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� <br />v <br />nc� Evergreen C O IV ST R U CT I O`1 <br />uTr oF r <br />everett P ER M IT <br />GITY HALL 259�8745 <br />EVERETT, WA 98201 ❑ COMBINATION � BUILDING ❑ MECHANICAL <br />� OWNER MAIL <br />Robert C. Bibb 3624 Federal <br />� <br />Everett <br />PERMIT NO. 13252 <br />❑ PLUMBING <br />N <br />IiGNtHML l.V rv 1 �1P�.1 V n ... . <br />Riverside Roof Company 2916 State Street Everett 98201 258-46 6 <br />MAIL AD�RESS CITY 21P PHONE LICENSE N <br />MECHANICALCONTRACTOP ��`j� �'3OZ TO <br />PLUMBING CONTPACTOR MAIL AUOPESS CITY 21P PHONE LICENSE N <br />❑ NEW ❑ AODITION O ALTERATION C�iEPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSER7 <br />f 3,640.00 <br />re-roof <br />L0��17 BLOCK <br />3624 Federnl <br />PLUMBIN6 <br />NO. TYPE OF FIXTURE OR <br />WATERCLOSET(TOILEn <br />BATHTUB <br />:HOWER <br />DISP. <br />�AUN�RVTHAV <br />CLOTMES WASHER <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUl1M BREAKERS <br />ROOF DRAINS — RAINLEADERS <br />SINK ISERVICE — BAR, ETC.) <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />1. ENVIRONMENTAL CHECK LIST <br />2. BUILDING PLANS <br />3. FIRE HVDRANT <br />4. FIHE PROTECTION SYSTEM <br />5. GRADING <br />6. DHAINAGE <br />7.ENVIRONMENTALIMPACTSTAI <br />8. HEALTH DISTRICT <br />eaa� icA710N ACC. BY PLA <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />OFATTACHFOUHCOPIES) 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 />L�OCAL LAW H EGU�LATINGS �ONSTRUCTION SOR THE <br />PERFORMANCE OF CONSTRUCTION. onre <br />SIGNATURE OF CONTRACTOH Ofl AUTMORIZED AGENT <br />S <br />S <br />f <br />iiYES ❑NO <br />;=YES <br />FOR <br />MECNANICAL <br />N0. TYPE OF EUUIPMENT <br />AIR COND. UNITS — H.P. EA. <br />FEFRIC[RA?�ON UNITS — H.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIRED A.0 l�N1T5 — 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 DRVEFiS <br />VENTILATION FAN <br />RANGE HOOD <br />AIR HANDLING UNIT — C.F.M. <br />STOVE — WOOD <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />FEE <br />SUB 70TAL S <br />PERMIT S <br />TOTALFEE S <br />� NUMBER PLAN CHECK FEE <br />FEE RECEIPT NO. <br />FEES VALUATION FEE <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTY <br />TOTAL <br />$3,640. <br />44 I50 <br />.��m„ .�"��„�.. � � p � <br />WHEN PROPERLY VALIDATED (IN THIiS UP�GI 1 7HI $�Y IUji P€R�11T ' 1 <br />tl I U 4 7 U <br />N <br />(17 <br />, ••� �..��rlPl �-� <br />,. �.._� <br />BY <br />:'"°,: YC, U <br />ADDRESS FILE <br />I 9 1,r,t 8 � <br />� <br />