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die E��crirccn -� C O N ST R U CT I� 11 <br />Crtv c� <br />everett PERMIT PERMIT NO. � �12� <br />CITY HALL 259�8745 <br />EVERETT,1VA98201 � COMBINATION C 13UILDING `�3 MECHANICAL ❑ PLUMBING <br />1`; 01YNEH MAIL RDDRE55 CIiY ZIP PNONE <br />O. H. Elfes 7306 Highland Drive Ehrerett 98203 347-5951 <br />ARCNIiEGT OR pE51GNER MAIL I�DRE55 CITY ZIP PHONE <br />G <br />GENEHA� �ONTRACTOR MAIL AOOPE55 GITY ZIP PHONE UCENSE I <br />MECHANICAL CONiflNCTOR MAIL AODRE55 CRV ZIP PNUNE �IGENSE r <br />Same <br />PLl1MBING GONTFFCTOR MAIL A�DRE55 CITY 21P PHONE LI�ENSE M <br />❑ NEW ❑ A�DITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE � SIGN X� WOOD STOVEIFIRePLACE INSE(77 <br />OF 1YOPK <br />5 <br />LOT _ BLOCN _OF <br />7306 Highland Drive <br />Pl':'d71NG <br />r'�+. � TYPE OF FI%TURE OR ITEM <br />! l':rTERCLOSET�TOILEn <br />B.OTHTUB <br />LAVATORY�WASN BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />WA7ER HEATER <br />URINA� <br />DFINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS — RAINLEADERS <br />SINK (SERVICE — BAR, ETC.) <br />SI1B TOTAL <br />PERMIT <br />TOTALFEE <br />SIZE OF BLDG. <br />1. EN\'IRO'�MENTAL CHECK LIST <br />2. DUILDING PLANS <br />9. FIRE HVDRANT <br />4. FIRE PFiOTECTION SYSTEM <br />5. GRADING <br />6. DRAINAGE <br />7.ENVIRONMENTAL�MPACTSTATEMENT <br />B. HEALTH DISTRICT <br />APPLICA710N ACC. BV PLANS CHE <br />FEE <br />i <br />S <br />s <br />YES NO <br />VES NO <br />B� <br />I HEREBY CERTIFY ; 1AT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME T�� BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WnRK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DC-S NOT PRESUME TG GIVE AUTHOFlITY TO VIOLATE <br />OR CANCE� THE PROVISIONS OF ANY OTHER STPTE OR <br />LOCAL L�1N! tiEGULATING CONSTRUCTION OR THE <br />PERFORhiANDE OF CQiJSTRUCTION. <br />AUTHORIZE� AGENT <br />X ��f `75 L/tL_ <br />MECHANICAI <br />NO. TYPE F E�UIPMENT <br />AIR COND. 11NITS — H.P. EA. <br />REFF7IGERATION UNITS — H.P. EA. <br />BOILEFS — H.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />FORCED AIR SYS7EM5 -- B.1.U. M EA. <br />V:ALL HEATERS — B.T.U. M <br />UNI7 MEATERS — B.T.U. M <br />EVAPORA7IVE COOLERS <br />CLOTH�S DRYERS <br />VENTII��TION FAN <br />RANGEHOOD <br />AIR MANDLING UNIT — C.F.M. <br />STOVE — WOOD <br />METAL FIREPLACE 8 CHIMNEY <br />1 FIREPLACEINSERT <br />HEAT PUMP <br />SUB TO7AL S <br />PEHMIT f <br />TOTAL FEE S <br />( NUMBEF PLAN C <br />FEE <br />FEES VALUATION <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTMER <br />PENALTY <br />S <br />DATE <br />ii/s/aa <br />i 50 <br />10 00 <br />17 50 <br />K FEE <br />RECEIPT NO. <br />FEE <br />17 50 <br />TO7AL I I 17 I50 <br />PENMIT VALIOATION <br />WHEN PROPERLV VALIDATED pN THIS SPACE) THIS IS,YpU[i PER�.41T � <br />_ I I �, ' <br />� <br />� <br />,. �.:� ��T `� <br />�� <br />.4DURESS FILE <br />i , , <br />d <br />