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�hc £vergreen <br />��r� oF <br />everett <br />CITY HALL 259�8745 <br />� �ONSTRUCTIO�' <br />PERMIT <br />PERMIT N0. 15612 <br />EVERETT,WA98201 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL � PLUMBING <br />OWNER MAILADORE55 CITY 21P PHONE <br />Giles Shepherd 3312 Federal Aveaue Everett 98201 252-7849 <br />AflCMITECT OR OESIGNEP MAIL ADDRE55 GITY ZIP PHONE <br />GENEflAL CONTflACTOF MAIL ADDRE55 CITY ZIP PHONE LICENSE II <br />MECHANICAL CONTRACTOF MAIL AODRE55 CITY 21P PHONE LICENSE M <br />PLUMBING CANTRACTOR MAIL AOORE55 CITY ZIP PHONE LILENSE N <br />Natural Energy Systems, Znc. 15405 53rd Avenue South Seattle 96188 431-1700 <br />CLA55OFWORK rrI�I�RE � oM <br />� NEW ❑ ADDITION ❑ ALTERATION O REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGNA v w oo stoVHFIREPLACE INSERT <br />s <br />Installaticn of <br />Single Family Residence <br />25-26-27 784 Everett Division H <br />l0T_BLOCK_OF <br />3312 Federal Avenue <br />PLUMBING <br />NO. � TYPE OF FI%TURE OR <br />W ATEH CLOSET (TOILEn <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISHWASHER <br />LAUNDRYTRAV <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF DRA�NS - RAINLEADERS <br />SINK ISERVICE - BAFi. ETC.1 <br />SUB TOTAL <br />PEHMI7 <br />TOTALFEE <br />OF S70RIE5 <br />FIRE <br />1. ENVIRONMEN7AL CHECK LIST <br />2. BUILDING PLANS <br />3. FIRE HYDRANT <br />4. FIRE PRO7ECTION SYSTEM <br />5. GRADING <br />6. DRAINAGE <br />7.ENVIRONMENTALIMPACTSTATEMENT <br />8. HEALTH DISTRICT <br />FEE <br />I HEREBY CERTIFY THAT I HAVE 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 />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUMETO GIVE AUTHORITY TO VIOLATE <br />OR GANCEL THE PROVISIONS OF ANY OTHER STPTE OR <br />LOCAL LAW REGULA'fING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGNATUREOFCONTRACTOflORAUTHOflIZEDAGENT UATE <br />X Check #3680 10/22/85 <br />MECHANICAL <br />NO. TYPE OF EOUIPMENT FEE <br />i L 00 <br />f 3 00 <br />f <br />REAR YARD SETBACK PLAN <br />VACANT SITE <br />�YES ;=NO <br />MAX. <br />--Y�ES ❑�NO <br />BY I OATE <br />FOR ISSUANCE BY <br />AIR COND. UNITS - H.P. EA. <br />REFRIGERATION 11NITS - H.P. EA. <br />BOILERS - H.P. EA. <br />GAS FIRE� A.C. UNITS - TONNAGE EA. <br />FORCED AIR SYSTEMS - B.T.U. M EA. <br />WALL HEATERS - B.T.U. M <br />UNIT HEA7ER5 - B.T.U. M <br />EVAPOFA7IVE COOLERS <br />CLOTHES DRVERS <br />RANGEHOOD <br />AIR HANDLING UNIT - C.F.M. <br />STOVE - WOOD <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />SUB TOTAL S <br />PERMIT S <br />70TAL FEE f <br />FEl I PECEIPT NO. <br />FEES I �A�UATION I FEE <br />BUIL�ING $ <br />PLUMBING S 00 <br />MEGHANICAL <br />OTHER <br />PENALTY U.B.C. <br />SEC. 303 (a1 <br />TOTAL S OJ <br />PERMIT VALIUATION <br />WHEN PROPERLY VALIDA7ED (IN THy �I 6 OE) THIS_I�YQI�i P�y[AIT !�j <br />a u5 u � <br />ADDRESS �ILE <br />� <br />(�1 <br />'�'; . ' ; (.; C r I PT �- ; <br />�'�'i;J.i: 1': U <br />; ;) uL'T & 7 <br />z <br />0 <br />� <br />� <br />m <br />�� <br />M � <br />�n x <br />v <br />m <br />c o <br />mo <br />n <br />� C <br />o� <br />i� <br />m <br />.o z <br />C <br />a -i <br />rx <br />.-� .. <br />� N <br />� <br />O 7� <br />'*1 > <br />3 <br />=m <br />mN <br />o r <br />c� m <br />C N <br />m N <br />� I'n" <br />. m <br />a <br />A <br />-1 <br />2 <br />a <br />z <br />� <br />x <br />.. <br />N <br />Z <br />O <br />� <br />.-� <br />(7 <br />m <br />