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1hc Ll'crSrcen <br />��,. �: <br />ev��ett <br />CITY MALL 259�fl745 <br />� CONSTRUCiI�'" <br />PEI�NiIT <br />PERMIT NO. �-��� � <br />EVERETT,VlA9B201 � COMBINATION ❑ BUILDING �X MECHANICAL ❑ PLUMBING <br />�OWNEF MAILADURE55 GITY Z�P VMONE <br />B. J. Potter 4615 Hoyt Everett 98204 252-0988 <br />ARCHRECi OR OESIGNEF MAI� ApOFE55 QTY ZiP PMONE <br />GENERAL CONTPICTON MAIL ADDRESS CITY ZIP PMONE L:CENSE Y <br />MECNANICA� CONTPAGtOR MAIL AODRE55 GITY Z�P PHONE �ICENSE M <br />Eylander Heating and Refrigeration 2419 California Avenue 98206 <br />PWfdBING CONTRACiOR MAIL AD�RESS CITY ZIV PHONE LICENSE N <br />339-3363 <br />❑ IIEW ❑ ADDITION ❑ ALTERATION O REPPIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑'N000 STOVEIFIREPLACE INS'cRT <br />VA W ATAN UF YlOtik <br />S <br />DESCRI9E WOFN <br />PROPOSEO USE OF BUIL�ING <br />LEG4l DESGRiPtION OF PPOPEF <br />LOT __ BLOCK _OF <br />JOP ADDRE55 <br />46�� Hoyt <br />PLUMBING <br />NO. TYPE OF FI%TURE OR <br />WATER CLOSET (TOILEn <br />BATHTUB <br />LAVATORY�WASHBASIN) <br />SHOWER <br />KRCHEN SINK 8 GISP. <br />DISHWFSHER <br />LA�INDRV TRAV <br />CLOTME54VASHER <br />WATER HEATER <br />URI4AL <br />DRINKING FOUNTAIN <br />f-LOOR DRAIN <br />VACUUM BREAKERS <br />ROOF �RAINS — RAINLEADERS <br />SINK �SERVICE — BAR, ETG) <br />SUB TOTAL <br />PEHMIT <br />TOTAL FEE <br />IEET SETBACK <br />TYPE OF CONST. <br />ZONE <br />APPROVALS <br />1. ENVIfiONMENTAL CMECK LIST <br />2. BUILDING PLANS <br />3. FIFE H'lDRANT <br />4. FIRE PROTEGTION SYSTEM <br />5. GRADING <br />6. DRAINAGE <br />7. ENVIRONMENTAL Ih1PACT STATEMENT <br />8. HEALTM DISTFICT <br />FEE <br />_� 5 <br />PEAR <br />VACANT SITE <br />�.�.YES :�.NO <br />OCC.L04D <br />VEF <br />BY <br />PLANS CHECKEO 3V IAPPR.FOR <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRE�UME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PER�ORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTR/GTOR OR Al1THORIZE� AGENT �FTE <br />X 9/19/83 <br />MECHANICAL <br />NO. TYPE CF E�UIPMENT FEE <br />AIR COND. UNiTS — H.P. EA. <br />FEFRIGERAI'ION UNITS — H.P. EA. <br />901LER5 — H.P. EA. <br />GAS FIRED A.C. UNIT�'� — TONNAGE EA. <br />FORCED AIF SYSTEMS — B.T.U. M EA. <br />WALL HEATERS — B.T.U. M <br />UNIT HEATERS — B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTMES ORYEHS <br />VENTILATION FAN <br />RANGEHOOD <br />AIR HANDLWG UNIT — C.F.M. <br />STOVE — WOOD <br />METAL FIREPLACE 8 CNIMNEY <br />FIREPLACE INSERT <br />1 HEATPUMP I h 00 <br />SUBTOTAL S <br />PEfiM1T S <br />TOTAL FEE 5 <br />FEE � RECEIPT NO. <br />FEES I VALUATI9N I FEE <br />BUILDING S <br />PLUM8ING <br />MECHANICAL ZE OO <br />OTHER <br />PENALiV U.B.C. <br />SEC. 303 �a) <br />Tora� I � 16 �00 <br />PEflM1T VALIDATION <br />W�1EN PFOPERLV VALIDATED (IN THIi �SP� C�E) THIS�S�YiUR P€Rj.11T � <br />o / 6 U„ <br />'� <br />l �.' <br />��i <br />i', R=C�IP7 "-. <br />'. .. .. . \ �f \/ l� <br />I % i�� ,:, � <br />ADDf:[.�S f=1L'c <br />