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rhr Frrrcri=�n <br /> A�7Qr + ;on���'�ucTior� <br /> 1. 11.1 ��R p�R� �T PERMIT N0. �4 .� �� <br /> CITV HALL 25487c5 <br /> evEREtT,e�H oazo� jJ COMBINATION � BUILDING u MEmHANICAL L�PLUMBING <br /> I]I�iIlEP 1.:41�4�^.';:FE.S$ C:TY 21P �H'J!i[ <br /> BURNETT BOILDING 16�6 HEWITT E`:HRETT WA 98201 <br /> ARCMITECL OR DESIGNER MAIL AOORE55 GRY ZIP PHONE <br /> GENERnL CONTPPCiOR MeAL qDORE55 CITV ZiP PHONE UCENSE� <br /> MECMRHICALCONTpACiOR NAilq00RE5S GRY ZIP PNONE LiCENSE• <br /> PLUMBWG CONiBALiOR MR4 q�DRE55 C�TY 2iP � PHONE LiCENSE� <br /> HOLMSTAD PLUMBING 3211 BROADWAY EVERETT WA 259-9131 _ <br /> CLn55 OF YlORN <br /> ❑ NEW 0 ADDITION I}�AITERFTION ❑REPdIR ❑ �F.MOLITION ❑ FEMCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSEFT <br /> VALUATION OF Y:OPK <br /> S <br /> D���9i8E WORK <br /> Plumbing fixtures <br /> PFOPOSE�1.5E OF B W L�V�G <br /> I HERE3Y CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> lEG<l�ESCPiPtIONOFPROGERiY�SHOWBE�OWORARALHF0Uf1GOPIES� CORRECI'. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> LOi�BLOCN�OF GOVERNING THIS TYPE OF WORI(WILL BE COMPLIED WITH <br /> WHETHER SPECIFIED HEREIN OR NOT.Ti1E GrIANTING OF A <br /> PERMIT DOES NOT PRESUMETO GIVE AI:THORITY TO VIOLATE <br /> OR CANCEL THE PAOVISIONS OF ANY OTHER STPTE OR <br /> � LOCAL LAW REGULATiNG CONSTRUCTION OR THE <br /> PERFORMANCE CONSTRUCTION. <br /> JO[3 ADDPE55 SiGNAiURE .HiH R OR Al1iHORi EO/+GENT DAtE <br /> 1616 HF.WITT X � 1/19/85 <br /> PLUMBING ME ICA <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. � TYPE OF E�UIPMENT FEE <br /> (� WATERCLOSFT�TOILEn 12 QO AIR COND.UNITS - H.P.EA. <br /> BATHNB FEFRIGERATION 11N1T5- M.P. EA. <br /> j LAVATORY(WASH BASIN) 6 OO 80!lERS- M.P. EA. <br /> SHOWER GAS FIREU A.Q UNITS-TONNAGE EA. <br /> KITCMEN SINK 8 DISP. FORCED HIR SYSTEMS- B.T.U. M EA. <br /> DISHWASHEH WALL MEATERS- B.T.U. M <br /> LAUNDFlY TRFY UNIT HEATERS- B.T.U. M <br /> CLOTHES WASHEri FVAPORATIVE COOLERS <br /> 4 WATER MEATER H OO CLOTHES DRYERS <br /> URINAL VENTILATION FAN <br /> ORINKING FOUP:TAIN RANGE HOOD '� <br /> c' <br /> PLOOR Df;AIN AIR HANOLING UNIT- QF.M. - <br /> VACUUM BREAKERS STOVE - WOOD � <br /> ROOF DRAINS- RAINLEADERS �AETAL FIREPLACE 8 CHIMNEY • <br /> SINK(SERVICE- BAR,EfC.) FIREPLACE INSERT <br /> HFAT PUMP <br /> _ , —' 'l ` <br /> SUB TOTAL 26 00 SUB TOTAL S �.r j <br /> PEAMIT S 3 OO PEflMIT 5 - <br /> TOTAL FEE S 29 OO TOTAL FEE S .- <br /> SIDE YARD SETBACK 57REET SETBACK REHR YFRD SETBACR PLAN CHECK NUt?f1LR PLAN CNECK FEE .. <br /> I FEE RECEIPT NQ ' <br /> u5E ZONE LOT AREA VACANT SITE -- --�- - <br /> - .YES NO _FEES VALUATION FEE . <br /> �J <br /> iYPE OF CONST. OCCUP4NCY Gf10UP N0.OF DWELLING URI�S <br /> BUIIDING S <br /> :�,i.:E OF BLDG. NO.OF STORIES MAX.GCC. IOAD <br /> PWMBING Z(j �0 ' <br /> FIRE:7NE �OnSEMENT FIHESPRINKLEfiS �,�ECHANICAL _- <br /> I REOUIRED <br /> YES NO <br /> APPROVALS BY DATE O7HER ' <br /> 1. ENVIRONMENTAL CNECK LIST pENALTY U.B.C. -- <br /> SEC.307�a� - <br /> .^..BUILDING PLANS <br /> Tora� 29 00 <br /> 3.FIRE HVDAANT - <br /> 4.FIRE PAOiEGTION SYSTEM PL�RMIT VALIUATION _ <br /> 5.GRADING J�'HEN PROPERLY VAIIDATE�(IN THIS SPACEI THIS IS YOUF�;PLPh71T_ � , <br /> '.�i�4INPGE <br /> � ;,VIRONMENTALIMPACTSTATEMENT <br /> . �,r4LTfiDISiPICT . <br /> . r I'i iG/RIOt: �±::C L'f ��LAN$CF ECKED DY APPR. FOR ISSUANCE P ' <br /> —---.—� — — -� <br /> r <br /> i. <br />