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thc Evergreen <br /> °��°F � �ONSTRUCTIOI� ` <br /> everett PERMIT PERMIT NO. 15154 <br /> CITY HALL 259�8745 <br /> EVERETT,WA98201 ❑ COMBINATION ❑ BUILDING II�tY MECHANICAL ❑ PLUMBING <br /> OWNER MAIL AD�RESS CITY ZIP PNONE <br /> Steve Westcot 1022 Grand Avenue �erett <br /> AflGNITECT OR DESIGNER MAIL ADDRE55 CITY 21P PMONE <br /> GENERAL GONTqqCTOR MAIL AOOHESS CITY IIP PMONE LICENSE I <br /> MECHANICAL CONTRACTOR MAIL AD�RESS CITY ZIP PHGVE LICENSE� <br /> Barron Heatinq P.O. Box 1118 Bellingham 98227 676-i131 <br /> PLUMBING CONTRRCTOR MAIL pDDRESS CITY ZIP PNONE UCENSE/ <br /> . BARROH27302 <br /> cuss oF woAK - <br /> O NEW ❑ ADDITION ❑ ALTERATION ❑REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD S70VEIFIREPLACE INSERT <br /> VAl11ATION OF WORK <br /> S <br /> DESCflIBE WORK <br /> PROPoSEU USE OF BUILDING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED TKIS <br /> LEGRL OESCflIPTION OF PPOPERTY�SMON'BELOW OR pTTACN POUR COPIES� APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> �or_e�ocK_oF_ GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITN <br /> WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br /> OR CANCEL THE PfiOVISIONS OF ANY OTHER STATE OR <br /> LOCAL LAW REGUTATING CONSTRUCTION OR THE <br /> PERFnRMANCE OF CONSTRUCTION. <br /> JOB ADOqE55 :1GNAT OF CONTR�CT R OR AUTMORIj��AGENT OATE <br /> 1022 Grand Avenue X ,rGce o� 7/17/BS <br /> PLUMBINO MECHANI L <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATEF CLOSEI(TOILE'� AIR COND.UNITS— H.P. EA. <br /> BATHTUB REFRIGERATION UNITS— <br /> H.P. EA. <br /> LAVATORY(WASHBASIN) BOILERS— H.P, EA. <br /> SHOWER GAS FIRED A.C.UNITS—TONNAGE EA. <br /> KITCHEN SINK 8 OISP. FORCED AIR SYSTEMS— B.T.U. M EA. <br /> DISHWASHER WALL HEATERS— B.T.U. M <br /> LAUNDRYTRAY UNIT HEATERS— B.T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLERS <br /> WATER HEATEfi CLOTMES ORVERS <br /> URINAL VENTILATION FAN <br /> DRINKII'G FOUNTAIN RANGE HOOD <br /> _ FLOOB�aAIN AIR HANDLING UNIT— QF.M. <br /> � !':• ��� � bf6?,'ERS STOVE—WOOD <br /> r'JUf JrIP.Nii-� RAINlEAO[RS METAL FIREPLACE 8 CHIMNEY <br /> : '�'�° '�`Vf c— BAR, ETC.) FIREPLACE INSERT <br /> HEAT PUMP <br /> SUB TOTAL 3 SUB TOTAL f 6 f� <br /> PERMIT S PERMIT f <br /> TOTAL FEE f TOTAL FEE 2 16 O <br /> SIDE YARD SETBACK STREET SETBACK REAR VARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE qECEIPi NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> �!YES ::NO FEES VAWATION FEE <br /> TVPE OF CON57. OCCUPANCY GROUP NO.OF OWELLING UNI7S <br /> BUI.DING 5 <br /> SIZE OF BLDG. NO,OF STORIES MA%.OCC. LOAD <br /> PLUMb'NG <br /> FIqE ZONE BASEMENT FIRE SPRINKLERS MECHANICn� <br /> REQUIRED 16 00 <br /> CYES �=NO <br /> APPROVALS BY �ATE OTHER <br /> 7. ENVIRONMENTAL CHECK LIST PENALTY U.B.G � <br /> 2.BUILDING PLANS SEC.J03(al _ <br /> 3.FIREHYDRANT TOTAI 16 00 <br /> 0.FIRE PROTECT!ON SYSTEM PERMIT VALIDATION <br /> S.GRADING WHEN PROPERLY VALIDATED(W THIS SPAGE)TMIS'ISYC�UE�PERI�IT-- � <br /> 6.DRAINAGE � <br /> 7.ENVIRONMEN7ALIMPACTSTATEMENT �"'I <br /> B.HEALTH DISTFICT � � T� <br /> � i i � <br /> APPLICATION ACC.BY PLANS CHECKED BY APPR.FOR�SSUANCE BY <br /> i . . . <br /> ADDRESS FILE <br />