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<- <br />1 't � <br />� • <br />hi � <br />",�E"��gYQF ��� CC'�`VSTRUCTION -°����^� <br />everett PERMOT PERM,T No. os5�a <br />CITY HALL 259�8745 <br />EVERETf, WA 98201 ❑ COMBINATION �BUILDING ❑ MECHANICAL ❑ pLUMBING <br />01YNER MAILAODPE55 GRY 21P PHONE <br />5i11 Robinson 7th and South aroadway <br />AflCHITECT OF 7ESIGNER MAIL AD�RESS qTY ZIP PHONE <br />GENERAL CONTRACTOR MAIL AD�RESS CITV 21P PHONE LICENSE I <br />Bill 0'Brien 5027-33rd Avenue West 98204 355-9105 <br />MEq1ANICALCONTMCTOR MAILADDRESS CITY ZIP PHONE UCENSE/ <br />PLUAIBINGCqNTRACTON MAIIADDRESS CITY ZIP PHONE �ICENSE� <br />S <br />❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR �EMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />demolish single <br />5E0llSE OF OUILOING <br />LE: e� DESCflIPTION OF PflOPENTY (SMOW <br />LOi BLOC�_OF _ <br />Sec. 18 Twp. 28 <br />182805-3-0002 <br />OB AOOiiE55 <br />500 South Broadwav <br />PLUMBING <br />NO. TYPE OF FIXTURE Ofl <br />YlATER GLOSET (TOIi.FT1 <br />SINK <br />iRAY <br />ROOF DRAINS — <br />SINK IFFRVICF — <br />SIOE YARD SETBACN SiREET 51 <br />USE ?ONE �OT AREA <br />TVPE OFCONST. OCCUPAN <br />SIZE OF BLDG. NO. OF ST <br />FIRC ZONE PASEMEN' <br />1. ENVIRONMENTALCHECKLIST <br />2. BUILDING PLANS <br />3. FIflE HYDRANT <br />4. FIqE PROTECTION 3YSTEM <br />5. GRADING <br />6. DRAINAGE <br />7.ENVIflONMENTALIMPACTSTATEMENT <br />8. HEALTH DISTRICT <br />APPLICATION ACC. BY PLANS CHECKED BY <br />residence <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />ATfACHFOURCOPIES� PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND OFlDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br />HERE�N OR NOT. THE GRANTING OF A PERMIT DOES PJOT <br />O S PRESUM E TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO� <br />VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br />CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br />SIG�NA�T,U�RE /fF�" TRACiOR AUiHORI � AGENT DATE <br />X/Ui1�-../,�.__ /Q��_.� _ 11/13/80 <br />MECHANICAL <br />FEE NO. TYPE OF E�UIPMENT <br />AIR COND. UdITS — H.P. EA. <br />REFRIGERATION UNITS — H.P. EA <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />FORCED AIR SYSTEMS — B.T.U. M <br />WALLHEATERS—B.T.U. M <br />tINITHFATFRS—RTii u <br />REAR VARD : <br />VACANT SITE <br />❑YES ❑NO <br />NO.OF DWEL <br />MA%.00C.LC <br />FIRE SPRINKL <br />REOUIRED <br />�YES ❑NO <br />a�' o� <br />APPR. FOR ISSUANCE BY <br />AIR HAN <br />METAL <br />PENMIT <br />TOTALF <br />CHECK NUMBER <br />FEE <br />FEES V <br />iING $ <br />MECHANICAL <br />OTHER <br />PENALTY <br />U.B.C. <br />SEC.303 <br />C.F.M. <br />FEE <br />RECEIPT NO. <br />PFt: PERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />Not connected to� �a�cu�er � O O O. O O�� <br />� <br />,••.,��� {i;:C�:�Fd7 <br />. : � �v i�i I. `C-. � ) <br />