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_ -t <br /> rNc E�•r,Arccir <br /> ��TY°� ��ONSTRIJCTlO � � <br /> everett PERMIT PERMIT N0. �-4�.34 <br /> CITV HALL 259�tl7d5 <br /> EVERETT,WA 982C1 ❑ COMBINATION ❑ BUILDING �c MECHANICAL ❑ PLUMBIP:� <br /> OWNEN MAIL AD�RESS CITV <br /> Howard Moore 5201 College Everett Z" PHONE <br /> 98201 297-0257 <br /> ARCMITECT OR OESIGNER MAIL ADORE55 CITY ZIP <br /> � ��a��� <br /> GENERA�CONTRAGiOR MAILADORESS CITY ;IP PHONE <br /> IICENSE r <br /> MECHANILAL CONTpACTOfl MPIL A�DRESS LRV 21P PHONE LICENSE M <br /> Valley Natural Gas 519 S.E. Everett Mall Way Everett <br /> 355-7730 <br /> . PLIIMB'�If. :ONTRACTOR MAIL ADOqESS CIlY ZIP PHONE <br /> UCENSEI <br /> GLASS OF WOPK � <br /> O NEW O ADDITION ❑ ALTERATION ❑REPAIR O OEMOL�TION ❑ FENCE ❑ SIGN ❑ WOOD S70VFJFIREPLPCE INSERT <br /> YAWATION OF WORN <br /> S <br /> DCSCRI9E WJiK <br /> I.�stall forced air system <br /> PflOPO5E0 USE OF BUILDING <br /> I HEREBY CEFTIFY THAT I HAVE READ AND EX4MINED THIS <br /> LEGAL�ESCRIPfIONOFPROPERTY�5MJIVBELOWORATTACMFOURCOPIES� APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> CORRECT. ALL PROV�SIONS OF LAWS AND ORDINANCES <br /> �or_e�ocK_oF_ GOVERNING THIS TYPE OF WORK WILL BE CUMPLIED W�TH <br /> WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUNiE TO GIVE AUTHORITY TO V�OLATE <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br /> LOCAL LAW REGUL/1TING CONSTRUCTION OR THE <br /> �oe nooaess '- - -'--' PERFO ANCE OF CON T T FJ. <br /> 5201 College SIGN OF GO T RI AGENT� DATE <br /> .. � . __..___.._.._..__ / 1�,�6/84 <br /> PLUMBING C NICA� <br /> NO. TYPE UF FIXTVRE OR ITEM FEE NO. TY EOUIPMENT FEE <br /> WATERGLOSET(TOII.En AIR COND. NI75— H.P. EA. <br /> _ BATHTUB REFRIGERA7ION UNITS— H.P. EA. <br /> LAVATORY(WASHBASIN) 601LERS — M.P. EA. <br /> _ SHOWE(i GAS FIRED A.C.UNITS— TCNNAGE EA. <br /> _ KITCHEN SINK 8 DISP. 1 FORCED AIR SYSTEMS— e.T.U. M EA. 6 00 <br /> DISHWASHER WALL HEATERS— B.T.II. M <br /> LAUNDRYTRAY UNIT HEATERS— B.T.U. M <br /> CLOTHES WASHFR EVAPORATIVE COOLERS <br /> WATER HEATER CLOTHES DRYERS <br /> URINAL VENTILATION FAN <br /> ORINKING FOUNTAIN PANGE HOOD <br /> FLCOR DRAIN AIR HANDLING UNIT— <br /> VAWUM BREAKERS QF.M. <br /> STOVE—WOOD <br /> _ ROOF DRAINS— RAINLEADERS METAL FIREPLAf:E 8 CHIMNEY <br /> SINK�SERVICE — BAR, ETC.) FIREPLAGE INSERT <br /> — HEAT PUMP <br /> SUB TqTAL f SUB TOTAL 5 6 00 <br /> PERMII' S PERMIT = <br /> 70TAL FEE f TOTAL FEE f 16 00 <br /> SIDE YARD SETBACK STREET SETBACK REAH YARD SETBqCK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE � RECEIPT ND. <br /> USE ZONE LOT AREA VACANT SITE <br /> �, IYES : :NO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANGY GFOUP NO.OF DWELLING UNITS <br /> SIZE OF BLDG. NO.OF S70RIES B111L�ING E <br /> MA%.00Q LOAD <br /> PLUMBING <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS <br /> R�ESIREDNO MECHANICAL 16 00 <br /> �„ APPROYAlS BY DATE O7HER �.� <br /> 1.ENVIRONMENTAL CHECK LIST P:NALTY U.B.C. <br /> 2.BUILDING PLANS SEC.303(al <br /> 3.FIR[MVDFANT TOTAL 16 OO <br /> 4.FIRE PROTEC710N SYSTEM PERMI7 VALIDATION <br /> 5.GRADING WHEN PR�JPERLY VALIDATEO�IN THIS SPACE)THIS IS YOUR PERMIT � <br /> 6.DRAINAGE ' _ . '�' � �.. R i.l _ M� <br /> I I ` C <br /> 7.ENVIRONMENTALIMPACTSTAtEMEN � � � �� � <br /> B.HEALTH DISTHICT � <br /> APPLICATION ACC.BY PLANS CHECKED BY APpR. FOR ISSUANCE BY n;��+ � � - �'-I <br /> i <br /> /�U�:�i�'$S ���� -- ., f . . <br /> k� <br />