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�he EirrRrern C O N ST R U CT I Q y <br /> Ci�Y OF � <br /> �verett PERMIT PeRnnir No. 12313 <br /> GTV HALL 259�87d5 <br /> EVEREfT.WA98'.01 [J COMBINATION ❑ BUILDING �% MECIiANICAL ❑ PLUMBING <br /> UdlNE9 MAIL ADDRE55 dTY ZIP PHONE <br /> Gail McDonald 2412 East Grand Avenue Everett 98201 259-5214 <br /> APCMiTECT OR OESiGNER MAIL ADDRE55 CITY 2iP VHONE <br /> GENERAL CONTRACTOR MAIL AD�RE55 CITV ZIP PMONE LICENSE M <br /> MEGHANICAL LONTRACTOR MAIL AODPE55 CITY 2tP PMON'c LICENSE� <br /> Gas Equipment Contractors 2221 120th N.E. Bellevue 98005 455-9320 <br /> - PLUMBING GONTRRGTOR MAIL ADORE55 GITY ZIP PHONE LICENSE 11 <br /> G1A550F WORN <br /> ❑NEW O ADDITION 0 AL7ERA710N ❑REPAIR ❑ DEMOLITION ❑ FENCE O SIGN O WOOD STOVE/FIREPLACE INSERT <br /> VALUATION OF WORK <br /> f <br /> DESCRIBL WORK <br /> PROPOSED UtE OF BUILDING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE uAME TO BE TRUE AND <br /> LEGAL DESLRIPTION OF PROPERTYISHOW BELOW ORATTACM FOUR COPIE51 CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> LOT_BLOCK__OF WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br /> OR CANCEL THE PROViSIONS OF ANY OTHER STATE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION. <br /> JOB ADDRESS SIGNATURE OF CONiPAGTOR OR AUTHOR2EU AGENT OATE <br /> 2412 East Grand Avenue X Check #9566 8 10 83 <br /> PLUMBIN6 MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATERCLOSET�TOILE� AIR COND.UNITS — M.P. EA. <br /> BATMTUB REFRIGERATIUN UNITS— N.P. EA. <br /> . LAVATOHY(WASH BASIN) } BOILERS—H.P. EA. 6 00 <br /> SHOWER GAS FIRED A,Q UNITS�—TONNAGE EA. <br /> KITCMCN SINK 8 DISP. FORCED AIR SYSTEMS— B.T.U. M EA. <br /> DISHWASHER WALL HEATERS— B.T.U. M <br /> LAUNDRV TRAV UNIT HEATERS— B.T.U. M <br /> CLO7HES WASHER EVAPORAiNE COOLERS ' <br /> WATER HEATER �LOTHES DRYERS <br /> URINAL VEN7ILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR ORAIN AIR HANDLING UNIT— G.F.M. <br /> VACUUM BREAKERS STOVE—WOOD <br /> ROOF DRAINS— RAINLEADERS METF.L Flf�PLAGE 6 CHIMNEY <br /> SINK(SERVICE — BAR,ETQ) FIRF.PLACE INSEFT <br /> hEOT PUMP <br /> 1 �tan e 4 50 <br /> �'v <br /> 1 L�ate e <br /> SUB TOTAL f SUB TOTAL S I <br /> PEPMIT f PENMIT f � <br /> TOTAL FEE S TOTAL FEE S 19 50 ' <br /> SIDE VARD SETBACK STREET SEiBACK REAR YARD SETBACK PLAN CHE(K NUMBER PLAN CMECK FEE <br /> FEE RECEIP7 NO. I <br /> USE ZONE LOT ARGA VACANT SITE — FEES VALUA710N FEE � <br /> : :YES ��.NO <br /> TYPE OF CONS7. OCq1PANCY GROUP NO.OF DWELLING UNITS � <br /> BWLDING s � <br /> SIZE OF BLOG NO OF STORIES MA%.OCC. LOAD <br /> PLUMBING � <br /> FIRE ZONE BASEMENT q OUIRED KLERS MECMANICAL 1 J SO <br /> VES , NO <br /> APPROVALS BV DATE OLHER <br /> 1. ENVIRONMENTAI CHECK LIST PENALTV U.B.Q � <br /> SEC.309(a) , <br /> 2.BUILDING PLANS <br /> TOTnL 19 50 <br /> 3.FIPE HYDRANT <br /> a.FIRE PROTECTION SYS7EM PERMIT VALIDATION <br /> 5.GRADING WMEN PROPERLY VALIDATED�IN THIOS�4�1 THI$�ISOYQUP PEF�AIT ( • i I <br /> 6.DRAINAGE o I Y 5 U � <br /> 7.EN VIRONMENTAL M�PACT STATEMENT r,• r <br /> APPL CATION ACCTFIY PLANS CMECKED BY APPF. FOR ISSUANCE BY 1'cl U R REC[I PT � ` <br /> TI-I���K 1'OU <br /> I Q I'.�v �.Zi <br /> ADDRESS FILE <br /> ! . -- ' <br />