�ST'R U CT I C 'V � <br /> ,-�,-�,-,; i� <br /> everett PERMiT PERMIT NO. 1� 9 � � <br /> CITY HALL 259�Bia5 <br /> e:�aerz e�a sezoi ❑ COMBINATION ❑ BUILDING ❑ MECNANICAL ,xX PLUMBING <br /> OWNER lSt M.AIIApORE55 LITY ZIP PHONE <br /> LKY American �itle <br /> � �PGXITEGT OR DESIGNER MAIL RDDRE55 GITY ZIP PMOHE <br /> GEHER�L CANTMGTOR MALL�OOPESS qTY ZIP PMONE LIGENSE� <br /> MECNANIGILCONTRIICTOR MAILADOFE55 GiTY 21P PH�NE LICENSEw <br /> VWMBINGGONTBALTOR MMLAOORESS LITY ZIP PHONE tJCENSE• <br /> BdtSYYHE(HltOQ Sieh Pltmibinq 10907 29th Drive S E Ae]t t nqh„m oR�nd <br /> f.LA55Oi WDRN <br /> ❑NEW ❑AD�ITION ❑ ALTERA710N ❑REPAIR ❑DEMOLIt10N ❑fENCE ❑ etGN O WOOD STOVEIFIHEPLACE INSERT <br /> VAIUNTION Of WOFK <br /> 5 <br /> DESGRIBE WOPK <br /> PROPJSEO USE OF BUILDINQ <br /> I HEREBY CERTIFY THAT I Hl+.VE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW 7'HE SAME TO BE TRUE AND <br /> LE6ALDE8CRIPTIONOFPROVERTYf5MOW8ELOWORRTTACMfOURCAPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> LOT_BLOCK_OF GOVERNING THIS TYPE OF VJORK WILL BE COMPLIED WITH <br /> WHETHEF SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOL'+TE <br /> OR CANCEL T E PROVISIONS OF ANY OTHER STA7E OR <br /> LOCAL LA FGULATING CONSTRUCTION OR THE <br /> F C 1STRUCTION. <br /> �oe A 3019 Colby SiGN RE Ni A TO TNORIZ[C�AGENi �41E <br /> X..� 1/19/84 <br /> PLUMBING MECNANICAL <br /> NO. TYPE OF FI%TUHE OR ITEM FEE NO. TVPE OF E�UIPMENT FEE <br /> WATERCLOSET�TOILET) AIR COND.UNITS— H.P.EA. <br /> 6ATMTUB REFRIGERATION UNIiS— N.P. EA. <br /> LAVATORY pNASH BASIN) AOIlERS— M.P. EA. <br /> SHOW�R GAS FIRED A.C. UNITS—TONNAGE EA. <br /> 1 KITGHEN SINK d DISP. FORCED AIR SYSTEMS— B.T.U. M EA. <br /> DISHWASHER WALL HEATERS— B.T.U. M <br /> LAUNDRV TRAV UNIT HEATENS— B.T.U. M <br /> CLOTHES WASHEH LVAPORATIVE COOLERS <br /> ]. WATEfl HEATEP CLOTMES DRYERS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RFNGE HOOD <br /> FLOOR�RAIN AIA HAN�LING UNIT— C.F.M. <br /> VACUUM BREANERS STOV[—WOOD <br /> ROOF DRAINS— RAINLEADERS METAL FIREPLACE&GHIMNEY <br /> SINK ISERVICE— BAR,ETGI PIHEPLACE INSEPT <br /> NEAT PUMP I <br /> SUB TOTAL f 9 00 SUB T�TAL S _ I� <br /> PERMIT f PERMIT f � <br /> TOTAL FEE f TOTAL FEE S <br /> SIDE YARD SETBACK STREET SET9ACK NEAR YARD SETBACK PLAN ChECK NUMBER PLAN CHECK FEE � <br /> FEE RECEIPT NO <br /> USE ZONE LOT ANEA VACANT SITE ', <br /> !;VES .NO _ FEE6 VALUATION FEE . <br /> TYPE OF CONS . OCCUPANGY GROUP NO.OF DWEIUNG UNITS �� <br /> BUILDINO S <br /> SRE OF BLDO. NO.OF STOFIES MAX.OCQ LOnD � <br /> PLl�M81N6 7 00 i <br /> FIHE ZONE BASEMEN� PIRF �PqINKLEflS MECHANICAL I <br /> REOUIREU <br /> YES NO <br /> APPPOVALS BV DATE OTMER <br /> 1.ENVIRONMENTAL CHECK LIST PENA�T� U.B C. � <br /> _ SEC.303(o) <br /> 2.BUILDING PLANS <br /> 9.FIREMYDRANT T�Tp� 7 JO � <br /> a.FIREPRCIECTIONSY57EM PENMITVALIDATION ' �. <br /> 5,GRADING WHEN PROPERLV VtLIDATED(IN THIS SPACE)THI IS YOUR P[RMIT � ' <br /> E � s3 � 001 00 -- � <br /> 6.DRAINAGE I <br /> 7.ENViRONMENTALIMPACiSTATEMENi �y� <br /> 8.HEALTH DISTRICT , <br /> ' , '� (1-_^ ^ �) p'"+ <br /> APPLICATION ACC.9V PLAN6�MECKED BY APPR.FOP ISSUANCE 8V . - • -.1.t.I � T <br /> �: � �`��t'�h y ��V ' <br /> � <br /> � gJtN84 <br /> ADDRESS FILE <br /> � ' � <br />