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� r,1eL1C�v�OF � Ct�-�ISTFiUCTION � � � <br />everett �ERMIT pER1AIT NO. O%747 <br />CITY HALL 254B7A5 <br />eveaen.wn sazo� ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑'r�.UMBING <br />0\YNFN MAILAUORESS CIiY 21P PNONE <br />Tan N' m'm �02� FVPrgreen Way Fverett 35�-5817 <br />ARCMITECT OR �ESIGNEF � MAIL ADDFE55 CITY ZIP PHONE <br />GENERALCONTRACTOP MnI�qDDBESS CITY 21P PMONE UCENSE� <br />��an-O T.itP 1.030 mnk. Gpy,q�_Lynnc...,.,a aan7ti 75'�-A000 224-02-5 295P <br />MECHANICALGONTflACTOP MAILAOOPESS CITY ZIP PNONE IICENSEI <br />PLUMBINGCONTPACTOR b1AILA0DflE55 CITY 21P PMONE LICENSE� <br />C1A550F WORK <br />❑NEW <br />5 h40_C <br />�ESCRI�E WORK <br />LEGFI DESCflIPTION OF PFOPERT' <br />LOT 1 l�l i BLOCK_OF <br />JOB ADDPESS <br />9021 1 <br />PLUMBING <br />UFINAL <br />FLOOR DRAIN <br />ROOF DRAINS — <br />SINK ISFRVICE — <br />SIDE vARD SETBACK <br />USE ZONE <br />FIRE ZONE <br />❑ADDITION ❑AL7ERATION ❑REPAIR ❑OEMOLITION ❑FENCE I�ySIGN ❑GARAGE <br />I=1 <br />Way <br />OR ITEM <br />STREET SETBACK <br />OCCUPANCY <br />FEE <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH WI�ETHER SPECIFIED <br />HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO� <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW R[GULATING <br />CONSTRUCTION OR THE PERFORIvtANCE OF CONSTRUCTION. <br />SIGNATU�RE OF (IINTPPCTOR OR AUTMORIZED AGEkT DATE <br />X /o.CL�/rx ��Gti�I_'-�P <br />MECHANICAL <br />N0. TYPE OF EDUIPMENT FEE <br />emrnnin iinur¢—uo re � <br />GAS FIRED AC. UNITS— TONNAGE EA. <br />FORCED AIR SYS7EM5 — B.T.U. M EA. <br />WALL HEATERS — B.i.U. M <br />UNIT HEATERS — B.T.U. M <br />EVAPORATIyE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FFN <br />RANGEHOOD <br />AIR HANOLING UNIT — C.F.M <br />STOVE <br />METAL FIREPLACE 8 CHIMNEY <br />SUBTOTAL <br />REAR YAflD SETBACK PLAN GHtGK NUMtltH <br />VACANT SITE <br />❑YES ❑NO FEES <br />NO.OF DWELLING UNITS <br />BUILDING <br />MPJ(. OCC. LOAD <br />PLUMBING <br />FIRE SPRINKLERS <br />acnniarn MECHANICAL <br />APPROVALS BY UATE <br />1, ENVIRONMENTALCHECKLIST <br />2. BUILDING PLANS <br />3. FIRE HYDRANT <br />4. FIRE PROTECiION SYSTEM <br />5. GRADING <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />8. HEALTH DISTRICT <br />APPLICATION ACC. BY PLANS CHECKED BY APPR. FOR ISSUANCE BY <br />PENALTV <br />PLAN CHECK FEE <br />FEE RECEIP7 NO. <br />VALUATION FEE <br />$ 640.00 <br />U.B.C. <br />SEC. 303 (a) <br />� �1 <br />PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOIiR PERMIT <br />3987 $005.00 --�: ri- <br />d" <br />� <br />1'OUR RECEIPT o <br />THANK YOU <br />ZtiJu;�EO <br />ADDRESS FILE <br />