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UieE�•e�rTYre�n ; CONSTRUCTIf�'-� <br />everett PERMIT PERMIT NO. 14605 <br />GTY HALL 259�8745 <br />EVERETT, WA 98201 ❑ COMBINATION ❑ BUILDING �'k MECHANICAL ❑ PLUMBING <br />YX <br />OWHER MAILADDFE55 CITY 21P PMONE <br />Virgil Parcels 5105 Dogwood Drive Everett 98204 <br />APGHITECT OR DESIGNER MAIL ADOflE55 CITY 21P PHONE <br />GENERnL CONTRAGTOR MFIL ADDRESS CIiY ZIP PMONE LICENSE � <br />MECNANICRL CONTRACTOR MAIL AOORE55 LITY ZIP PMONE UCENSE • <br />Natural Gas Equipment 1625 East Marine View Drive Everett 96201 258-2441 <br />PLUMBING WNTHAGTOR MAIL ADORE55 GITY 21P PMONE 4CENSE M <br />s <br />USE <br />❑ NEW ❑ ADDITION ❑ ALTERATION O REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD 5'fOVFJFIREPLACE INSERT <br />LOT _ BLOCK _OF _ <br />JOB A�ORlSu <br />5105 Dogwood Drive <br />PLUMBING <br />TYPE OF FIXTURE OR ITEM <br />WA7ER CLOSET (TOILEn <br />BATHTUB <br />LAVATORY (NASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 01! <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS — RAINLEADERS <br />SINK ISERVICE — BAR, E7C.) <br />PERMIT <br />TOTAL FEE <br />BLDG. INO. <br />ZONE <br />7. ENVIRONMENTAL CMECK LIST <br />2. BUILOING PLANS <br />3. FIRE HYDRANT <br />4. FIFE PROTECTION SYSTEM <br />5. GRADING <br />6.ORAINAGE <br />?.ENVIRONMENTALIMPACTSTATEMENT <br />e. HEFLTH DISTfiICT <br />aPPLICATION ACC. BY PLANS CHE <br />FEE <br />f <br />S <br />S <br />VACANT SIT[ <br />�.:YES .:NO <br />BY <br />FOR <br />LOAD <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 />WHETHEA SPECIFIED HERcIN 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 CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE NT .TOR OR AUTMOFIZED AGENT DATE <br />X ��.... 3/20/85 <br />MECHANICAL <br />NO. TYPE OF EOUIPMENT FEE <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — H.P. EA. <br />BOII.ERS — M.P. EA. <br />GAS FIRED A.C. UNIT$ — TONNAGE EA. <br />FORCED AIR SYSTEMS — B.T. M EA. 7 SO <br />WALL HEATERS — B.T.U. M <br />UNIT MEATERS — B T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES �RYERS <br />VENTILATION FAN <br />RANGEHOOD <br />AIR HANDLING UNI7 — C.F.M. <br />STOVE — WOOD <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />SUB TOTAL f <br />PERMIT S <br />TOTAL FEE S <br />PLAN CHECK NUMBER I PLAN <br />FEE I PECEIPT NO. <br />FEES I VALUATION I FEE <br />BUILDING E <br />PLUMBING <br />MECHANICAL 17 <br />OTHEP <br />U.B.C. <br />PENALTY SEC. 30J (al <br />TOTAL I I 17 SO <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) 7HIS,IS YOUR PF:aMIT U7 <br />� i '__c� <br />:.� <br />�' <br />.. . c—{ <br />BY � I <br />r1DDRC-55 FIL[ <br />i <br />z <br />0 <br />-� <br />c <br />m <br />... ., <br />-i �t <br />�1 <br />�' m <br />v <br />ro <br />rn � <br />-� c <br />O 3 <br />m <br />S 1 <br />m <br />� <br />C 2 <br />r 2 <br />M F�1 <br />�--� N <br />{ <br />-r� <br />O 7� <br />�a <br />a <br />-� m <br />x <br />m� <br />N <br />0 <br />o r <br />c� m <br />C N <br />3 tn <br />m <br />2 C� <br />-i r <br />. m <br />a <br />A <br />�--I <br />2 <br />Y <br />Z <br />--1 <br />2 <br />N <br />z <br />0 <br />� <br />n <br />m <br />