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1hrEcc�ereerr � �O!\V�`1������\'. <br />cnr OF � <br />ev�erett P�F�MIT PERMIT N0. 1-2��`� <br />CITY HALL 259�8715 <br />EVERETT, WA 93201 � COMBINATION ❑ BUILDING t�. MECHANICAL ❑ PLUMBiNG <br />OVJNEe MAIL ADDRE55 CITY ZIP PMONE <br />?3oward 7.iebell 732 Hoyt Avenue Everett 98201 252-0067 <br />FRCIIITECT OR �ESIGNER MAIL AD�RE55 GITY ZIP PHORE <br />GENERPL LONTFRLiOF Ma1L /OOPE55 GITY 21P PMONE LICENSE u <br />MECHANIGAL COHiRAGTOP MAIL A�ORE55 CITY ZIP PHONE LICENSF � <br />Custom Gas 22329 57th Avenue S.E. Everett 98011 481-5515 <br />PLUMBINF GONTRnGTOF <br />MAIL /DOPE55 CIiY ZIP PHONE LIGEIISF x <br />CUS;OG523LP6 <br />CLASS OF WOF.N <br />� NEW ❑ ADOITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVFJFIREPLACE INSERT <br />5 <br />LOT__BLOCK__OF <br />732 Hoyt Avenue <br />PLUMPING <br />NO. TYPE OF FIXTURE OR <br />WATER CLOSET QOI LEn <br />BATHTUB <br />LAVATORY (WAiM BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISHWASHER <br />LAU�IDRY TRAV <br />CLOTHES WASHER <br />WATER HEATEfl <br />URItlAL <br />DRINKING FOUNTAIN _ <br />FLOOR DRAIN <br />VACl1UM �REAKERS <br />ROOF DRAINS — RAINLEADERS <br />, SINK (SERVIGE — BAR, ETC.) <br />SIZE <br />E <br />SUB 70TAL <br />� <br />TOTAL FEE <br />� APPFOVALS <br />1. F.NVIRONMENTAL CHECR IJST <br />2. BUILUiNG PLANS <br />3. FIRE HYDRANT <br />4. FI RE PRO fECTION SYSTEM <br />5. 6P.ADING <br />6. DflnINnGE <br />7. ENVI RONMENTAL IMPACT STAT <br />8. HEALTH DISTRICT <br />aPPLICATION AJC. BY PLAI <br />_ -�� .. s:t..._ ,,_ , _ . , ....>....,.,-. <br />. _ <br />�; s- . <br />� ��Ya,,,� - <br />FEE <br />S <br />5 <br />YES '.�NO <br />10. OF DWEL <br />LOAD <br />APPR.FORISSUANCE BY <br />i HEREBY CERTIFY THAT I HAVE READ AND EXAMINFG THIS <br />APPLICATIOfI AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS UF LAWS AND ORDINANCES <br />GOVERNIP'3 THIS TYPE OF WORK 4VILL BE COMPLIED WITH <br />WHETHEH SPECIFIED HEREIN OR IdOT. THE GRANTING OF A <br />PERMIT DOFS NOT PRESUPAE TO GIVE AUTNORITY TO VIOLP.TE <br />Ofl CANCEL THE PAOVISIONa OF ANY OTHER STPTE OR <br />LOCAL -AW REGULATING CONSiRUCTION OR THE <br />PE RM,EINCE OF CONST� • nATE <br />SIG ATUFE fjf CONTRACTORggAUTHORI ENT <br />V / i /C .l y ..�(%/i'�./`1/ 10/4/83 <br />FEE <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — M.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIflED A.C. UNITS — TONNAGE EA. <br />FOF�ED l.IR �YSTEMS — B.T.U. M�A. <br />N/ALL HEATERS — B.T.U. M <br />UNIT HEATERS — B.T.U. M <br />EVAPORATIVE COOIERS _ <br />CLO7ME5 �RYERS <br />RANGE400D <br />AIR HANDLING UNIT — C F.M. <br />STOVE — W000 <br />IdETAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEAT PL'M° <br />SUB TOTAL 5 <br />PEflM1T S <br />TOTNL FEE S <br />IFEE I RECEIPT N0. <br />FEES VALUAiiON FEE <br />BUILDING $ <br />PLUMBIN� <br />MECHANICAL LZ OO <br />OTHER <br />U.B.C. <br />PENALTY SEC. 303 (a) <br />TOTAL 12 OO <br />PEHMIT VALIDATION <br />WHEN PFOPERLY VALIDATFD (IN TIi,�SC P�A'OE) THI� I� Y��R O F�MIT �� <br />� J U <br />�� 1 <br />1,"•, � <br />,�_���� ��cEir-i -' <br />��! i^.(�1K YO�� <br />aoo��.ess � n � <br />�.�mk;�d :; :. ,,:: .t�;;� <br />- !� CCi �; <br />s <br />�'� <br />�.�-'_�_>, ���.:, <br />