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dre Errr,ercen <br />everett � CONSTRUCT IO� � P`Rtiiir No. 14329 <br />PERN►!. <br />CITY HALL 259�8745 <br />EVERETT. WA99207 ❑ COMBINATION ❑ BUILDING �x.+c MECHANICAL ❑ PLUMBItJG <br />OWNEP IAAIL ADOPE55 GTV 21P PMGNE <br />Carol Evans Wickenkamp 5818 East Drive �erett 98204 <br />ARCHITELT OR DESIGNER MAIL ADDRESS GITV ZIP PMONE <br />I GENERAL CONTRACTOR MI IL ADORE55 CITY 21P PHONE LIGENSG I <br />MEGMANIC4L LONTRAGTOR MAI� AOONESS CITY 21P PHONE LILENSE Y <br />Same <br />PLUMBING CONTRAGTON MAIL A�DRE55 LITY ZIP F�DNE LICENSE I <br />❑ NEW O ADDITION ❑ ALTERA710N ❑ REPAIR ❑ DEMOLI710N ❑ FENCE ❑ SIGN ❑ WOOD STOVFJFIREPLACE INSERT <br />f <br />PROPOSED USE OF BUILDING <br />LOT_BLOLK_OF <br />581�3 East Drive <br />PLUMBINC <br />TYPE OF FIXTURE OR ITEM <br />BATHiUO <br />LAVATORV pNASH BASIN) <br />SHOWFR <br />KITCHtN SINK d DISP. <br />LAUNDRYTRAY <br />C�OTHES WASHEF <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACWM BREAKERS <br />ROOF DR:.INS -- RAINLEADERS <br />SINKISERVICE — BAR,ETC.) <br />TYPE OF CONST. <br />FIHE <br />SUB TOTAL <br />PENMIT <br />TO7AL FEE <br />LOT <br />NO. OF STORIES <br />APPROVALS <br />t BNVIRONMENTAL CHECK UST <br />2. BUILDINCa PLANS <br />3. FIRE HVDRANT <br />4. FIRE PROTECTI(IN SYSTEM <br />5. GRADING <br />6. DRAINAGE <br />7.ENVIRONMENTALIMPAi.TSTA7EMENT <br />8. HEAl1H DISTRICT <br />4PPLICAT�ON ACC. BY �LANS CHE <br />FEE <br />5 <br />S <br />f <br />ACAN7 SITE <br />YES NO <br />MA%.000. LOAD <br />BY <br />BY IAPPR.FOR <br />I Hf_REBY 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 />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRCSUME TO GI VE AUTHORITY TO VIOLATE <br />OR CANCE� THC PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANC� OF CONSTRUCTION. <br />vGGNA� E O�GONT� 0� UT 0� AG� pATE <br />n wi..�.C. � � <br />MECHANICAL <br />N0. TYPE OF EOUIPMENT FEE <br />AIR COND. UNITS — H.P. EA. <br />REFFIGERATION UNI7S — H.P. EA. <br />BOILERS — H.N. EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />FORCED AIR SYSTEMS — B.7.U. M EA. <br />WALL HEATERS — B.T.U. M <br />UNIT HEATER$ — B.T.U. M <br />EVAPORATIVE COOLERS <br />GLOTHES DRVERS <br />VENTILATI(1N FAN <br />RANGEHOOD <br />AIR HANDLING UNIT — C.F.M. <br />S70VE — WOOD <br />METAL FIREPLACE 8 CHIMNEY <br />1 FIREPLnCEINSERT 7 SO <br />HEAT PUMP <br />SUB TOTAL S <br />PERMIT S <br />TOTAL FEE S <br />PLAN CHECK FEE <br />FEE I RECEIPT NO. <br />VALUA710N FEE <br />BUILDING S <br />PLUMBING <br />MECHANICAL 17 SO <br />OTHER <br />PENALTY U.B.C. <br />SEC. 903 (a) . <br />TOTAL 1% SO <br />PERMIT VALIDATION J� <br />WHEN PROPERLV VALI�ATED pN 7HISI,ShAC�) THIS �S YOpR�P,EFiM1T Q'� � <br />N <br />M <br />, i 1� <br />r-: <br />ADDRE55 FILE <br />L <br />J <br />� <br />� <br />� <br />