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7he Grerxreen <br />piv br <br />everett <br />CITV HALL 259�8745 <br />EVERE77. WA 98201 <br />� -�ONSTRUCTIOe-� <br />PE�nnir <br />❑ COMBINATION ❑ BUILDING Gt�t MECHANICAL <br />PERMIT NO. � 2� g 4 <br />❑ PLUMBING <br />MAIL AODRESS �"' 353-4533 <br />OWNER Everett 98203 <br />Bruce Olson 6929 Evergreen Way _ — <br />pRCMITEGT OR OESIGNER MAIL ADOPESS <br />CITY ZIP �NONE <br />GENERALCONTRAGTOP <br />MAIL AO�RESS CITY ZIP PMONE LICENSE X <br />MELMANICAL CONTRAGTOF MAIL AOOBESS <br />CITY ZIP PMONE LILENSE N <br />Rescon Inc. P.O. Box 5062 Bellewe 980U5 641-2528 <br />MPIL ADDRESS CITY 21G PHONE L�CENSE � <br />PLUMBItl6 GONTPAGTOR RESCO217N4 <br />CLASS OF WORN <br />❑ NEW <br />s <br />DESCFIBE WORK <br />�(AODITION ❑ AL7ERA710N ❑ REPAIR ❑ DEMOLITIOII � FENCF ❑ SIGN ❑ WOOD STOVFJFIREPLACE INSEilT <br />LOT _ BLOCK _OF <br />JCB AODRESS <br />7404 <br />PLUM0ING <br />TYPE OF FIXTURE OR <br />WATER CLOSEi ROILEn <br />8A7HTUB <br />LAVATORY(WASH BASINI <br />SHOWEF <br />KITCHEN SINK 8 DISP. <br />OISHWASHER <br />LAUNDRVTRAY __ <br />CLOTHES WASHER <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS — RAINLEADERS <br />SINK (SERVICE — BAR, ETC.) <br />SUB TOTAL j <br />PENMIT S <br />TOTA� FEE s <br />IEET SETBACK REAR YARD S <br />� qpEq VACANT SITE <br />Y[S NO <br />T\�FE OF CONST <br />MAX. <br />APPROVALS _ <br />1. ENVIRONMENTAI CHECK LIST <br />2. BUILOING PLANS <br />3. FIRE HYDRANT ___ <br />4.FIREPPOTECTIONSYSTEM _ <br />5. GRADING <br />6. ORAINAGE <br />7.ENVIROIJMENTALIMPACTSTATEMENT <br />O.HEALTH DISTRICT <br />...........�...� nrr uv ai ANS CHEGKED BY <br />LOAD <br />FOfl <br />I HEREBY CERTIFY THAT I Hl.VE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />P RM T DOES NOT PR SUME TO GIVE AUTHORIRA TO V OLATE <br />L�OCAL LAW REGUOLA'TINGSCONSTR CTTIONSOR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGNATUNE OF GONTRACTOR�f R AUTHORIZED AGENT _^OA^E ,^ ^ <br />MECHANICAI <br />TYPE OF E�UIPMtn i <br />AIR COND. JNITS — H.P. EA. <br />REFFIGERATION UNITS — H.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UNiTS — TONNAGE EA. <br />FORCED AIR SYSTtMS — B.T.U. M EA. <br />VJALL HeATERS — B.T.U. M <br />UNIT HEATERS — B.T.�. M <br />EVAPORATNE COOLERS _ <br />GLOTHES DRYERS <br />VENTILATION FAN <br />RANGE HOOD <br />AIR HANDLING UNIT — C.F.M. <br />STOVE — WOOD <br />ME7AL FIREPLACE 8 CHI1dNEY <br />FIREPLACEINSERT <br />�EAT PUMP <br />BUILDING <br />PLUMBING <br />MECHANICAI <br />OTHER <br />PENALTY <br />5110 TOTAL S <br />PERMIT s <br />TOTAL FEE s <br />PLAN G <br />FEE <br />VALUATION <br />5 <br />303 <br />4 <br />RECEIPT NO. <br />FEE <br />17 �50 <br />TOTAL I I 1.% I SO <br />PERMIT VALIDATION . �. <br />WHEN PFOPERLV VALIDATED IIN THI i 2P'Ci) THIS jS�0�9�P ���T� � <br />J J I .y I <br />L.'7 <br />� `� <br />�,-`���2 RECEIPT•-� <br />�;; �n.fJK YOU <br />Z�octo3 <br />ADDRESS ��I F <br />I <br />