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d�eE�erAmen CONSTRUCTIC'y <br />CirY OF ' <br />everett PER�IIT PERMIT NO. 13�64 <br />CITY HALL 259�87a5 <br />EVERETT.1NA98207 ❑ COPABINATION ❑ BUILDING �XI MECHANICAL ❑ PLUMBING <br />QWNEq MRIL AD�RE55 CITY ZiP �HONE <br />STEWART BRITT 3202 Grand N3 Fv rP t — <br />ARGNITECT OR DESIGNER MR4 pODRESS GITV 21P PMONE <br />GENEFALGONTRPGTON MAILADDRE55 GITY ZIP PMONE LIGENSE� <br />MEGMANIGAL LONTRACTOR MFIL AODFESS dTY Z�P �HONE LILENSE � <br />Natural Gas Equipment 1625 E Marine View Drive _ <br />PWMBING LONTRACTOR MAIL ADDRE55 CITY 21P PHONE LIGE <br />S <br />rc Ck�lEW O ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION O FENCE O SIGN ❑ WOOD STOVFJFIREPLACE INSERT <br />WOPN <br />Install �nvented <br />�OT _ BLOCK __OF <br />3202 Grand #3 <br />PLUMBING <br />N0. TYPE OF FI%Tl <br />W ATER CLOSET (TOILEn <br />BATHTUB <br />FI <br />water heater <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISHWASHER <br />LAUNDRVTRAY <br />CLOTHES WASMER <br />WATEF HEHTER <br />URINAL <br />�RMKING 'OUNTAIN <br />FLOOR ORAIN <br />VACUUM 6PEAKERS <br />ROOF DRAINS — RAIN!.EADER$ <br />SINK (SERVICE — BAF, ETC.) <br />ITEM <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />APPflOVALS <br />1. ENVIRONMENTAL CHECK LIST <br />2. BUILDING PLANS <br />3. FIRE HYDRANT <br />4. FIRE PROTECiION SYSTEM <br />5. GRADING <br />6. DRAINAGE <br />7. [NVIRONMENTAL IMPACT STATE� <br />B. IIEALTH OISTRICT <br />aPPI ICATION ACG 9Y PLANS <br />I HEREBY CERTIFY THAT I HAVE NEAD 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 />PERMI7 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 />PERFORMANCEOFCONSTRUCTION. <br />SIGN T R F CO TRACTOH OR AUTHORRED AGENT DAiE <br />j( C� �- 4/20/8 <br />MECMANICAL <br />FEE N0. TYPE OF EOUIPMENT <br />AIR CON�. U..,lS — H.P. EA. <br />PEFHIGERATION UNITS — H.P. EA. <br />BUILERS — H.P. EA. <br />GAS FIRED A.Q UNITS — TONNAGE EA. <br />FORCED AIR SYSTEMS — B.i.U. M EA. <br />WALL HEATERS — B.T.U. M <br />UNIT HEA7ERS — B.T.U. M <br />EVAPOFATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILA710N FAN <br />RANGEHOOD <br />AIR HANDLING UNI7 — C.F.M. <br />STOVE — WOOD <br />METAL FIREPLACE 8 CMIMNEV <br />FIREPLACEINSERT <br />HEAT PUMP <br />3 <br />f <br />f <br />YES NO <br />BY <br />FOR <br />SUB TOTqI. <br />PERMIT _ <br />TOTAL FEE <br />:NUMBER F <br />FEE <br />FEES VALUATION <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />S <br />FEE <br />� <br />S <br />f <br />CHECK F[E <br />RECEIPT NO. <br />FEE <br />PENALTY SEC. J03 �al <br />TOT�L 14 � <br />PERMIT VALIDATION � <br />WHEN PROPERLV VALIDATED pN THC 6�AC�EI THI$�I�YQUH P�qMIT � � <br />� �4 U <br />ADDRESS FI!f <br />l� � <br />.. ,. .�_.: il � � . <br />. . ,; �'• ( . t 1 <br />V <br />;Z u � i <br />