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thc L��rrqrcen � ^p N ST R U CT I O n <br />c���.�.: � <br />everett PERMIT PERMIT NO. 1�55� <br />CITY HALL 259�8745 <br />EVERETT. WA 98T01 ❑ COMBINATION ❑ BUILDING Gc MECHANICAL PLUMBING <br />��Ty Z�p GHONE <br />OWNEP MPII ADDAE55 <br />Greg Elwood 918 Colby Everett 98201 <br />ARCNREGT ORDE9GNER <br />MAR NODRESS CITY LP PHONE <br />��T� 2�p PNONE LIGENSE � <br />GENEP�I GONTflRGTOR MAII ADDPE55 <br />_ ,... oHot�E UGENSE � <br />�n. <br />S�I[le C�n, Z�p PMONE L�GENSE � <br />PLUMBING GONTR�GTOR <br />MAIL ADDRE55 <br />❑ NEW ❑ ADDITION ❑ ALTERATION ❑ RE�AIF ❑ OEMOLITION ❑ FENCE ❑ SIGN � WOOD STOVEIFIREPLACE INSERT <br />t <br />oescnieE won� <br />Install woodburni.ng stove <br />PROPOSED USE OF BUILDING <br />LEGPL DESGFIPTIOH OF PRDPERtY ISHOW BEl( <br />l0T__BLOCN�OF <br />JOB ADOPESS <br />916 Colby <br />pLUMBIN6 <br />H0. TYPE OF FIXTURE OR <br />W ATER CLOSET (iOILET) <br />BATNTUB <br />SMOWER <br />KITCHEN SINK 8 DISP. <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />WATER HEATER <br />UPINAL <br />DRIWKING FOUNTAIN <br />FLbOR DRAIN <br />�/OOF DRAINS - RAINLEADERS <br />SINK (SERVICE - BAR, ETC.) <br />TOTRL <br />TOTAL FEE <br />SIZE <br />1. ENVIRONMENTAL CMECK LIST <br />2. BUILDING PLANS <br />�. FIRE PROTECTION SYSTEM <br />s. canou+c <br />6.DRAINP.GE <br />e. <br />ACC. <br />BY <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVlSIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />PERMIT DOES NOIT PRESUME TO GIVE AU HORITY TO V OLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STPTE CR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE O� CONSTRUCTION. oA�E <br />eG7aa�ppK)F 2pNtflRT�/)R OR AUTMOAIZE� AGE�1T <br />MECHANICAL <br />FEE NO. TYPE OF EOUIPMENT <br />AIR GOND. UNITS - H.P. EA. <br />FEFRIGERAiION UNITS - H.P. EA. <br />BOILERS - H.P. EA. <br />GAS FIRED A.C. UNITS - TONNAGE EA. <br />FORCED AIR SYSTEMS - B.T.U. M EA. <br />WAIL HE4TERS - F7.T.U. M <br />UNIT HEATERS - B.T.U. M_ <br />EVAPOPATIVE COOLEHS <br />ClO7MES OPV@FS <br />VENTILATION FAN _ <br />RANGE MCOD <br />AIR MANDLING UNIT - C.F.M. <br />SiOVE - N/00D <br />METAL FIREPLACE & CHIMNEV <br />FIREPLACEINSEflT <br />HEAT PUMP <br />� <br />f <br />f <br />IEAfl YARD ? <br />/ACANT SITE <br />YES NO <br />JO. OF OWEI <br />UAX. OCQ L( <br />FOR <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />F <br />FEE <br />VALUATION <br />BUILDING s <br />PLUMBING <br />MECMANICAL <br />OTHER <br />S 7 50 <br />S 10 00 <br />s 17 50 <br />CMECK FEL <br />RECEIPT NO. <br />FEE <br />1% 5� <br />PENALTV SEC. 303 (al <br />1% 5� <br />TOTAL — <br />PERMI7 VALIDATION <br />WHEN PROPERLY VALIDATEO qN THI5�2AGFJ.TH�S �� `(PVR'pEeM�IR ��'�/� <br />a y v � i i� �i �•s, <br />'. � r <br />f. � i <br />•,���UR RECGIPT: : <br />I �' i ^,iJK Y(�U <br />ADDfCSS FlLE <br />� nr <br />- � l",1 U/ <br />z <br />0 <br />ti <br />c� <br />m <br />�� <br />r .� <br />�n x <br />0 <br />m <br />cv <br />m � <br />O 3 <br />-i Z <br />2 -1 <br />m <br />O 2 <br />D -i <br />�..-i <br />� y <br />O 7c <br />�a <br />3 <br />--i m <br />S <br />m .-. <br />N <br />or <br />c� m <br />C N <br />m y <br />Z l"f <br />1r <br />• m <br />a <br />A <br />-i <br />S <br />a <br />z <br />1 <br />._. <br />N <br />Z <br />O <br />-i <br />C'f <br />m <br />