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�llY LrCrIIr[Pl! <br />e�erett ����TRlJ�1'IOC � <br />PERNIIi PEftMIT N0. � <br />CITY HALL'<59-87a5 <br />eveaerr. �vn �azo� C COMBINATION ❑ BUILDING 3Cx' MECHANICAL ❑ PLUMBING <br />J�:r:[R rdhlL A�DRE55 Ciir ZiP PHONE <br />G. Elwood 721 Laurel Drive Everett <br />APCNITECi OR OESIGNER 1AqiL A�DFESS CITY ZiP PMO��E <br />GENERAL CONTRAGTOR MqIL AODRE55 LITY ZIP PHONE IIGENS� u <br />fdECNM1N�CAL CONTRACTOR IApIL AO�RESS CiTV ZIP PMONE LICENSE � <br />Natural Gas Equipment 1625 East hfarine View Drive Everett 98201 258-2441 <br />PLU!dBING CONTRAGTOR IAFIL A�ORE55 GITY 21P PHONE LIGENSE • <br />❑;lEW ❑ ADDITION ❑ ALTERATION ❑ qEPAIR ❑ �EMOLITIpN ❑ FEiJCE ❑ SIGN ❑ WOOD STOVE/FIREPLACE INSERT <br />s <br />�ur_e�ocK_oF <br />721 Laurel Drive <br />I]lqi;I:IC[H <br />SI�E <br />FIR[ <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />ORATTAGHFOURCOPIE51 CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERiJING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUPAE TO GIVE AUTHORITY TO VIOIATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR TNE <br />PERFORMANCE OF CONSTFUCTION. <br />SiG� > RE OP CONiRA TOR OR AUtHORIZED AGENT p fE <br />x r�-� I.,_.r ��<,��fri;.t I-:�.� <br />TYPE OF fIXTURE OR ITEM <br />VJATER CLOSET (i01 LEn <br />BATHTUB <br />LAVATORV�WASH BFSIN� <br />SMOwER <br />KITCHEN SINK 8 DISP. <br />�ISHWASHER <br />LAUNDRYTHAY <br />CLOTHES WASHER <br />WATER HEATER <br />URINAL <br />DflINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM 89EAKERS <br />f700F DRAINS - RAINLEADEFS <br />SINK (SERVICE - 6AR, ETC.) <br />SUBTOTAL <br />PERMIT <br />TOTALFEE <br />NO.OF <br />APPAOVALS <br />L ENVIRONMENTAL CMECK LIST <br />2. �UILDING PLANS <br />9. FIRE HVDRANT <br />d FIREPP�TECTIONSYSTEM <br />5 GRA�ING <br />6. DRAINAGE <br />7.ENVIRONMENTALIMPACTSTATEMENT <br />d. HEALTH DISTRICT <br />APPLICATION ACC. BY PLANS CHE <br />FEE I NO. <br />A!R COND. UNITS - H.P. EA. <br />REFRIGEPATION UNITS - H.P. EA. <br />BOILEF±S - H.P. EA. <br />GAS FIRED A.C. UNITS - TONNAGE EA. <br />FORCED AIR SVSTEMS - B.T.U. M EA. <br />WALL HEATERS - B.T.U. M <br />UNIT HEATERS - B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRVERS <br />VENTILATION FAN <br />RANGEHOO� <br />AIR HANDLING UNIT - C.F.M <br />STOVE - WOOD <br />METAI FIREPLACE 8 CHIMNEY <br />PIREPLACE INSERT <br />HEAT PUMP <br />S <br />5 <br />5 <br />REAR VARD SETBACN PLAN CNE( <br />VACANT SITE <br />YES NO <br />NO. OF DWELLING UNITS <br />OUILDING <br />MAY..00C.LOAD - <br />PLUMBING <br />FEE <br />10 <br />SUBTOTAL 5 _�y� <br />PERMIT S SO OO <br />TOTAL FEE 5 2D SO <br />NUMBER PLAN CHECK FEE <br />FEE I RECEIPT NO. <br />EES VALUATION FEE <br />S <br />�n���+' MECHANICAL 2� SO <br />NO <br />DATE dTHER <br />PENALTY U.B.C. <br />SEC. 303 �a� <br />- TOTAL XXX XR <br />PERMIT VALIOATION �(� SO _ <br />WHEN PPOPERIY VALIDATED �IN THIS SPAGE) THIS IS YOUR�PEflMIT _ <br />2 <br />O <br />� <br />� <br />m <br />�� <br />..� <br />cn x <br />m <br />O <br />C C <br />m o <br />� <br />—i C <br />O � <br />—i z <br />S —I <br />m <br />.O � <br />n —+ <br />.r-. ._. <br />-i V1 <br />K <br />T <br />O :LJ <br />-n n <br />-i m <br />2 <br />m � <br />N <br />O <br />o r <br />c� m <br />C N <br />� N <br />m <br />z c� <br />-i r <br />• m <br />v <br />� <br />� <br />_ <br />n <br />� <br />._-� <br />N <br />Z <br />O <br />-� <br />c� <br />m <br />