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drr ErrrArcen � C O N ST R U CT I O' � <br />Cirv OF � <br />everett PERMIT PER4.�iT N0. 12O�a <br />GTY HALL 259�B7a5 <br />EVERETT.Y�A98201 ❑ COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNER MM�ADDPE55 QTY ZIP PMONE <br />New Life Center Church 6110 Colby Everett 98?03 355-9330 <br />qqLnITELT OR OESIGNER MAIL ApDRE55 GTY ZIP FMONE <br />GENERALGONTRAGTOR MAILRDDRESS CITY IIP PMONE LIGENSE� <br />Robert Butterfield 2905A Hewitt Avenue EveretY 98201 258-4413 <br />MEGNANiCAI GONTRACTOR MAIL ADD9E55 GITY 2iP PMONE LIGENSE � <br />TL 1490 <br />. _ _._ e..,...� iir.Er�sE � <br />O NEW ❑ ADDITION �%�CLTERATION ❑ NEPAIR ❑ DEMOLITION O FENCE O SIGN ❑ WOOD STOVFJFIREPLACE INSERT <br />= 1200.00 <br />church <br />l0T_BLOLK_OF <br />6 28 S <br />6110 Colby <br />PLUMBING <br />N0. TYPE OF FIXTU <br />W ATER CLOSET (TOILETI <br />BATMTUB <br />LAVATORY(WASMBASIN� <br />SHOWER <br />KITCMEN SINK d DISP. <br />FIRE <br />LAUNDflVTRAY <br />CLOTNES WASHER <br />WAiER HEATER <br />URINAL <br />ORINKING FOUNTAIN <br />FLOOF DRAIN <br />VACUUM OREAKERS <br />ROOF DRAINS - AAINI <br />SINK ISERVICE - BAR. <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO 8E TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WOHK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN UR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STPTE OR <br />LOCAL LAW REGULATING CUNSTRUCTION OR THE <br />PERFORMANCE OF CONST UCTION. oATE <br />SiG'�ATV R �OF CONTqpy OR 0_q�T� O 12E0�('Q�NT V ] 8 3 <br />..., \'Ii��n 1��-11�Aw.��1/}i � � <br />MECHANICAL V <br />FEE NO. TYPE OF EUUIPMENT <br />AIF COND. UNITS — H.K EA. <br />REFRIGERATION UNITS — N.P. EA. <br />BOILERS — M P. EA. <br />GAS FIRED A.C. UNIiS — T�NNAGE EP.. <br />FORCED AIF SVSiEMS — B.T.U. M EA. <br />WALL HEATERS — B.T.U. M <br />UNIT HEATERS — B T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRVERS <br />VENTILAiION FAN <br />RANGEHOUD <br />AIR HANDLING UNIT — G.F.M. <br />STOVE — VJOOD <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACE INSEFT <br />HEAT PUMP . <br />SUB TOTAL � <br />PERMIT S <br />TOTAL FEE f <br />iEET SETBACK REAR YAFD 5 <br />f AREA VACANT SITE <br />f�.YES �..NO <br />CUPANCVGROUP NO.OP�WEL <br />A-3 0 <br />.OFSTORIES MAX.00C.L( <br />1 <br />SEMENT FIRE SPRINKI <br />RCOUIRED <br />Yes vEs XX+o <br />eis I ev <br />1. ENVIRONMENTAL CHECK LIST <br />2. BUILDING PLANS <br />3. FIRE .1YDRANT <br />4. FIRE PROTECTION SYSTEM <br />5. GRAUING <br />8. DRAINAGE <br />7.ENVIRONMENTAL�MPACTSTATEMENT <br />8. NEALTH DISTRIGT <br />nPPLICATION ACC. BY PLANS CHE <br />FOR <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />FEE <br />FEE& � VALUATION <br />BUILDIN� s 1200. <br />PLUMBINd <br />MECHANICAL <br />OTHER <br />FE�: <br />� <br />t <br />f <br />CHECK FEE <br />RECEIPT NO. <br />FEE <br />20 50 <br />PENALTY SEC 30J �a� <br />TO7AL ZO SO <br />PERMIT VALIDATION ���� � D �� ��—' � <br />WHEN P�70PERLY VALIDAiED �IN T E� TMI I V �T <br />� <br />N <br />YOUR R[CEIPT •-+ <br />BY THANK YOU <br />ADDRE55 FILE <br />- 7 .� 83 <br />