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����• c�•��.�.����„ <br />��,�oF <br />everett <br />CI7Y HALL 259�8745 <br />� ^ON�T�UCTIOI� <br />PERMIT <br />Peannir ivo. �.4379 <br />EVERETT,WA90201 ❑ COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNER MAILADOFE55 CITY ZIP PHONF <br />Kathy Westun 9129 Evergreen Way Everett 98204 584-722Z <br />ANCHITECT OR D[SIGNER MAIL AODRESS CITY ZIP PHONE <br />GENERALCONTRACTOR MAILADDRESS LITY ZIP PMONE LICENSEM <br />Signworks 10608 South Steele Street Tacoma 98444 584-7222 <br />MECMANICAL GONTRACiOR MAIL ADDRESS CIiV ZIP PHCNE LIGENSE N <br />PLUMBING CONiflAGTOR MAIL AO�RE55 CITY 21P PHONE UGENSE M <br />O NEW ❑ A�DITION ❑ AL7EPATION ❑ REPAIR O DEMOLITION ❑ FENCE I}�}{�iIGN O WOOD STOVE/FIREPLACE INSERT <br />VALUATION OF WORN <br />E S,OOO.00 <br />OESCRIBE WOflK <br />Install illuminated sian <br />LOT <br />JOBA��RESS <br />9129 Evergreen Wny <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSE7 (701LEn <br />BATHTUB <br />LAVATORY(WASH BA$IN) <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />WA7ER HEATER <br />URINAL <br />ORINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS - RAINLEADERS <br />SINK(SERVICE - BAR,ETC.) <br />SUBTOTAL <br />PERMIT <br />TOTAL FEE <br />�IZE OF BLDG. <br />FIRE ZONE <br />APPROVALS <br />1. ENVIRONMENTAL CHECK LIST <br />2. BUILDING PLANS <br />3. FIRL HYDRAN7 <br />4. FIRE PROTECTION SYSTEM <br />5. GRAOING <br />6. DRAINAGE <br />7.ENVIRONMENTALIMPACTS7A7EMENT <br />8. HEALTH �ISTRICT <br />I HEREBY CERTIFY THAT I HAVE READ AND EXA1�11NED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />coaies� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGNATIIRE OF CONTRACTOR OR AUTH REO AGENi OATE <br />X /1%n, �, i . ?7��n ., <br />FEE N0. TYPE OF EQUIPMENT FEE <br />AIR COND. UNI7S — H.P. EA. <br />REFRIGERA710N UNI75 - 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 />WALL HEATERS - B.T.U. M <br />UNIT HEATERS - B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />AIR HANDLING UNIT - � F M. <br />S70VE - WOOD <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />S <br />E <br />S <br />�..VES ".:NO <br />LOAD <br />FIRE SPRINKLEFS <br />REQUIRED <br />�.:YES :.:NO <br />BY DATE <br />APPLICATION ACC. BY PLANS CHECKED BY APPR. FOR I5: <br />LNC <br />SUB TOTAL 5 <br />PEHMIT 5 <br />TO7AL FEE 5 <br />FEE I RECEIPT NO. <br />FEES I �ALUA710N I FEE <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTY <br />5 <br />U.B.C. <br />SEC. 303 lal <br />TO7AL 18 00 <br />PEHMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACEJ THIS IS YOUH-.PERMIT _Q� <br />.. � :. . -" r. <br />M <br />�' <br />BY .� <br />ADDRESS FILE <br />�. .. <br />-� 'n <br />.. -i <br />�n x <br />0 <br />m <br />C O <br />m� <br />�c <br />O 3 <br />m <br />�z <br />x --i <br />m <br />O 2 <br />C <br />D -I <br />r x <br />� �. <br />< N <br />�'I <br />O � <br />T Y <br />3 <br />�m <br />2 <br />m� <br />N <br />O <br />or <br />c� m <br />C (n <br />3 fn <br />m <br />z c� <br />-i r <br />• m <br />D <br />� <br />-�-I <br />S <br />n <br />z <br />--� <br />x <br />N <br />Z <br />O <br />� <br />.-i <br />C'f <br />m <br />