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die Ll�ergreen • � � O N ST R 11 C�' I O�' <br />GT f OF � <br />everett P ERM IT <br />GTY HaLL 259�6745 MECHANICAL <br />EVERETT, V!A 98201 ❑ COMBINATION ❑ P.UILDING �,�1 <br />JOHN DEWISPELAERE <br />Same <br />S <br />h1AIL PUunm> <br />5824 LOWELL RD <br />cnr <br />EVERETT WA 98203 <br />PERMIT N0. 138 � �� <br />❑ PLUMBING <br />355-2594 <br />. <br />. <br />A <br />� NEW ❑ ADDITION ❑ ALTEHATION ❑ REPAIR � DEMOLITION O FENCE ❑ SIGN W �NO00 STOYFJFIREPLA� <br />Install wood stove <br />POSED USE OF BUILOING <br />Residence <br />�or <br />5824 LOWELL RD <br />PI.UMBING <br />NO. 7YPE OF. <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 5 DISP. <br />DISHWASHER <br />I.AUNDRV TRAY <br />CLOTHES WASHEP <br />WA�ER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />ROOF DRAINS — <br />SINK (SERVICE — <br />SIZE <br />sue <br />TOTAL FEE <br />APPROVALS <br />1. ENVIRONMENTAI GHECK LIST <br />2. DUILDING PLANS <br />9. FIRE HYDRAt:T <br />4.FIREPROTECTIONSYSTEM _ <br />5. GRADING <br />6. ORAINAGE <br />7.ENVIRONMENTALIMPACTSTAI <br />B. HEAIiH DISTRICT <br />eaa�.iCA710N ACG. BY PLA <br />BY <br />FEE <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAA�1INED �HIS <br />APPLiCATION AND Y.NOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />C;OVERNING THIS TYPc OF WORK WfLL BE COMPLIED WITH <br />PERMIT DOES NOIT PRESUMETO GIVEOAUTHORTY TO V OLOATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATW� CONSTRUCTION OR 7HE <br />PERFORMANCE OF CONSTRUCTION. oA�E <br />$IGN�I�EOFL^NTRFCIOROR=UiHORIZ� AGENT (3/IO�HZ <br />/J i/ <br />NO. TYPE OF EOUIPMtrvi <br />AIR COND. UNITS — H.P. EA. <br />REFPIGERATION UNITS — H.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIRED A.Q UNITS — TONNAGE EA. <br />FORCED AIR SVSTEMS — B.T.U. f.1 [A. <br />WALL HEATERS — B.T.U. M <br />UNIT HEATERS — B T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRVEFS <br />VENTILAT�ON FAN <br />RANGEHOOD <br />qIR HANDLING UNIT — C.F.M. <br />S70VE — WOOD <br />METAL FIREPLACE � CHIMNEV <br />FIREPLACE INSC-RT <br />HEAT Pl1MP <br />0o stove ___ <br />FEE <br />sua rorn� s � <br />s S 10 <br />FERMIT <br />S �% <br />TOTAL FEE 5 <br />S PLAN CMECK FEE <br />7EAR YARD SETBACK PLAN CMECK NUMBER FEE RECEIPT NO. <br />VACANTSI7E FEES VALUATION FEE <br />'�'.YES -:NO <br />BUILDING § <br />PLUMBING — <br />MECHANICAL � � 50 <br />OTHEfi — <br />U.B.C. <br />PENAL7V SEC. 30S (a) <br />TOTAL � % SO <br />PEHMIT VALIlJAT10N <br />WHEN PROPERLY VALIDATED (IN THIS SPACn) THI5�5 YOi R P r MIT—_ �, <br />!i <br />� <br />M <br />. . �i .. .. i' ' <br />: , . . � <br />.-'�f`,D�:SS� � Il.i: <br />C. <br />� <br />(. <br />C <br />