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,,,�Erergreen ^ �ONSTRUCTION �- <br /> CITV OF <br /> ���erett PERMIT pERMIT I�O. O97H5 <br /> CITY HALL 259�8745 <br /> EVERETT.WA 98207 ❑ COcJIBINATION ❑ BUILDING �tMECHANICAL PLUMBING <br /> O\4NE�1 AIAI�ApOFE55 CIiY 21P VHONE <br /> Joel 0. Niemi 1131 Grand Everett <br /> ARCHIiEGT OR OESIGNER MI.IL ADORESS CITY ZIP PRONE <br /> GENERALCANTRACiOfl MAILADDPESS CRY ZIP PNONE LICEN;E/ <br /> I.iECNANICALCONTRAGTOR MRILPpDPE55 CITY ZIP PNGNE LIGENSEI <br /> Natural Gas Equipment 1611 East Grand Everett 98201 258-2441 <br /> PWMBMGGONiPACiOR MAILAD�RESS CITY 21P PMONE LICENSEI <br /> C1A550F WOPK <br /> ❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOIITION ❑FENCE ❑SIGN GARAGE <br /> VRLUATION OF WOFN <br /> 5 <br /> OESGfiIpE WORK <br /> PROPOSED USE 0°�U�LDING <br /> I HEREBY CERTIFY THAT I FIAVE READ AND EXAAIINED THIS AP• <br /> LEGAL�ESCRIPllONOFPROPERTYISNOWBELOWORATTACHFOIIPfAPIES) PUCATION AND KNOW THE SAME TO BE TRUE AND CORFECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOV=RNING THIS <br /> �or e�a�_oc TYPE OF WORK WILL BE COIAPUED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRAVTING OF A PERMIT DOES NOT <br /> PRESUME TO GIVE AUTHORITl'TO VIOLATE OR CANCELTHE PRO� <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br /> CONSTRUCTION OR THE PERFORMANCE 0� CONSTRUCTION. <br /> SIGNAT RE OF CONTRACTOR OR AUTMORIZEC`AGENT 9�16/81 <br /> JOB P�DRESS <br /> 1131 Grand X �'_ t � <br /> PLUMBIN6 MECHANICA <br /> NO. TYPE OF FIXTUAE OR ITEM FEE NO. TYPE OF E�UIPMEPIT FEE <br /> WATER CLOSET(TOILET) AIR COND UNITS—H.P.EA. <br /> 6ATH1U0 REFRIGERATION UNITS—H P.EA <br /> LAVATORY(WASH BASIN) BOILERS—H.P.EA. <br /> SNOWER GAS FIRED A.C,UNITS—TONNAGE Ei�. <br /> KITCHEN SINK&DISP. ]. FORCED AIR SYSTEMS—B.T.U. �I S ^A EA. 6 O O <br /> DISHWASHER WNLL HEAIERS—B T.U. �' <br /> LAUNDRV TRA'/ UNIT HEATEPS—B.T.U. M <br /> CLOTHkS'NASHER EVAPORATNE COOLERS <br /> V(4TEI1 HE.TFR CLOTHES DRYERS <br /> -- VENTILATION FAN _ <br /> URh�A: <br /> DRINKING FOUNTAIN RANGE HOOU <br /> AIR HANDLING UNIi— GF.M. <br /> FLOOR L9AIN <br /> VACUUM 63EAKEFS STOVE <br /> ROOF DFAINZ—RAINLEADERS METAL FIREPUICE&CHIMNEY <br /> SINK ISERVICE--BAR.ETC.1 <br /> — SUBTOTAL S 6 00 <br /> SUB TOTAL <br /> PERMir S PEFMIT S 3 00 <br /> TOTALFEE f 9 00 <br /> TOTALFEE F <br /> PLAN CHECK FEE <br /> SIDE�AFlD SETBACK STREET SETBACK REAR VARD SETBACK PLAN CHECK NUMBER �EE pEC'cIPT N0. <br /> USC ZONE LOT AF7EA VACANT SITE FEES VALUATION FEE <br /> IJYES ❑NO <br /> TYPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING UNI75 <br /> BUILDING b <br /> SIZE OF BLDG NO.OF STORIES MAX.OCC.IOAD <br /> PLUMBING <br /> FIREZONF BASLMENT FIRESPRIVKLERS MECHANICAL 9 OO <br /> REOUIRED <br /> ❑YES ❑NO <br /> APPROVALS <br /> BY DATE OTHER <br /> t. ENVIRONMEN7ALCHEGlLIST PENALTY U.B.C. <br /> SEC.303�a) <br /> 2. BUILDINGPLANS TOTAL 9 00 <br /> 3. FIRE HYGRANT <br /> 4. EIRE PROTEC710N SYSTEM PEPMIT VALIDATION <br /> WHEN PROPEHLY VALIDATED(IN THIS SPACE)THIS IS YOUR PERMIT <br /> 5. GRADING ; � , � � , �'' � �' '� — � <br /> 6. DRAIttAGE � <br /> Z E'JVIRONMENTAL IMPACT STATEMENT � <br /> B. HEALTH DISrRICT ,. ; i�l � <br /> APPLICATION AIX..8Y PLANS CHECKED BY APPR.FOR ISSUANCE BY , , i <br /> ADDRFSS FILE <br />