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rhr £vererren <br />everett � �ONSTRlJCTIO�. <br />CITYMALL259�B745 PER�IIIIT PERMIT NO. 122H3 <br />EVEflETT, WA 98201 ❑ COMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNER MAILADDRESS CITY ZIP PHONE <br />City of Everett (Fire Station #6) 9520 Evergreen Way <br />ARCHITEC� OH pE51GNER �AqIL ADDHE55 �ITY 21P pNONE <br />GENERnLGONTHAGTON MqILA00RE55 �ITY ZIP PHONE UCENSE� <br />City of Everett (Tri State Const.) <br />MECHANICnLCONTRACTON MAILAD�RESS CITV 21P PHONE LICErvSEx <br />P.IIM61NuCONTRACTOR MNILADDRESS CITY ZIP PNONE UCENSE� <br />❑ NEW O AOOITION ❑ A�TERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN � WOOD ^uTOVFJFIREPLACE INSERT <br />SS�000.00 <br />iESCqIBE WORN <br />install foun3ation <br />POPOSEU USi OF 61111p�NG <br />Office <br />EGAL OESCPIPTION OF PROPERTY �SHOW BEI <br />LOT ainre nc <br />9520 Evergreen Way <br />PLUMBING <br />NO. TYPE OF FI%TURE OF <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LF9ATOFY (1NASH BAE <br />SHOWEH <br />KITCHEN SINK 8 DISP. <br />LAUNDflYTRAY <br />CLOTHES WASHER <br />DRINKING FOUNTAIN <br />FLOOR �RAIN <br />VACUUM BREAKERS <br />ROOF DRAINS — RAINLEFDE:IS <br />SINK I.SERVICE — 6AR. ETCI <br />SUBT�TAI <br />TOTALFEE <br />NO OF <br />� HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />'�PPLICATION AND KNOW THE SAME TO BE TRUE AND <br />�.QRRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERtd!NG THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUMETO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVIS�ONS OF ANY OTHEA STATE OR <br />LOCAL LAW REGULAT�NG CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGNATUREUFGONTRACTORONApTHORIZEDAGENT DATE <br />X Jim IIrandley 8/1/d3 <br />MECHANICAL <br />ITEM FEE NO. TYPE OF EOUIPMENT <br />AIP Cld:n. UNITS — H.P. EA. <br />REFRIGERATION UNITS — H.P. EA. <br />BDILERS — H.P.EA. <br />GAS FIRED A.C. UNIT$ — TONNAGE EA. <br />� FORCED AIR EYSTEMS — B.T.U. M EA. <br />WALL MEATERS — B.T.U. M <br />UNIT HEATERC — B.T.U. M <br />EVAPORA i IVE COOLERS <br />CLOiHESORYERS <br />VENTILATION FAN <br />RANGEHOOD <br />AIR HANDLING 11N1T — C.F.M. <br />S'OVE — WOOD <br />METAL FIflEPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />, HEAT PUMP <br />APPPOVALS <br />1. £NVIHONMENTAL CMECK LIST <br />2. BUILDING PLANS <br />3. FIRC HYJRANT <br />�7. FIRE PROTECTION SYSTEM <br />5. GRADING <br />f,. DRAINAGE <br />7. ENVIRONh1ENTAL IIAPACT STATEMENT <br />8. HEF�LTH DISTRICT <br />A?PLICATION ACC. BY PLANS CHECKEC <br />S <br />S <br />5 <br />VACANT SITE <br />CYES ::NO <br />IOAD <br />DATE <br />PEflM1T <br />TOTALFEE <br />< NUMBER F <br />FEE <br />FEES VALUATION <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTY <br />5 <br />� <br />f <br />S <br />�HECK FEE <br />RECEIPT NO. <br />FEE <br />$0 SO <br />TOTAL I I SO I 50 <br />PERMIT VALIOATION <br />WHEN PROPEPLY VALIDATED (IN TIj�S9S�?/LCE) THI I Opf�R ERMIT (� <br />SJ17 7/22/83 7 U� .���"•�O—' � <br />N <br />N <br />YOUR RECEIPT '� <br />tI;ANr Yn� <br />ADDRESS fllE <br />-�auc83 <br />1 <br />� <br />� <br />