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� TI01� <br /> �,�� � ��NS�� r � � _ . <br /> ��p ����� J - � h; <br /> ��+�v� �,:' . - F�ERMITNO. O�Z67 , � <br /> '�rtv w�u xeae�.s ❑ COMSINATION � OIIILbINO . . (� MECHANICAI- .I� PLUi1d1N0 , <br /> IEv�perr.w� oezoi �"' <br /> ' ' wa , _ a-v . , :. � <br /> Harold Gilberteon 1422 Grand ' Everett 98201 252-1703 <br /> ARCHIIECT OR DESIGNER <br /> MAIL ADDRE55 GITY 21P ��E <br /> GENEML CONTMCTO� IM��ADDRE55 <br /> Cltt 21P PIIONE LICENSE I <br /> Same <br /> MECHANICAL CONTRACTOR 1MR ADDRE55 <br /> Cltt 21P q10NE LICENSE� <br /> PLUMBING CONTRAGTOR MAIL ADDRESS <br /> CITY ZIP PNONE LICENSE I <br /> CUSS OF WOPK <br /> O'dEW ❑ADDITION ❑ALTEMTION I�REPAIR ❑DEMOLITION ❑fENCE ❑SIGN CJ�RAGE <br /> ���u 600 OJ� <br /> s <br /> DESCRIBE WOPK <br /> re-roof comp. <br /> PROPOSED CS'.OF B W LDING <br /> single family reaidence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS A • <br /> LEWLDESCRIPTIONOFPHOPERTYISHOW BEIOWOHATTPGHFOURfAPIES� PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> �oT e�ocK 31bF Hiltons lst TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> S 50 Ft. of N 171 Ft Block A HERE�N OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> PRESUM E i0 GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO• <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br /> � CONSTRUCTION OR THE PERFORMANCE OF CANSTRUCTION. <br /> SIGNATWE OF CANTHACTOR OR AUTNORI2ED AGENT DATE <br /> .NB R��RE55 � X _ 3IQ�BO <br /> 1422 Grand <br /> PLUMSINO MECHANICAL <br /> TYPE OF EOUIPMENT FEE <br /> N0. TYPE OF FIXTURE OR ITEM FEE NO A�R COND.UNITS—H.P.EA. <br /> WATEF ClOSET ROILETI <br /> REFRiGERATION UNITS—H.P.EA <br /> 6ATHTUB BOILERS—M�P �� <br /> LAVATORY(WASH BASIN) <br /> GAS FIPED AL.UNITS—TONNAGE EA. <br /> `iHOWER FORCEL AIR SYSTEMS—B T.LL M EA. <br /> KITCHEN SINK 8 DISP. WALL HEATERS—B T.U. M <br /> DISHWASHER <br /> UNIT HEPTERS—B.T.U. M <br /> LAUNDRY TRAY EVAPORATN[COOLERS <br /> CLOTHES WASHER CLOTHES URVERS <br /> WATER HEATER yENTILITICN FAN <br /> URINAL RANGE HOLD <br /> DRINHING FOUNTAIN AIR HANDLING UNIi— GP M. <br /> FLOOR DFAIN STOVE <br /> VACUUM BREAKERS ME1AL FIREPLACE B CHIMNEV <br /> ROOF DRAINS—RAINLEAOERS <br /> SINK ISERVICE—BAR ELG.1 <br /> SUBTOTAL = <br /> SUB TOTAL pERM1T f <br /> � PERMIT s f <br /> TOTALFEE f TOTAIFEE <br /> pLAN CHECK FEE <br /> SIDE YARD SETBACK SiREET SET�ACK REAR YARD SETBACK PLAN CHECK NUMBER FEE RECEI�T N0. <br /> USE ZONE LO7 AREn l'AG1Ni SITE FEES VALUATION FEE <br /> ❑YES ❑NO <br /> TVPE OF CONST. OCCUPANCV GROUP NO.OF D\4ELLING UNITS E 600.00 E OO <br /> BUILDING <br /> SIZE OF BLDG. NO.OF STORIES MA%.OCC.LOAD <br /> PLUMBING <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS MECHANICAL <br /> REOUIRED <br /> ❑YES ❑NO <br /> 11PPNOVALS <br /> BY DI1TE OTHE7 <br /> 1. ENVIRONMENTAL CMECK LIST PENALTY U.B C. <br /> SEC.303(a) <br /> 2. BUILDING PLANS TOTAL 6 00 <br /> 3. FIRE HYDRANT <br /> PERMIT VALIDIITION <br /> 4. FIRF.PROTECTION SYSTEM WHEN PROPERLY VALIDATED(IN THISeSPA�C1EI THIS IS VOUR PERMIT <br /> 5. GRADING 7 f ` O S O O �.O O �'� � <br /> liJ <br /> 6. DRAINAG� N <br /> 7. ENVIRONMENTAL IMPACT STATEMENT ' <br /> & HEALTH OISTRICT - <br /> YOUR RECEIPT o <br /> APPLICAiION ACC.BV PLANS CHECKED BY APPF.FOR ISSUANCE BY THANK YO U . <br /> . ! � � i <br /> - 5 Wrl Y1 <br /> � ADDRE F <br />