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• <br />`'"'`'���`�F r _ '^ONSTRU�'TIOP" <br />everett `' � <br />CITYHALL255�B7a5 PERMIT PERMIT N0. �.4120 <br />EVERE7T,WA98201 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNER MAILAO�RE55 CITY I�p PIIONE <br />Eldon Wexler P.O. Box 2676 Everett 98203 252-1234 <br />ARCHITECT OR OESIGNER MAIL APDRE55 LITY ZIP PNONE <br />GENERAL CONTqqCTOR MAIL ADDRESS dTY ZIP PMONE LICENSE N <br />MECHANICAL CONTflAGTOF MAIL ADDRESS CITY ZIF PMONE LICENSE M <br />G& 5 Heating Co. Inc. 500 East Main Monroe 98272 794-7306 <br />PLUMBING CONTRACTOR MAIL ADDRE55 CITY ZIP PHONE UCENSE M <br />GS FIE *1 90Me <br />CLASS OF WORK <br />❑ NEW O ADDITION <br />VAIUAT10N OF WORK <br />f <br />Install heat Pump <br />LOT__BLOCK_UF <br />6�09 7 <br />PLUMBING <br />TYPE OF FIXTURE OR I' <br />WATER CLOSET (TOILEn <br />BATHTUB <br />LAVATORY�WASHBASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />�ISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS — RAINLEADERS <br />SINK (SEfiVICE — BAR, ETC.1 <br />SUB TOTAL <br />TOTAL <br />APPROVALS <br />1. ENVIRONMENTAL CHECK LIST <br />2. BUIL�ING PLANS <br />3. FIRE HVDRANT <br />4. FIRE PRGTECTION SYSTEM <br />5. GRAOING <br />6. DRAINAGE <br />7.ENVIRONMENTALIMPACTS7ATEMENT <br />8. HEALTH DISTRIC7 <br />ACC. BY I PIANS <br />! <br />❑ ALTERATION ❑ REPAIR ❑ DEh10LITION O FENCE O SIGN O WOOD STOVE/FIREPLACE INSE'riT <br />I HEREBY CERTIFY THAT I F?.4VE READ AND EXAMINED THIS <br />FOURCOPIES) APPLICATION AND KNOW iHE SAME TO BE THUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WqRK WILL BE COM"LIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS UF ANY OTHeR STPTE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />�T riE OF CONTqALTOR OR AUTMORI2ED AGENT DATE <br />_ . _ ) . . � �. A 7 1 /5 /Ad <br />FEE <br />S <br />S <br />s <br />VACANT SI7E <br />GYES LNO <br />OCQ LOAD <br />DATE <br />ISSUANCE BY <br />NO. <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERAT�ON UNITS — H.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE Fp, <br />FORCED AIP. SYS7EM5 — B.T.U. M[A. <br />WALL HEATERS — B.T.U. M <br />UNI7 HEATERS — B.T.U. AI <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />AIN HAN�LING UNIT — C.F.M. <br />S70VE — WOOD <br />METAL FIREPLACE 8 CHIMNEY <br />FII7EPLACE INSERT <br />HEAT PUMP <br />SUB 70TAL <br />PEflMIT <br />TOTAL FEE <br />(NUMBER I <br />FEE <br />FEES VALUATION <br />BUILDING <br />PLl1MBING <br />MECHANiCAL <br />O7HER <br />PENALTY <br />3 <br />SEC. <br />FEE <br />S <br />S <br />S 18 OC <br />:HECK FEE <br />REGEIPT NG. <br />FEE <br />18 0 <br />TOTA� � � ia po <br />PERMIT VALIDATION <br />WHEN PROPERLV VALIDATED pN THI�S SPACE) THISAS;YO�1fpPERhIIT_ �f <br />, . :: 1 ,.. �:; I 0. �1 U �v <br />�-� <br />� . . , . , 1 i' I `....� <br />, U <br />ADDK��S �ILE <br />- ; . : �' � . <br />z <br />O <br />� <br />� <br />c� <br />m <br />.. «. <br />--I 'n <br />.. -� <br />N S <br />m <br />v <br />co <br />m o <br />n <br />—1 C <br />O � <br />m <br />-i z <br />S -i <br />m <br />� <br />�C � <br />D --I <br />r x <br />H I--I <br />� Cn <br />-G <br />O � <br />T 2� <br />3 <br />= m <br />m� <br />N <br />v <br />o r <br />c� m <br />� N <br />m <br />�r <br />� m <br />A <br />� <br />� <br />2 <br />n <br />z <br />� <br />x <br />� <br />Z <br />O <br />--i <br />�--i <br />c"f <br />m <br />� <br />