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Me Evergreen �P P L 1 CA T I O N F O R <br /> "�,°� C4NPE�M TTIOf� ""`�',`" <br /> �verztt <br /> DFPT OF CO'-lMUNITY DEVELOPMENT SERVICES <br /> CITY HALI. 259�8755 <br /> eveaerr,wn9e�^� �COMBINATIVN ❑ BUILDING }�MECHANICAL ❑PLUMBING PER��11TN0. <br /> O��hEH nInIL�O�kfSS Ul1 ZIP PIION[ <br /> Bill Overman, 171.9 Lombard Ave. , E��erett, Wa. 259-35'l�+ <br /> �NCHRfCi OR 0(SIGNfft, MMl ADUNfSS CI1Y ZIV PHONE <br /> CLntNnlCO�iRACIDF nlAlleDDRfSS CIiY LIP PMOnE IICFNSE/ <br /> nRCMnNIUICU�u1NnQON MAILnUppE55 Cllv LI pppH( IICEHSEI lYl <br /> GAS APPLIANCE SERVICE, I1�C. , 1103 No. 36th St. , Seattle , Wa. 632-,Soo, GAsnPz#371 <br /> 19N�IIILSL COFIX�QOR MAII hO�R[55 ❑iY Z�P P40N[ IICEN$E/ <br /> CU55 Of N'pNK <br /> ❑N:W �ADDITION ❑ALTERATION ❑REPAIR ❑DEhtOLIiION ❑FENCE ❑SIGN ❑GARAGE ❑BUILDING RELOGTION <br /> VAIU�iIOh Of NOPK <br /> f <br /> Of5CN1111 KONK — <br /> Installation o� gas conversion burner to existing furnace <br /> ruorosEn ust oi nuuoiHc <br /> I HERE�Y CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> residence PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL <br /> imni o!scu�rnov or veoriati�v�o�u�v ntioH�ox nruo�rouu carusi PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE <br /> OF WORK WILL OE COMPLIED WITH WHETHER SPEC�FIED HEREIN <br /> ��� �����N--�� OR NOT. THF GRANTINC OF A PFRMIT DOE$ NOT PRESUME TO <br /> GIVE AUTHOR�TY TO VIOLATE OR CANCEL THE PROVISIONS Of <br /> �NY OTHER STATt OR LOCAL LAW REGUTATING CONSTRUCTION <br /> OR THE AERFORMANCE OF CONSTRUCTION. <br /> SICNATURE qF CONTR4[TOR Oft AUTHORIZED AGENT DATE <br /> I Oil AUDNt SS �/ <br /> X ,f/1/ <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FI7(TURE FEE NO. TYPE OF EQUIPMENT FEE <br /> N'A7fNQO5FT�70LlET1 AINCOND UNI75—HP EA <br /> IlATMTUEt NEFHIGERATION UNITS—H P EA <br /> lM'ATORIIWASHIlA51Nl OOILLRS—HP EA <br /> SIIOIVFH CAS FlHED A C UNRS—TONNAGE EA <br /> KIiCHIN Sltil(g DISP lONCCD AIR 51'$TIM$—�T U M IA OO <br /> DISWASHCR WALL II6AiER$—U 7 U M1t <br /> IAUNpNY iRAY UNIi HlA1LN5–ff f U M <br /> CLOIHE$\Y�SMEft EVAPORATIVE COOLEHS <br /> tVAIf R HEAiCH CLOTHES DP.YFRS <br /> UkINA; VENiILATION FAN <br /> UNINAING FOUNTAIN ftANGE MOOD <br /> IIOOH �HAIN <br /> . AIR HANDLIhG UNIT– �.F M <br /> \'ACUUM E7N(AAlRS STOVf <br /> NOOV DRAINS–IinIN�EAI)fR5 MCT�L fIRtPLACF R CHIMNFY <br /> Slnl:I51 N\'�(t–NPN, E iC 1 � <br /> SUB TOTAL SUB TOTAL S <br /> VEPMIT S PERMIT S Q <br /> TOTAI FEE S TOTAI fEE S <br /> SIDf YARp S[TL1.1CK tiN[IT SRItACK RUN YAHU SEillACA PLAN CHiCR NUhtlifft PUN CHECA FEF <br /> FEE RKfIPTNO. <br /> USE ZOVk LOT ARFA y���N7 SITF <br /> ❑YFS L�NO FEES VALUATION FEF <br /> iYPF Of CONST OCCUYANCY GROUP NO OF DWEIIING U�11T$ <br /> 13UILDING 3 <br /> $IZC OF fiLDC NO Of STORIES MA% OCC LOAD <br /> PlUM111NG <br /> HRE ZOti( PAS(h1kNT IfIUNUOtIS {IRE SPNINKlEHS <br /> RFQUIkED MECHANIUL <br /> flYFS I,NO <br /> ( <br /> APPROVALS BY DATF OTHEH -_..J <br /> i WVIRONn1fNTALCM(CKLISi � <br /> PENALTY U�C <br /> : fIURUING VUrvS SEC 307�a1 , <br /> 1 IIHI HVDRANi TOTAL <br /> 4 FIRE NH0IECTION SYSTEhI kERMIT VAIIDATION <br /> 5 GH�IUINGit%C4VA710N 6 QLANINGCRUHflINC �'�'HEN PROPERLY VALI�ATED(IN THIS SPACE)THI$IS YOUR PERMIT <br /> ' 6 URAIN�GC <br /> 7 ENVIRONMFNTALIMPACTSTATCMfN7 <br /> 9. MUITII UISTRICT <br /> APPI IUIION�CC NY PLANS CHECKED 9Y APPR fOR ISSUANCk BY <br /> 9-1-;9 <br />