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�he�.��RY�oF rflNSTRUCTION <br />everett PER��� PERMIT NO. �O66H <br />GTY HALL 259�8745 <br />eveaeTr. wn se2o� ❑ COMBINATION ❑ BUILDING Cx�xMECHANICAL ❑ PLUMBING <br />OWNER MAILF�I)R[55 CITY ZIP FHOHE <br />Rob Lund 3007 Panaview Blvd. Everett 96203 353-8282 <br />n�crutecT oa oesic�,en una nooa�ss aTv zia rHorie <br />GENERFL CONiPAGiOR MAIL ADDFE55 CITY ZIP PHOHE LILENSE 1 <br />Same <br />MECHANICAL GONiRACTOR MAIL AODRE55 QTY ZIP PHONE LICENSE I <br />PLUMOINGCONiRACTOR MAIIADDPE55 Cliv ZIP PNONE UCENSE/ <br />CLASS OF Y/ORK <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIfl ❑DEMOLITIQN ❑FENCE ❑SIGN ❑GARAGE <br />4 <br />USE <br />�EGPL DESGRIPTION OG PfiOPERTY (SMOn' �E101Y OR ATTAGR iOUR GOPIES� <br />N Sior-55 y��K_o� Beverly Hills Div. #3 <br />JOB AUUNIJS <br />6416 B Fleming Street <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />BATHiUB <br />KITCHEN SINK & DISP. <br />DISHWASHER <br />URINP�. <br />DFINKING FOUNT <br />FLOOR �RAIN <br />VACUUM riREAKE <br />ROOf DRAINS — <br />ciniv �cro�nrc — <br />SUViTOTAL <br />SIDE VARD SE7BACK STREET SE1BACf< <br />USE ZONE l07 AREA <br />NPE OF CONST. OCCUPANCY GRC <br />STORIES <br />L EM9RONMENTALCHECKLIST <br />2. BUILDWC PLANS <br />3, FlRE HVDRANT <br />4. F!RE PROTECTION SYSTEM <br />5. GRADING <br />6. DRAINAfE <br />7.ENVIRONMENTALIMPACTSTATEMENT <br />B. HEAL7H DISTRICT <br />APPLICATION ACC. �Y PtANS CHECKEO BY <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP� <br />PLICATION AND KNCW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br />PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THF pR0- <br />VISIONS OF ANY OTHER STATE OR LCCAL LAW REGULATING <br />CONSTRUCTION OR THE PE�3F�RMANCE OF CONSTRUC�IRN. <br />FEE N0. � TYPE OF EOUIPD <br />AIR COND. UNITS — H.R EA. <br />REFRiGERATION UNRS — M'.,'r. I <br />BOILERS — H.^. eA. <br />G�S FIRED A.0. UNITS — TONN <br />r FORCED AIR SYSTEAIS — B.T.U. <br />�� I WALL NEATERS — B.i.U. <br />—�� IIINITHFFTFRS—BT.U. <br />REAR YARG SETBACK <br />VACANT SITE <br />!1YE5 i:;NO <br />NO.OF DWELLING UP <br />MAX.00C.LOAD <br />FIHF SPRINKLERS <br />REOUIRED <br />�❑YES I'iN0 � <br />eV I DATE <br />APPR. FOR ISSUANCE BY <br />M <br />VENTILATION FAN <br />RANGEHOOD <br />AIR HANDLING UNIT — GF <br />SiOVE WOO$ <br />tAETAI FIREPLACE & CHIMNEY <br />NUMBER <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTY <br />TOTAL <br />SUBTOTAL <br />PEPMIT <br />TOTAL FEE <br />PLAN <br />FEE <br />5 <br />U.B.C. <br />SEC. 303 (a) <br />RECEIPT NO. <br />FEE <br />17 I 50 <br />PI70PERLY VALIDATED pN THIS SPACE) THIS IS YOUR PERMIT <br />Sals ;017.50 -- oRl <br />� <br />, � <br />YO�U'R ItEGrE1PT`� <br />THANk YOU <br />�t�;�,;,���s �::, - ;I 5 ,� 81 <br />