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�he Evergreen <br />CIIY OF <br />�- everett <br />CITV HALI 259�8745 <br />EVERETT, WA 98201 <br />� -� - ;ONSTRUCTIOP' <br />PERIIAIT <br />❑ COMEINATION ❑ BUILDING � MECHANICAL <br />PERMIT NO. 1545� <br />❑ PLUMBING <br />OWNER �OHN LOVEHIK 6202 F1"��ii�Ess — Evc�'r�ett WA 9820�'P 54�'=�g%1 <br />ARCHITECT OR DESIGNER MAIL AO�RESS CITY ZIP PHONE <br />GENERRL CONTRACTOR MAIL AOORESS GITY ZIP PHONE LICENSE I <br />MECMANICAL CONiRACTOR MAIL AOORE53 QTY ZIP PHONE UCENSE I <br />Natural Gas Equipment 1625 E. Marine View Drive Everett 98201 258-2441 <br />PLUMBING fANTFACTOR <br />MAIL ADOPESS CITY 21P PMONE LIGENSE N <br />f <br />I� NEW O ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE O SIGN ❑ WOOD STOVFJFIREPLACE INSERT <br />WV111� <br />:nstall gas-fired conversion burner and hot water heater <br />Residence <br />LOT�BLOLK_OF <br />6202 Fleming <br />PLUMBING <br />TYPE OF FIXTURE OR <br />WATER CLOSET (TOILEn <br />BATHTUB <br />SHOWER <br />KITCHEN SINK & DISP. <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />WATEF HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />HOOF DRAINS - RAINLEADERS <br />SINK (SERVICE - BAR, ETQ) <br />SUB TOTAL <br />PENMIT <br />7pTAL FEE <br />NO. OF <br />t. ENVIRONMENTAL CHECK LIST <br />2. BUILOING PLANS <br />3. FIRE HYDRAN7 <br />4. FIRE PROTEGTION SYS7EM <br />5. GRAOING <br />6. DRAINAGE <br />7.ENVIRONMENTALIMPACTS7A1 <br />ACC. <br />S <br />f <br />PEAR YARD S <br />VACANT SITE <br />['YES ❑NO <br />NO. OF DWEL <br />MAX. OCC. lC <br />FIRE SPRINKI <br />REOUIRED ^ <br />APPR. FOR <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 PRESUME TO GIVE AUTHORITY TO VIOLAI'E <br />OR CANCEL THE PROVISIONS OF ANY OTHER STPTE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />cifr�nTUREOF CONTF3BGTOfi OP AUTHOHIZED AGE9T UATE <br />N0. l"i PE OF E�UIP�7ENi <br />AIR COND. 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 SYSTEMS - B.T.U. M EA. <br />WALL HEA7ERS - B.T.U. tii <br />UNIT HEATERS - B.T.U. M <br />EVAPORATIVE COOLERS _ <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />AIR HANDLING UNIT - C.F.M. <br />STOVE - WOOD <br />METAL FIREPLHCE & CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP _ <br />SUBTOTAL <br />PERMIT <br />TOTALFEE <br />;NUMBER F <br />FEE <br />FEES VALUATION <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTY <br />S <br />303 <br />9/20/85 <br />FEE <br />f �Q OQ <br />S �9 �0 <br />CHECK FEE <br />RECEIPT NO. <br />FEE <br />19 00 <br />TOTAL � 9 �� <br />PENMIT VALI�ATION � ���� THIS��'¢�.�g���"— � <br />WHEN PROPERLY VALIDATED (IN THI � <br />�' <br />Yi� U P. RGCEIPT � <br />BY TI-lAI�K YOU <br />ADDRESS FIL� <br />2 p stP � 5 <br />z <br />1 <br />� <br />m <br />... .. <br />�� <br />.. ...i <br />N S <br />m <br />co <br />m� <br />03 <br />1 z <br />x� <br />m <br />.o z <br />c <br />a -i <br />rx <br />H � <br />� N <br />< <br />� <br />O 7e <br />�1 D <br />3 <br />-i m <br />2 <br />m .+ <br />N <br />O <br />o r <br />c� m <br />C N <br />3 �n <br />m <br />Z n <br />�r <br />• m <br />D <br />� <br />� <br />2 <br />a <br />Z <br />--1 <br />S <br />rv-i <br />N <br />2 <br />O <br />1 <br />n <br />m <br />