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,,,�`:`","„ ,pNSTRU�TlO� <br />��,� oF � ^ " <br />everett pERMIT PER��T ��. ���z�! � <br />CITY MALL 259�87d5 <br />EVEREiT,W�9B207 ❑ COMBINATION ❑ BUILDING '�.J�' MECHANICAL ❑ PLUMBING <br />OWN?R MAILAOOPE55 LITY Zlv PHONE <br />RUSSELL EASTMAN 3127 GRAND EVERETT WA <br />ARGHITEGT OR DESIGNER MAIL ADOFE55 QTY ZIP PMONL <br />GENENl.LCONTF/GTOF MAILADDRESS QiY ZIP PMONE LICENSE• <br />MECMANILAL CONTRf.QOR MAIL ADD0E55 CITY ZIP PHONE LICENSE • <br />Natural Gas Equpment 1625 E Marine View Drive Everett 258-2441 <br />PWMBING CONTRACTOR MAIL A�ORESS CITV 21P PMONE LICENSE • <br />s <br />LOT <br />C� NEW ❑ ADDITION � ALTERATION ❑ REPAIR O DEMOLITION ❑ FENCE ❑ SIGN O WOOD STOVEIFIREPLACE INSERi <br />RIBE WORK <br />Install conversion burner <br />3127 Grand <br />PLUMBING <br />NO. TYPE OF FIXTURE OR <br />WATER CLOSET ITOILEn <br />BATHTUB <br />LAVATORt�WASH BASIN) <br />SHOWER <br />KITCHEN SINK & DISP. <br />D!SHWASF!ER <br />LAUNDRYTRAY <br />CLOTMES WASHER <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />FOOF �PAINS — RAINLEADEFS <br />SiNK ISERVICE — BAR, ETC.) <br />SIDE <br />BLDG. <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />APPROVALS <br />1. ENVIRONMENTAL CMECK LIST <br />2. BUILDING PLANS <br />7. FIRE NYDRANT <br />4. FIRE PROTECTION SVSTEM <br />5. GRA�ING <br />6. DHAINAGE <br />7.EN'.IRONMENTALIMPACTSTATEMENT <br />e. MEALTH DISTRICT <br />APPUCATION ACC. BY PLANS CHECKED BY <br />! <br />I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINFD THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS P.ND ORDINA�VCES <br />GOVERNING THIS TYPE OF WORK 1NILL'dE COMPLIED'NITH <br />WHETHER SPECIFIED HEREIN OR NOT.',-HE GRA�'INf, OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TU VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STPTE OR <br />LOCAL L�W REGULATING CONSTRUCTION OR THE <br />PERFOR CE OF CONSTRUCTIGN. <br />SIGNATOR F G ALTi7A OR AU MOPiZEC AGENT DlTE <br />v .�f \�. � �Cl 12/4/84 <br />MECHANICAL <br />FEE NO. TYPE OF EOUIPMENT <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — H.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />FORCED AIR SYSTEMS — �.T.U. M EA. <br />\NALL HEATERS — B.T.U. M <br />UNIT N'eATERS — B.T.U. M <br />EVAPCAA7IVE COOLERS <br />CIOTHES DFYERS <br />VENTILATION FAN <br />ftANGE HOOD <br />AIR IIANOLING UNIT — C.F.M. <br />stove - w000 <br />ME7AL FIREPLACE S CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />1 conversion burner <br />�S <br />REAR YARD SETBACK <br />VACANT SITE <br />YES . NO <br />NO. OF DWELLING UNITS <br />M11AY.00G LOAD <br />FIR[ SPRINKLERS <br />HLOUIRED <br />VES NO <br />BV I DATE <br />ISSUANCE BY <br />PLAN CMECH NUN <br />FEES <br />BUILDING <br />PLUMBING <br />SUB TOfAL S <br />PERMIT S <br />TOTAI FEE S <br />PLAN C <br />FEE <br />VALUATION <br />5 <br />RECEIPT NO. <br />FEF <br />MECHANICAL �G OO <br />OTHER <br />PENALTV U.e C. <br />SEC. 30J lal <br />TOTqL � ( QO <br />PERMIT VALIOA710N <br />WHEN PROVEflLV VALIDATED pN THIS.SPACE) TMIS IS YO R�PEjiM�T (�1 <br />, Y : � -- �, <br />�� <br />�' <br />, -� <br />�. � <br />�iD�:;i:_'�1�, i�iU.' <br />z <br />z <br />0 <br />� <br />r� <br />m <br />H <br />� T <br />.. -a <br />v+ x <br />m <br />00 <br />mo <br />n <br />� C <br />O 3 <br />m <br />--1 2 <br />S —i <br />m <br />.. <br />.O Z <br />v -i <br />r x <br />.. .-� <br />--1 N <br />< <br />O A <br />�a <br />-r m' <br />S <br />m � <br />N <br />v <br />or <br />;� m <br />C N <br />� N <br />m' <br />< ("1 <br />�r <br />. m <br />n <br />a <br />.� <br />x <br />a <br />z <br />� <br />2 <br />N <br />Z <br />O <br />--I <br />i--� <br />n <br />m <br />