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�- <br /> � <br /> ,,�� `��.,�,��.,� �ONS�'RlJr�IOP� <br /> �VQret� ���{� �T i�ERmir r�o. 12�7'� <br /> CITV HALL 259-8745 <br /> eveaeTl,vaasazo� ❑ COMBINATION ❑ BUILDING � MECHANICAL ❑ PLUMBING <br /> GITI Zp PHONE �r.1 <br /> OWNEP IdAIL RDORE55 ♦ <br /> 1907 Ho}�t Joel Cabot Everett 98201 <br /> ARCMITELi OR OESIGNER MPIL F��FE55 <br /> CITY 2iP PMONE <br /> GENEFRLGONiflACTOR MAILAODPE55 <br /> GITY 21P PMONE LIGENSE� <br /> h1ECMANILFL CONTRALTOR MAIL ADDRE55 <br /> CITY ZIP PMONE LICENSE x <br /> Natural Gas Eguipment 1G25 East Marine View Drive 98201 256-2441 _ <br /> PLUMBING CONTRACTOP MAIL AOORE55 <br /> GITY ZIP PMON� LILENSE� <br /> CLASS OF YlORK <br /> ❑ NEW ❑ ADOITION � ALTERATION ❑REPAIR ❑ DEMOLITION ❑ FENGE ❑ SIGN ❑ WOOD STOVEIFIREPLFCE IFSERT <br /> VALUATION OF WORK <br /> S <br /> �ESCRIBE WORK <br /> PROPOSED USEOF BWLOING I HEAEBY CERTIfY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGALOESLRiPT10NOFPROPEHTYISMOWBELOWORAiTACHFOURCOVIES) CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> lpT�_BLOLK_OF WHETHER SPECIFIED HEREIP� OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRtSUME TO GIVE AUTHORITY TO VIOLATE <br /> OR CANCEL THE PROVISIONS OF ANY OTH�R STPTE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION. oqrE <br /> �oe noor+ess sicNnrur+e oc Hra . a oa nur izeo�cer+r 1�6/84 <br /> 1907 Hoyt X <br /> MECHANICAL <br /> PLUMBING FEE <br /> N0. TYPE OF FI%TURE OR ITEM FEE NO. � TYPE OF EQUIPMENT <br /> AIR COND.UNITS— M.P. EA. <br /> W ATEF CLOSET(TOILET) <br /> REFFIGERATION UNITS— H.P. EA. <br /> BATHTUB <br /> BOILERS— H.P. EA. <br /> LAVATORY�WASH BASIN) <br /> GAS FIRED A.C.UNITS —TONNAGE EA. <br /> SHOWER <br /> FORCED AIR SYSTEMS— B.T.U. M EA. <br /> KITCHEN SINK 8 DISP. <br /> WALL MEATERS— B.T.U. M <br /> DISH W ASHEfl � <br /> UNIT NEATERS— B?.�. M <br /> LAUNDRYTRAV <br /> EVAPOflATIVE CDOLERS <br /> _ CLOTHES WASHER CLOTHES DRYERS <br /> WATER HEATER <br /> VENTILATION FAN <br /> URINAL <br /> pANGEHOOD <br /> ORINKING FOUNTAIN C.F.M. <br /> AIR HANOLING UNIT— <br /> FLOOR ORAIN STOVE—WOOD <br /> VACUUM BREAKERS <br /> ROOF DRAINS— RAINLEADERS <br /> METAL FIREPLACE 8 CHIMNEV <br /> SINK(SERVI�E— BAR, ETC.) <br /> FIREPLACEINSEflT <br /> HEAT PUMP <br /> 1 Water Reater <br /> SUB TOTAL S �} SO <br /> SUB TOTAL j <br /> PEHMIT S <br /> PERMIT s <br /> TOTAL FEE S <br /> TOTALFEE S p�AN CHECK FEE <br /> SIDE�AR�SETBACK STREET SETBACK REAR VARD SETBACK PLAN CHECK NUMBER FEE RECEIPT NO. <br /> USE ZQNE LOT APEA VACANT SITE FEES VALUATION FEE _ <br /> VES . NO <br /> iYPE OF CONST. OCGUPANCY GROUP NO.OF OWELLING 11NITS _ - <br /> BUILDING S <br /> SiZE OF BLDG. NO.OF STORIES MAX.OCQ LOAO . <br /> PLUM9ING <br /> FIRE ZONE BASEMENT FIRE SPRINKlERS MECHANICAL L�I SO <br /> REOIIIRED <br /> � YES NO OTMER <br /> APPROVALS BY DATE <br /> U.B.C. <br /> t.EtNIRONMENTAL CHECK LIST PENALTY SEC.903(a� <br /> 2.BUILOING PLANS T�TA� Z�I SO <br /> 3.FIRE MY�RAYi <br /> PERMIT VALIUATION <br /> 4.FIRE PROTECTION SYSTEM WMEN PROPERL\'VALIDATED(IN TMIE�PA�E�THI$�IS�,YQUf�P�F�71T ' <br /> 5.GRADVJG F I I ` u — �'` ,1 <br /> 6.DRAINAGE � <br /> 7.ENVIRONMENTAL IMPACT STATEMENT N <br /> �- �i � T-i <br /> tl HEALTMDISTR�CT � � � �` � - <br /> qpPLICATION ACC.BY PLANS CHEC.!:cD BY APPR. FQR ISSUANCE OY iJ <br /> . . �I . <br /> - � C I <br /> ,^�CORiSS �`IlE <br />