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die LccrRreen <br />��T� OF <br />everett <br />GTY HALL 259�8745 <br />�- CONSTRUCTIO!�' <br />PERMIT PeRMir No. 12299 <br />ErERETT,WA98707 ❑ CUMBINATION � BUILDING ❑ MECHANICAL ❑ PLUMBING <br />• �NEi MAILADOPESS dTY 21P PHONE , <br />Louis Hudson 4131 Federal Everett 98203 252-7448 <br />ARCMI'ELT OR OESIGNER MAIL ADDflE55 CITY ZIP PHONE <br />GENERPL GONTRqCTOR MRIL AOORE55 CITY 21P PNONE LIGENSE M <br />Same <br />MELHRNICA� CONTRAGTOR MRII AD�RE55 CITY 21P PHONE UCENSE Y <br />P�UMB NG CONTf1AGTOR MAIL AO�RE55 CITY 21P PMONE LICENSE M <br />❑ NEW ❑ ADDITION ❑ ALTERATION �REPAIR ❑ DEMOLI710N ❑ FENCE ❑ SIGN ❑ WOOD STOVE/FIREPLACE INSER7 <br />S 1700.00 <br />Re-roof Co <br />LOT__BLOCK 7 OF <br />50' of S 100' <br />ition <br />n <br />4131 Pedsrx7. <br />PLUF�:.tVf�� ,�..,.�_� <br />NU. I 'fYPE OF FIXTURE OR ITEM <br />b.. i MY� �' <br />{,AVATOHi (WASH BP.^.iN) <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISHN/ASHER <br />LF,UNDRY TRAY <br />WATER HEA7ER <br />UF.INAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BFEAKERS <br />ROOF DRAINS — FAINLC-AOERS <br />SUB TOTAL <br />PERMIT <br />TOTALFEE <br />OF <br />APPROVALS <br />1. ENVIFlONMENTAL CHECK LIST <br />2. BUILDING PLAIJS <br />3. FIRE MVDRANT <br />4. FIRE PROTECTION SYSTEM <br />5. GRADING <br />6. �RAINAGE <br />7.ENVIRONMENTALIMPACTSTATEMENT <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />COP:ES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNINti THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUMETO GIVE AUTHORITYTO VIOLATE <br />-- OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION CR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGN�AyT RE OF CONTflACTry+ OR AIITy� RRE� AGENT PATE <br />X ../ ..._ .F'i �/, _r.� „ 8/5/83 <br />S <br />:7YES '��NO <br />BY <br />LOA� <br />FOR ISSUANCE BY <br />MECIIANICAL <br />N0. TYPE OF EOUIPMENT <br />AIR GOND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — H.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA <br />FORCED AIR SYS7EM� — B.T.U. M EA. <br />WALL HEATERS — B.7.U. M <br />UNIT HEATERS — B.7.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES ORYERS <br />VENTILATION FAN <br />RANGEHOOD <br />AIR HANDLING UNIT — C.F.M. <br />STOVE — WOOD <br />METAL F:REPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />SUB TOTAL S <br />PERMIT S <br />TOTAL FEE f <br />FEE I FIECEIPT NO. <br />FEES I �A�UATION � FEE <br />BUILDING $ <br />PLUMBING <br />MECHANICAL <br />O7HER <br />PENALTY e <br />TOTAL I I 2 8 I O O <br />PENMIT VALIDATION � �p� � ��� ��iy � <br />WHEN PROPERLY VALIDATED (IN 7 S P E) THI I i IT <br />. • � <br />N <br />Yt�UR RECEIPT `� <br />� i 1.�lV K Y O U <br />ADDRESS FILE <br />- 5 auc 8 3 <br />