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�hc E�rrgreen �p N ST R U CT I O N � � <br /> CITY OF <br /> everett PERMIT pERMIT NO. OH73rJ <br /> CITV HALL 259-87A5 <br /> Fieaerr.wa �ezoi ❑ COMBINATION y�cCBUILDING ❑ MECHANICAL ❑ PLUMBWG <br /> OWNEF MAIL A�DNE55 CI1Y ZIP CHOIIE <br /> Cappy Weeks 2225 Jade 98201 259-1088 <br /> hRCHRECt OR DESiGNER MAIL ADORE55 CItY ZiP FNONE <br /> GENERALCOtlTfiFCTOR MAILA�011E55 GiY ZIP PMONE LICP+SiI <br /> Same <br /> MEC��ANICALCANTRFCIOR MFILADDPESS CITY ZIP PMONE LICEflSE� <br /> PLUAIBIt�GCONTRACTOR MAILADD`iE55 CITY ZIP PNONE LICENSEI <br /> LU1550F WORN <br /> GNEW ❑AD�ITION ❑ALTEflATiON ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br /> VAWATION OF N'ORN <br /> S <br /> �ESCRI�EtYOBK <br /> Install fireplace insert <br /> Pnoroseo use oF om�oi��c <br /> single family residence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> �ecn�oe;cairnor+oFrnoNenrrisHowee�owonnnncnwuncoa�esi ' PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> 33 Timwalt Terrace ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> �or eiocK_o= TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRANTING OF A PERMlT DOES NOT <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO- <br /> VISIONS OP ANY OTHER STATE OR LOCAL LAW REGULATING <br /> CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. <br /> J0�AODRE55 SiG�1qiUP[OF CONiPACiOR OR AUi��ORiZ[D AG'_IIT DAi[ <br /> 2225 Jade X/� 1/5/81 <br /> PLUMBING �dECFrANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET�TOILET) AIR COND.UNITS—H.P..A. <br /> BATHTUB REFRIGERATION UNITS—HP.EA ' <br /> LAVATORY�WASH BASIN) �OR@RS—H.R EA. <br /> SHOWER GAS FIRED A.C.UNITS—TONNAGE EA <br /> KITCR[N SINK A DIS^. FORCED AIR SVSTEIdS—6 T.U. M EA. <br /> DISHWASHEk WALL HEATERS—B.T.U. M <br /> LAUNDRV TRAY UNIT HF.AiERS—�.T.U. M <br /> CLOTHES WASHER [b'l.PORATIVE COOLERS <br /> WATER HEATER CLUTHES DRY[RS <br /> URINAL VEhTILATION FAN <br /> DqINKING FOUNTAIIJ RANGE HOOD <br /> FLOOR URAIN AIR HANOLING UNI?— C F M. <br /> VACUUMBREAKEHS STOVE lrep dCB nser <br /> ROOF DRAWS—RAWLEA�FRS METnL FIREPLAC[8 CHIMNEV <br /> S W K�SERVICE—BAR,ETC� <br /> SUU TOTAL SUB TOTAL S 9 5 0 <br /> PENMIT S PEHMIT S 3 OO <br /> TOTAL FEE S TOTAL FEE S 'I S O <br /> SIOE VARD SETBACK STREE'SETBACK R[AR YARD SET�ACY PIAN CH[CK NUMB[!i VLAIJ CHECK FEE <br /> FEE RECEIPT NO. <br /> USL ZONE .OT AREA VACANT SITE <br /> I_lYES I7N0 FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUP NO.Of DY7[LLI11G UIJITS <br /> BUILDING S <br /> SIZE OF 6LDG. NO.OF STORIES MAX.OCC.LOAD <br /> PLUMBING <br /> FIFE ZONE BASFMENT FlRE SPRINKLEFS <br /> REOUIPED MECHANICAL � S O <br /> ❑YES ❑NO <br /> APPftO\'ALS BY DATE OTHER �^ <br /> 1. ENVIRONMENTAL CHECK LIST U�C <br /> FENALTY SEQ 303 WI <br /> 2. BUIIDING PLANS _ <br /> 3. FlRE HYDRANi TOTAL '] S O <br /> a. FIRG PROTECTION SYSTEM PERMIT VALIDATION <br /> WHEN PpOPEHLY VCLIDATED(IN iNIS SPACEI TNI$IS VOUR PERMIT <br /> 5. GRAOING .. (� (� 7 /�(� <br /> 6. DRAIVAGF � ` '' !� r `� U 7. J C -- Lr= <br /> CT) <br /> 7. ENVIflONMENTAL IMPACT STATEMENT � <br /> 8 HEALTH DISTPICT • � <br /> APPLICATION�CC dY PL4N5 CHECKED BY APPR.FOR ISSUANCE BY , R E C�I PT O <br /> .,; ,;..- � <br /> K. C. <br />