Laserfiche WebLink
�hP£,.�R;°� ; -- '�:ONSTRUCTION- <br />� <br />everett PERMIT PERMITNO. 14567 <br />CITV HALL 253B7d5 <br />EVERET7. WA92207 � COMBINATION ❑ BUILDING �] MECHANICAI. ❑ PLUMBING <br />OWNER MRIL ADORESS �ITY :IP PNONE <br />John Medima 3020 Grand #4 Everett 98211 <br />ARCMITECT OR DESIGNER MAIL ADDRESS C11Y ZIP PMONE <br />GENERAL CONiq��70R MAIL AODRE55 LITY ZIP PMONE LICEN�E � <br />MECHANICAL CONTRACTOR MAI� ADDRE55 CITY ZIP PHONE LIGENSE � <br />Natural Gas Equipmeat 1625 East Marine View Drive Everett 258-2491 <br />PIUMBING CONTR��TOR MqIL AOORE55 GITY 21P PMONE UCENSE � <br />❑ NEW O ADDITION ❑ ALTERATION ❑ R'tPAIH ❑ DEMOLIT�ON O FENCE ❑ SIGN ❑ WOOD STOVE/FIREPLACE INSE�7 <br />s <br />UESCRIBE WORI( <br />PNOPOSEO USE OF BUILDING <br />LEGAL OESCRIPTION OF PROPERTY �SMOW BELOW OR <br />LOT__BLOCI(__Of <br />JOBRUDRESS <br />3020 Grand i14 <br />PLUMBINf3 <br />N0. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILETI <br />BAThiUB <br />LAVATORV�WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 �ISP. <br />DISNWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />WATER HEATER <br />URINAL <br />ORINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF ORAINS — qAINLEADERS <br />SINK (SERVICE — BAR, ETC.1 <br />SUB TOTAI <br />SIZE OF BLDG. N0. OI <br />FIRE 20NE BASEA <br />APPpOVALS <br />i. ENVIRONMENTAL CHECK LIS7 <br />2. BUILDING PLANS <br />3. FIPE MYDRANT <br /><. FIRE PROTECTION SYS7EM <br />5. GRADING <br />6. DRAINAGE <br />7.ENVIRONMENTALIMPACTSTAT <br />B. HEALTH DISTRICT <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />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 />SIGNAi)IRF OF CONTPACTOR Ofl AUTHOR2ED /GENT DATE <br />FEE NO. TVPE OF EOUIPMENT <br />AIR COND. UNITS — H.P. EA. <br />HEFRIGERATION UNITS — H.P. EA. <br />BOIl.ERS — H.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />FORCEU AIR SYSTEMS — B.7.U. M EA. <br />WALL HEA7ERS -- B.T.U. M <br />UNIT HEATERS — B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRVERS <br />VENTILATION FAN <br />RANG[HOOD <br />AIR HANDLING UNIT — C.F.M. <br />STOVE — WOOD <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />� <br />f <br />S <br />REAR VARD SET9ACK <br />�..YES �. �NO <br />mra <br />BY IAPPp.FOR�55UANCEBY <br />SUB TOTAL S <br />PEflM1T S <br />TOTAL FEE f <br />INUMBEfl PLAN C <br />FEE <br />FEES VALUATION <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />O7HER <br />PENALTY <br />S <br />(a) <br />FEE <br />RECEIPT NO. <br />FEE <br />14 <br />TOTAL I I 19 �O <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (W TMIS SPAGE� THIS�IS YOU�7 PERMIT _ �`-� <br />� ' . � '. � 11J <br />� <br />�" <br />. l e-'1 <br />ADDRESS HLE <br />