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- � <br /> ,., <br /> :� . <br /> Ihe ErrrArern <br /> a,r c; 'A1�IY1 ;r++y O 1 Y�7 1 Il��' 1 I O 1'ii4 ,.,..... <br /> everett pERMIT PERMir No. 13616 <br /> CITY HALL 259�87a5 <br /> EVERE7T,1NA9B201 � COMBINATION ❑ BUILDING � MECHANICAL ❑ PLUMBING <br /> 01'lNER MAIL ADDRE55 <br /> CITY ZIP PMONE <br /> Clara G. Quick 707 Crown Drive Everett 98204 252-5278 <br /> ARGMITECT Ofl DESIGNER MAIL ADDRE55 �ITY ZIP PHONE <br /> GENEflAL CONTRAGTOR MAIL ADDRESS CITY ZIP PMONE LICENSE N <br /> Valley Natural Gas 519 S.E. Everett Mall Way Everett 98204 353-3535 <br /> MEGMANICAL CONTRqLTOR MAIL AD�RE55 GI7Y ZIP PMONE LICENSE Y <br /> PLUMBING GONTRACTOR MAIL q00flES5 CITY ZIP PHONE LICENSE M <br /> CLA55 OF W ORK � <br /> ❑ NEV: ❑ ADDITION ❑ ALTERATION ❑REPAIR ❑ DEMOLITION O FENCE ❑ SIGN ❑ WOOD STOVE/FIREPLACE INSERT <br /> VALUATION OF WORK <br /> f <br /> DESCRIBE WORK <br /> install gas fired fu- .ace <br /> PROPOSED USE OF BUILDING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> LEGAL�ESCRIPTION OF PROPERTY�SNO1Y BELOW OR ATTACH FOUR COPIES� APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> LOT__BLOCK_OF GOVEFNING 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 VIOLATE <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br /> LOCAL LAW REGULATING CONSJRUCTION OR THE <br /> JOBADDRE55 PERFORM E OF CONSTRUC 0 <br /> 707 Crown Drive SIGNATURE NT TO �f}OH �ATE <br /> � X � � 7/10/84 <br /> PLUMBING MECH ICA ,./� <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF �UIPMENT FEE <br /> WA7ERCLOSET�TOILEn AIR COND.UNIT – H.P.EA. <br /> BATMTUB – <br /> — REFRIGERATI N UNITS – H.P. EA. <br /> LAVATORY�WASH BASIN) BOILEFS– H.P. EA. <br /> SHOWER GAS FIqED A.C.UNI75 – TONNAGE EA. <br /> KITCHEN SINK 8 DISP. 1 FORCED AIR SYSTEMS– B.T.U. M EA. <br /> DISHWASHER <br /> WALL HEATERS– B.T.U. M <br /> LAUNDRYTRAY . <br /> UNI7 HEATERS– B.T.U. M <br /> CLOTHES WASHER <br /> EVAPORATIVE COOLERS <br /> WATER HEATER CLOTHES DRYERS <br /> URINAL <br /> VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN AIR HANDLING UNIT– C.F.M. <br /> VACUUM BREAKERS STOVE – <br /> w000 <br /> ROOF ORAINS– RAINLEADERS METAL FIREPLACE 8 CHIMNEY <br /> SINK�SERVICE– BAR,ETC.) FIREPLACEINSER7 <br /> HEAT PUMP <br /> SUB TOTAL i SUB TOTAL S 6 00 <br /> PENMIT S PERMIT S <br /> TOTAL FEE S 701AL FEE S 16 00 <br /> SIDE VARD SETBACK STREE7 SETBACK REAR YARD SETBACK PLAN GHECK NUMBER PLAN CHECK FEE <br /> FEE RECEIP7 NO. <br /> USE 20NE LOT AREA VACANT SITE <br /> ;:YES ;:NO FEES VALUA710N FEE <br /> TYPE OF CONSi. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> SIZE OF BLDG. NO.OF STORIES MA%.OCC. LOAD BUILDING g <br /> PLUMBING <br /> FiRE ZONE BASEMENT FIRE SPRINKLEPS <br /> REOUIRED MECHANICAL 7.6 00 <br /> -YES ��. :NO <br /> APPROVALS BY DATE OTHEq <br /> 1. ENVIRONMENTAL CHECK LIST U.B.C. <br /> 2.BUILDING PL:.NS PENALTY SEC.303(a) <br /> 3.FIPEHYDRANT TOTAL 16 00 <br /> 4.FIRE PROTECTION SYSTEM PERMIT VALIDATION <br /> 5.GRADING WHEN PROPERLY VALIDATEO(IN THI�SPA�)THISQS��Ud P�R.CIT (�J <br /> 8.DRAINAGE — " <br /> 7.ENVIRONMENTALIMPACTSTATEMENT (D <br /> 8.HEALTH OISTRICT , n -.,^�-'n� (Y) <br /> APPLICATION ACC. BY PLANS CHECKED BV APPR.FOR ISSUANCE BY � � ,� �� 'i`� � � T"� <br /> ,:d� `;'�. U <br /> � !i •'�L u ! <br /> ADDRESS FILE <br />