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�. :�E�� � �;ONSTRUCTIOl�, � <br />everett PERMIT PERMIT NO. 16187 <br />CITY MALL 20pl715 <br />�vEa�n, w" °a°� ❑ COMSINATION ❑ BUILDIN� I� MECHANICAL ❑ PLUM81N0 <br />M�IL �ODf E98 CItY 21P PNONE <br />John Mashburn 5532 F�nq Everett, WA 98203 355-2593 <br />MAIL AUDRESS CITY ZIP PNONE <br />�• � MAIL ADDRESB �IiY Z�V PXONE LICENBE � <br />CMM11C11L CONTIIACTqR MAIL ADORE55 CITY ZIP PHONE LICENBE t <br />Valley Naturai Gas 11323 Highway 99 Everett, WA 355-7730 VALLENG153Li <br />PLW�INO TOX MA1L �DDRESS GITY LP PXONE LICENBE / <br />❑ NEW ❑ ADDITION I] ALTEMTION O REPAIR O UEMOLITION D FENCE ❑ SIGN ❑ WOpD STOVEIFIHEPUCE INSERT <br />V1ILWTION OF WORN � <br />{ <br />Inetall Payne furnsce <br />PROPOSED UBE OF p���DINO <br />l0T_�BLOt:!c_._OF_ <br />ioe �o oness <br />bFi,'�3-Fleming S,S <br />PLUM6INO <br />NO• TYPE OF PIXT <br />WATER CLO;iEf (TOILET <br />BATHTUB <br />LAVATORY�WA=H BASII <br />SNOWER <br />KITCMEN SINK 8 DI•„P. <br />DISMWASMER <br />LAUNDRYTRAY <br />CLOTNES WASHER <br />WATER HEATER <br />URINAL <br />DRINKIN6 FOUNTAIN <br />FLOOR DHAIN <br />VACUUM BREAKERS <br />ROOF DMINS - MINL <br />SINK BERVICF — B�R <br />SUS TOTAL t <br />PERM�T f <br />TOTAL FEE S <br />1. ENVIRONMENTAL CMECK LIST <br />2 BUILdNa PLANS <br />3. FIRE MYDRANT <br />♦. FIRE PROTECTION SYSTEM <br />5. GMDING <br />8. DRAINAOE <br />7.ENVIRONMENTALIMPACTSTATEMENT <br />8. MEALTH DISTRICT <br />APPLICATION ACC. 8Y PLANS CMECKEU BY <br />M.M. <br />FEE <br />L'YES ❑NO <br />MA%. OCC. LOAD <br />FORISSUANCE <br />I HEREBY CERTIFY TFIAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW 1'HE SAME TO BE TRUE AND <br />CORRECT. A�L PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED W!TH <br />WHETHER SPECIFIED HEREIN OH NnT. THE GRANTING OF A <br />PERMIT DOES NOT PrlESUME TO GIVE AUTHORIN TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL �AW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF COtiSTRUCTION. <br />SIGNA�OI�TMC�OR Oq A�ff/�pIZED AOENT O�IE <br />X <br />MECHANICAL <br />NO. <br />AIR COND. UNITS — H.P. EA. <br />REFR�GERATION UNITS — H.P. EA. <br />BOILERS — H.P. EA. <br />QAS FIRED A.C. UNITS — TONNAGE EA. <br />FORCED AIR SYSTEMS — B.T.U.lOUI EA. <br />WALL HEATERS — B.T.U. M <br />UNIT HEATERS �- B.T.U. M <br />EVAPORATIVE CGOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANOEMOOD <br />AIR HANDLING UNIT — C.F.M. <br />STOVE — WOOD <br />METnL FIREPUCE 8 CHIMNEV <br />FIREPLACEINSERT <br />HEAT PUMP <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTY <br />TOTAL <br />PENMIT <br />TOTALFEE <br />FEE <br />S <br />3/7/86 <br />FEE <br />• 7 0 <br />: 10 0 <br />f 17 0 <br />Cr1ECY.FEE <br />RECEIPT NO. <br />FEE <br />17 50 <br />17 $0 <br />WHEN PROPERLV VALIDATED (IN THIS SPAC� THIS IS YqU PER�+ IT y=- <br />OiG4 4�� I �.SU -r.� <br />•r-� <br />(�l <br />lr� i � ry n I C��:'� '` i <br />�� .; i. I.�' L.. t_ I � <br />� �:r r�. <br />i . . .. :.� L.i U <br />ADDRE55 FILE - I �+%�H U b <br />