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- . _ _ � <br /> u,��,�� _ <br /> everett ��'NSTRUCTION - = � 21645 <br /> 259 - 8�45 PERMIT PERMITN(3�: <br /> ❑ DEMOLITION ❑ COMBINATION $7 BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br /> OWNER MAILApOPE55 CITV 21P PHONE <br /> Temple Beth Or P.O. Box 1232 Everett 98201 259-7125 <br /> ARCMITECTOR�ESIGNER MAI�AODRESS CITY ZIP PlIONE <br /> GENEflAL CONTRACTOR MAIL ADDFE55 CITY 21P PHONE LICENSE w <br /> Owner <br /> AIECHANILALCONTRhCTOP MAILADORE55 CITY ZIP PMONE LICENSEx <br /> PLUMBING LONTRACTOR MAIL ADONESS CITV 21P PMONE LICENSE x <br /> CLASS OF WORK <br /> ❑ NEW ❑ ADDITION �ALTERATION O HEPAIR ❑ DEMOLITION O BUILDING RELOCATION <br /> VA�UATION OF WORK <br /> S 20,000.00 <br /> OESCRIB[WORK <br /> Relocate walls <br /> MEATSOURCE <br /> ❑ ELECTRICITY O GAS ❑ WOODSTOVE ❑ OTHER <br /> PFOPOSED USE OF BUIL�ING <br /> I HEREBY CER'�IFY THAT I HAVE READ AND EXAMINED THIS <br /> Tem le APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGAL�ESCRIPTIONOFPROPERTY�SNOWBEIOWORATTACMFOURWPIES� CURRECT. P.�L PROVISIONS OF LAWS AND ORDINANCES <br /> �nVERN!!;i; THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> LOT__OLOCK _ OF WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY 'i0 <br /> VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br /> STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br /> THE PERFORMANCE OF CONSTRUCTION. <br /> J00F�URESS SIGNATUPEO�FC/ONT ACT AUTHOR EDNGENT.OR OWNER DATE <br /> 3215 Lnmbard X �^" � <br /> PLUMBING MECH4NICAL <br /> NO. TVPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET� A/C—A,'HNDLG UNITS—H.P. <br /> BATHTUE� REFRIGERATION UNITS—H.P.EA. <br /> LAVATOFIV(WASH BASIN� BOIIERS—B.T.U./H.P. <br /> SHO WEFI GAS FIRED A.C.UNITS—8 T.U. <br /> KITCHEIV SINK d DISP. FORCED AIR SYSTEMS—B.T.U. M EA. <br /> DISHWf,SHER WALLHEATERS—B.T.U. M <br /> LAUNDRY TRAV UNIT HEATC-FS—B.T.U. M <br /> CLOI'YES WASHER EVAPORATIVE COOLERS <br /> URINA_ CLOTHES�RVERS <br /> DRINKING FOUNTAIN VENTILATION FAN <br /> FLOOII DRAIN RANGE HOOD <br /> BACKI'LOW PflEVENTERS WATER HEATER � <br /> ROOF DRAINS—RA�NLEADERS W OOD STOV� <br /> SINK(SERVICE—BAR,ETC.) METAI.FIREVLACE 8 CNIMNEV <br /> FIREPLACEINSERT <br /> HEAT PUMP <br /> GAS PIPING <br /> — EXHAUSTFAN <br /> SUB TOTAL S SUBTOTAL <br /> PERMIT S PEflMiT <br /> TOTALFEE S TOTALFEE :.k <br /> FRONTSETBACK REARSETBACK SIOESETOICN PLANCHECKNUMBER � ," <br /> 10 20 5 g9/21645 � 5 . 17400 <br /> USEZONE LOTAREA yqCANT5ITE <br /> R-5 SOx12C ❑1'ES fdNe FEES ATIO ^ FEE <br /> TYPEOFCONST. OCCUPANCYGROIIP NOOFOWELLINGl/NR5 BUI�DING �i2uµvvO.00� .SO ZO� OO <br /> V-N A-3 0 . �t . <br /> PLUMBING <br /> SIZE OF BLOG. NO OF STORIES MA% OCC.LOAD <br /> 1870 1 48 MECHANICAL <br /> INVESTIGATION FEE Sec.3041e) <br /> FIRE SPRINKLERS REOUIRED ❑VES NO STATE BUILDING SURCHARGE 3 SO <br /> STATEENERGYSURCHARGE <br /> AYPLILATION ACC.BV �LANS CHECNED BY APPR.FOR ISSUANCE�Y <br /> DRIVEWAY PERMIT <br /> SYH1C M.M. B.E. BE. . TOTAL 210 50 <br /> PEFiMIT VALIDATION <br /> WHEN PROPEflLV V�LIOATED(IN THIS SPACE)rHIS IS VOUR PERMIT <br /> �� <br /> �� <br /> �n <br /> r� <br /> N <br /> A�GHESS FILE <br />