Laserfiche WebLink
4� <br />!hp EcPr�;reen <br />everett �a��TRU�TIOf� <br />CITYHALL259�8745 PERIOIIIT PERMIT N0. 14�J5� <br />EVERETT, WA 9820! � COMBINATION ❑ Bl'ILDING ,�,�1 MECHANICAL ❑ PLUMBING <br />OWNEH I.iFILADBRE55 CIiY ZIP PHOHE <br />Round Table Pizza 237 North %BRXM 143rd Seattle 98133 367-4884 <br />ARGNItEGT Ofi �ESIGNER MAIL A�DRE55 CITY Z�P PHONE <br />GENERAL GONTRACTOF Mn'L ADORESS CITY ZIP PHONE LIGENSE x <br />MEGHANICAL GONiRAGTOR MAIL A�OdE55 CITY ZIP PHONE UCENSE X <br />Pacific Coast Plumbinq ;� Heatinq 9421 16th Av n� G W Geattle 98106 762-2154 <br />PWMBING GONTPACTOR MAIL ADf1PE55 CITV ZIP PHONE UCENSE � <br />❑ NEW ❑ ADOITION ❑ ALTERATION ❑ REPAIR O OEAIOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSEFiT <br />S <br />LOT_BLOCK__OF <br />S,E, Everett Mall Way <br />PLUMRING <br />NO. TYPE OF FiXTURE OR <br />WATER CLOSET (TOI LEn <br />BATHTUB <br />LAVATORY(WASHBASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISHWASHER <br />LAUNDFVTRAY <br />CLOTHES WASHER <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR 7RAlIJ <br />VACUUM BREAKERS <br />ROOF GPAINS — RAINLEADERS <br />SINK (SERVICE — BAR, ETC.) <br />PEflMIT <br />TOTAL FEE <br />APPflOVALS <br />1. ENVIRONMENTAL CHECN LiST <br />2. OUIL�ING PLANS <br />3. FIRE HYDRANT <br />d. FIRE PROTECTION SYSTEM1I <br />5. GRADING <br />ti. DRAINAGE <br />7. ENVIFONMENTALIMPACTSTATI <br />8. HEALTH �iSTRICT <br />APPLICATION ACC. BY PLAP <br />I HEREBY CERTIFY THAT i HAVE READ AND EXAMINED THIS <br />GOPIES� APPLICATION AND KNOW THE SAtv1E 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 PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STPTE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF COIJRACTOR OR AU��ORpED AGEWi �qTE <br />S� <br />REAR VARD SETBACN <br />VACANT SITE <br />YES : NO <br />NO. OF DWELLING UN <br />MA%.00C.LOAD <br />FIRE SFRINKLEFS <br />REOUIPED <br />VES . NO <br />BY DATE <br />APPR.FOR <br />_X Cy%a� i� n� <br />MECnANICAL <br />N0. TYPE OF E�UIPMENT <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERATION 11NITS — H.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />WALL HEATERS — B.T.U. M <br />UNIT HEATERS — O.7.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />AIR HANDLING UNIT — C.F.M. <br />STOVE — WOOD <br />METAL FIP.EPLACE 8 CHIMNEY <br />FIREPI.ACE INSERT <br />HEAT PUMP <br />SUB TOTAL 5 <br />PEHMIT 5 <br />TOTAL FEE 5 <br />S NUMBER PLAN CI <br />FEE <br />FEES VALUATION <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTY <br />5 <br />FEE <br />RECEIPT NO. <br />FEE <br />16 <br />TO7AL I I 16 I 50 <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATE� QN THIS SPAOE) THIS IS YOUb PERMIL.. _ 4'V <br />� <br />�7 <br />'�' <br />BY � <br />i,DIiRS:;; I-II; <br />� <br />�a' <br />� <br />