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, <br /> theEv��YeoF - C�'-NSTRUCTION r <br /> ���1 �� r��'Y'I t pERMIT NO. OHs91 <br /> an Hnu zss s�as <br /> EVERETT.WA eazoi ❑ COMBINATION ❑ BUILDING �XMECHANICAL ❑ PLUMBING <br /> OWNER MAILAOpRE55 CITY ZIP PHONE <br /> Cecil Sanie 1124 Lombard <br /> ARCHITECTORpE51GNER MAILAD�FE55 CITY ZIP PHONE <br /> GENEflALCONiRACTOR MAILAppRESS CITY 21P PHONE LICENSEI <br /> MECNANICALGONiPACiOR MAILADORESS CITY ZIP PHONE LICENSEY <br /> Natural Gas Equipment 1611 East Grand 98207. 258-2441 <br /> PLUfdBINGGONTRALTOR MAILADDRESS CITY ZIP PMONE �ICENSE� <br /> CLASS OF WOHR <br /> ❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLIiION ❑F[NCE ❑SIGN ❑GARAGE <br /> VALUATION OF WORK <br /> S <br /> DESGRIBE WO�IK ' <br /> PROPOSED USEOF BUILDWG <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> ieca�oescR�anor+oFaaoaeRrr�sHowee�owoannncHFouacoaiesi PLICATION AND KNOW THE SAME TO BE TRUE AND COHRECT. <br /> ALL PROVISIONS OF LAWS AND ORDIIJANCES GOVERNING THIS <br /> �or e�aK_oF TYPE OF WORK WILL BE COMPLIED W'ITH WHETHER SPECIFIED <br /> HEREIN OR lJOT. THE GRANTING OF A PERMIT DOES NOT <br /> � _ PRESUME TO GIVE AUTHORITY TO VIOLr1TE OR CANCEL THE PHO- <br /> VISIJNS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br /> CONSTRUCTION OR THE PFRFORMANCE OF CONSTRUCTION. <br /> JOB AODRE55 SIGNATURE OF CONTRFCTOR Ofl PUiHORIZE GENT � p4TE <br /> 1124 Lombard X 12/16/8U <br /> PLUMBIhG ME qL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> WATER CLOSET(TOILET) AIR COND.UNI75—H.P.EA. <br /> BATHTUB REFRIGEPATION UNITS—H.P. EA <br /> , LAVATORY(WASH BASIN) BOILERS—H.P.EA. <br /> SHOWER GAS FIRED AC.UNITS—TONNAGE EA. <br /> � KITCHEN SINK&DISP. FORCED AIR SYSTEMS—B.LU. M EA. <br /> DISHWASHER WAL�hIEATERS—B.T.U. M <br /> LAUNDRV TFAY UNIT HEATERS—B T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> WATER HEATER CLOTHES ORYERS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR DRAIN Alq HANDLING UNIT— C.F.M. <br /> VACUUM BREAKERS STOVE <br /> ROOF DRAINS—RAINLEADERS METAL FIREPLACE&CHIMNEY <br /> SINK�SERVICE—BAfl,ETC.) 1 Conversion Burner <br /> SUB TOTAL SUB TO7AL S 4 S 0 <br /> PERMIT S PERMIi S <br /> TOTAL FEE S TOTAI.FEE E <br /> SIOE YARD SETBACK STREET SETBACK PEAR YARD SETBACK P�AN CHECK NUM�ER PLAN CHFCK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE L'JT AREA VACAN'SITE <br /> OYES L]NO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> BUILDING $ <br /> SIZE OF BLDG. NO.OF STORIES MA%.OCC.LOAD <br /> PLUMBING <br /> FIR[ZODlE BASEMENT FIRE SPRINKLERS <br /> FEOUIRED MECHANICAL '] 5 O <br /> ;7YES UNO <br /> APPHOVALS BY DATE a7HER <br /> t. ENVIRONMENTAL CHECK LIST <br /> PENALTY U.B.C. <br /> 2. BUILDING PLANS SEC.303(a) <br /> 3. FIRE HYDRANT TOTAL 7 S O <br /> n. FIRE PROTECTION SYSTEM PEflMIT VALIDATION <br /> WHEN PqOpERLY VALIDATED(IN THIS SPACE)THIS IS YOUR PERMIT <br /> � 5. GRADING I 7 6 9 $ O O /. � �� — � <br /> 6. DRAINAGE <br /> � <br /> 7. ENVIRONMENTAL IMPACT STATEMENT � <br /> 8. HEALiH DISTPICT <br /> ' IR ��C �IPTo <br /> APPLICATION ACG BY PLANS CHECKED BY APPFl.FOR ISSUANCE BV � � � � I`\ ' `" ' 1 <br /> lJ <br />