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� thc Erer,�reen - - ^O N ST R U CT I O R' � <br /> GTv OF � <br /> ' everett PERMIT PERMIT NU. 14� ov <br /> ' � <br /> CITV HALI 259�8745 <br /> j eveRen,�vnsazoi � COMRINATION ❑ BUILDING r�tXMECHANICAL ❑ PLUMBING <br /> . <br /> � OWNER MAILAO�RE55 CITY ZIP PMONE <br /> ; , I:en Harvey 2423 Lombard F.verett � 98201 <br /> � IdAILADDRE55 qTY ZIP PMONE <br /> ARGMITEGT Oh DES�GNER <br /> 1 GENEFFL CONTRAGTJR MAIL ADDRE55 CITY ZI� PMONE UCENSE N <br /> MECHRNIGAL CONTHAOTOR MAIL ADDRESS CITY 21P PMONE LICENSE Y <br /> Natural Gas Equipment 1625 East Marine View Drive Everett 9d201 258-2941 <br /> .i <br /> PLUMBING GOHTRACTOH MAIL A��flESS CITY ZIP PMONE UCENSE 1 <br /> CLASS OF WORH <br /> ❑ NEW ❑ ADDITION ❑ ALTEHATION ❑REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVE/FIREPLACE INSERT <br /> '�ALUATION Of WOFK <br /> S <br /> DESCflIBE WORK <br /> PFOPOSEO USE OF OUILOING �- � <br /> I HEREBY CERTIFY THAT I HAVE REAU AND EXAMINED THIS <br /> � APPLICATION AND KNOW THE SAME TO BE TRUE AND n <br /> LEGALOESCFlIPTIONOFPPOPERTY�SHOYIBELOWORATfACHFOURCOPIES� CORRECT. ALL ?ROVISIO�dS OF LAWS AND ORDINANCES LTJ <br /> GOVERNING THIS TYPE OF VJORK WILL BE COMPLIED WITH " <br /> LOT_BLOCK__OF WHETHER SPECIFIED HEREI� OR NOT.THE GRANTWG OF A <br /> PERMIT DOES NOT PRESUMETO GIVE AUTHORITY TO VIOLATE <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STPTF OR <br /> LOCAL LAW REGULATING CONSTRUi.TION OR THE H H <br /> PERFORMANCE OF CONSTRUCTION. '� "`� <br /> JOB ADORESS SIGN T RE OF CONTFACTOH OR AUTMORIZtD AGENT �ATE <br /> H <br /> 2423 Lombard X `'�_� I� / � <br /> PLUMBING MECHANICAL � <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE y <br /> O <br /> WATERCLOSET�TOILE7) AIR COND.UNITS— H.P.EA. <br /> BATHTUd REFRIGERATION UNITS— H.P. EA. __ � <br /> C�] <br /> I LAVP.iORY(WASH BASIN) BOILERS — H.P.EA. � Z <br /> � SHOWER GAS FIflED A.C.UNITJ—TONNAGE EA. y <br /> � <br /> � KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS— B.T.U. M EA. t"! � <br /> i-i <br /> i DISHVlASMER WALL HEATERS— B.T.U. M '��' <br /> � LAUNDRV TRAY UNIT HEATERS— B.T.U. M � � <br /> I CLOTHES WASHER EVAPORATIVE COOLEFS <br /> WATER HEATER GLOTHES DRYERS � <br /> 1 URINAL VENTILATION FAN __ N <br /> DRINKING FOUNTAIN RANGE HOOD Q � <br /> FLOOR DRAIN AIR HANDLING UNIT— C.F.M. �,j <br /> I <br /> VACUUM BREAKERS STOVE—WOOD � N <br /> ' ROOF ORAINS— RAINLEADERS METAL FIREPLACE&CHIMNEV . � <br /> � SINK(SERVICE — BAR, ETC.) FIREPLACE INSERT <br /> HEAT Pl1MP <br /> i __ dY�Y--H2d-t — � <br /> Sl1B TOTAL i SUB TOTAL S 4 SO � <br /> PERMIT S PERMIT 5 N <br /> F TOTAL FEE S TOTAL FEE E LQ SO �f <br /> SIDE YARD SETBACK STREET SETBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE H <br /> FEE RECEIPT NO. � <br /> 1 USE ZONE LOT AREA VACANT SITE FEES VALUATION fEE <br /> � : .YES ..NO <br /> I TYPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING UNITS _ <br /> Bl11LDING S <br /> SIZE OF BLDG. NO.OF STORIES MAX.OCC. LOAO — <br /> PLUMBING <br /> � FIRE ZONE BASEMENT FIRE SPRINKLERS <br /> REOUIRED MECHANICAL I�S O <br /> '.-'YES . NO <br /> APPROVALS BY OATE OTHEF _ <br /> 1. ENVIROWMENTAL CHECK LIST PENALTY U.B.C. <br /> SEC.JOJ lal <br /> 2.6UILDI NG'LANS TOTAL Z�I O <br /> 9.FIRE MYDRANT . <br /> 4.FIFE PROTECTION SVSTEM PERMIT VALIDATION <br /> S.GRADING WHEN PROPERLY VALIDATED(IN THIS SPACE)THIS'IS Y(?U�j PERMIT _ Q() <br /> � <br /> f.DRAINAGE � <br /> 7.ENVIRONMENTALIMPACTSTATEMENT �f' <br /> B.HEALTHDISTRICT . � . � i a—i <br /> APPLICATION ACC. BY PLANS CHECKED BY APPR. FORISSUANCE BV <br /> i <br /> 1 <br /> ADDR[SS FILf_ <br /> i <br />