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i <br />e <br />lllC l:t'ClJ;lCC�� <br />��,, a� <br />ev�rett <br />CITY HALL 259�8745 <br />� _ '�O(V�TRUCi�Oi�� <br />PER�IT <br />PERMIT NO. 1�747 <br />EVERETT, WA 98201 � COMBINATION ❑ BUILDING L� MECHANICAL ❑ PLUMBING <br />I OWNER MFIL aDDRESS CIiY ZIP PHONE a� <br />American lst National Bank 6920 Evergreen Way Everett 98204 <br />ARGMITECT OR DESIGNER MFIL ADDRESS CITY 21P PHONE <br />GENERAL CONTRACTOP MAIL AOORE55 CITY ZIP PMONE UCENSE X <br />MECMANICAL WNTRACTOR MAIL ADDflE55 CITY � ZIP PHONE LICENSE M <br />Natural Gas Equipment Co. Inc. 1625 East Marine View Drive 98201 258-2441 <br />PLUMBING CONTRPCTOfl MAIL ADONE55 CITY 21P PHONE LICENSE N <br />E <br />USE <br />LOT <br />❑ NEW ❑ ADDITION O ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE O SIGN ❑ WOOD STOVFJFIREPLACE INSEFT <br />JOD AOORE55 <br />6920 Evergreen Way <br />PLUMBING <br />TYPE OF FIXTURE OR <br />WATER CLOSET (701LE11 <br />BATHTUB <br />SHOWER <br />KI7CHEN SINK 8 DISP. <br />DISHWASHER <br />LAUNDRY7RAY <br />CLOTHES WASHEFi <br />WATER HEA7EFi <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS — RAINLEADERS <br />SINK (SERVICE — BAR, E7C.) <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />SIOE <br />APPpOVALS <br />1. ENVIRONMENTAL CHECK LIST <br />2. BUILDING PLANS <br />3. FIRE HYDR.INT <br />4. FIRE PFiOTECTION SYSTEM <br />5. GRADING <br />6. DRAINAGE <br />7. ENVIRONMEN7AL IMPACT STA7 <br />8. HEALTH DISTRICT <br />APPLICATION ACC. BY PLAI <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED TH�S <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />COPIES� CORRECT. ALL PROVISIONS OF LAWS AMD ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMf�LIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GR �NTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORh-r TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW RECULFTING CONSTRUCTION OR THE <br />PERFORMANCE OF COi ISTRUCTION. <br />SIG /R�E O,F1C'ONTP1CTOF�/JfSj (l/,TlMQIP�IZED AGEIIT 8�8�$4 <br />i� l/�-"#'IM� 1�- t�l��� <br />MECHANICAL <br />FEE N0. TYPE OF EOUIPMENT <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — H.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />FORCED AIR SYS7EMS — B.T.U. M EA. <br />WALL HEATEFS — B.T.U. M <br />,;::�T HEATERS — B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />AIH HANDLING UNIT — C.F.M. <br />STOVE — WOOD <br />METAL FIREPLACE 8 CHIMNEY <br />I FIREPLACEINSER7 <br />S <br />5 <br />5 <br />VACANT SITE <br />_YES ; N0 <br />REUUIRED <br />.-:YES �,::NO <br />BY DA7E <br />ISSl1ANGE BY <br />1 <br />SUB TO7AL 5 4 <br />PERMIT S O <br />70TALFEE 5 14 <br />FEE � RECEIPT NO. <br />FEES I VALUATION � FEE <br />BUILDIMG 5 <br />PLUMBING <br />MECHANICAL 14 <br />OTHER <br />PENALTY U.B.C. <br />SEC. 303 lal <br />TO7AL I I 14 �.50 <br />PERMI7 VALI�ATION <br />WHEN PROPERLY VALIDATED (IN TF�ISJSPA�E) THI�S, IS YI UR PER�MIT � <br />I I y �.y <br />� <br />�'�i <br />� . ,. .�. �i�� � <br />' 'I <br />AUDRESS fILE <br />- ,. ..�.a .'i <br />H8 <br />y� <br />0 <br />