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lhcEl•frgrPert r" CONSTRUCTIOP" <br />Qiv OF <br />everett PERMIT PERMIT NO. 12235 <br />CITY HALL 259�B7d5 <br />EVERETT, WA 98201 � COMBINATION ❑ BUILDING ❑ MECHANICAL ❑ PLUMBING <br />X <br />OWNEN M41LRO�RE55 CITY ZIP PHONE <br />RRi(`c TLMtiC A71 GrwnA FVarP4f QR701 2S7-d011 <br />�RCMrtECt OP OESIGNEN M�II ���RESS GITY ZIV PHONE <br />GENENRLCONTR�CiOR MRILADDRE55 GITY ZIP PMONE �ICENSE/ <br />EVERETT BLDRS. <br />MECMRNIGAL GONTflRCiOP MAIL R�ORESS CITY 21P PHONE LiCENSE � <br />FLUMBING GONTP�GTOR MR4 qDORE55 GTY 21P VMONE LICENSE � <br />, GU55 OF WORN <br />❑ NEW � ADDITION ❑ ALTERATION O REPAIR O DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVFJFIREPLACE INSERT <br />VPLURTION OF WOPN <br />: 8915.�� <br />RESIDE RESIDENCE <br />ROPOSEO USE OF 6UILDING <br />RESIDENCE <br />EGPL DESGHIPTION OF PROPENTY �SHOW <br />�OT 16 BIOCK 17Opp LE' <br />iOB RDDRESS <br />831 GRAND <br />PLUMBINO <br />NO. TYPE OF FIXTURE <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY�WASH 9ASIN) <br />SMOWER <br />KITCMENSINKd DISP. <br />OISMWASHER <br />LAUNDRYTRAY <br />CLOTMES WASHER <br />WATER MEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACVUM BREAKERS <br />ROOF DRAINS — RAINLEADE <br />SINK (SEPVICE — BAR. ETC.) <br />SUB T0TI1L <br />PERMIT <br />TOTALFEE <br />1. ENVIRONMENiA� CHECK LIST <br />2. BUILDING PLANS <br />3. FIRE MY�RANT <br />1. FIRE PHOTECTION SVSTEM <br />f <br />f <br />S <br />YARD <br />YES ;:NO <br />8. DRAINRGE <br />7.ENVIRONMENTALIMPACTSTATEMENT <br />8. HEALTH DISTRICT <br />APPUCATION ACC. BV PLANS CHECKED BY APPR. FOR <br />i� i� <br />I HEREBY CERTIFY THAT 1 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 PRESUMETO GIVE F.UTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF AVY OTHER STATE OR <br />LOCAL W REG�ING CONS7RUCTION OR THE <br />PERFOR A NCE OF CO TRUCTION. ^ <br />SIGNAT RE GONTRACTORO TMORREDAGENT / �lTE <br />X 7 20 83 <br />MECHANICAL <br />TYPE OF EOUIPMENT FEE _ <br />AIR CONO. UNITS — H.P. EA. <br />REFRIGEflATION UNITS — M.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />WALL MEATERS — B.T.U. M <br />UNIT MEATEHS — B.T.U. M <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEMOOD <br />AIR HANDLING UNIT — C.F.M. <br />METAL FIREPLACE d CHIMNEV <br />FIREPLACEINSERT <br />PERMIT f <br />TOTRL FEE f <br />FEE I F7ECEIPT NO. <br />FEES I VALUATION <br />BUILDING = B41S <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTY U.B.C. <br />SEC. 3W (a) <br />TOTAL I I �4 ISO <br />PEflMIT VALIDATION <br />WHEN PROPERLY VALIDATED pN TH19 CPIC' � THI515oYQ�I�P�i�l' � <br />� j 1 5 <br />N <br />N <br />YOUR RECEIPT"� <br />7HANK YOU <br />ADDRESS FILf: <br />2 D .�. 83 <br />1 <br />� <br />J <br />..� <br />