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� <br />d�r ErcrB�ren - � 0 N ST R U CT I O��. <br />(;ITY OF � .. <br />everett PERMIT PERMIT N0. �-���q <br />CITY HALL 255�&ii5 <br />EVERETT,1NA98201 � COMBINATION � BUILDINCa ❑ MECHANICAL ❑ PLUMBING <br />OYINER MA�L ADDRE55 GTY 21P PNONE <br />Neil T Keefe 3311 Pine Street Everett 98201 252-0420 <br />ARGHrtEG] OR DESIGNER MAI� PDDRE55 QTY ZIP PHONE <br />GENERAL GONTHRLTOR MAII /ODPE55 CITY ZIP PIIONE LIGENSE � <br />Same <br />MECHANICRL CONiRAGTOR MAIL ADOPE55 CITY ZIV PHONE LICENSE � <br />PLUMBING GONTRRGTOP MAIL ROORE55 CITY ZIP PMONE LIGENSE M <br />❑ NEW ❑ ADDITION ❑ ALTERATION C.��EPAIR ❑ DEMOLITION ❑ fENCE � SIGN O WOOD STOVFJFIREPLACE INSERT <br />s 750.00 <br />)ESGRIBE WONN <br />Repair Porch <br />�NOPOSED USE OF BUILOING <br />single family resid <br />LEGRI OESGRiPT10N OF PROPERTY �SNOW BEL� <br />�o�'� e�ocK 804oF Evere <br />JOB AOORESS <br />3311 Pine Street <br />PLUMBINO <br />N0. TYPE OF FI%TUHE OR <br />WATER CLOSET �TOILET) <br />BATHTUB <br />LAVA70RV(WASMBASIN� <br />SNOWER <br />KITCHEN SIhK 8 DISP. <br />LAUNDRYTRAY <br />CLOTME$ WASMER <br />WATER MEAiER <br />URINAL <br />OFiINKING FOUNTAIN <br />FLOOR DRAIN <br />ROOF DRAINS — <br />SINK ISERVICE — <br />SIZE <br />PEPMIT <br />TOTALI <br />APPPOVALS <br />1. ENVIRONMENTAL CNELK LIST <br />2. BUILDING PLANS <br />3. FIF[ HYDFANT <br />a. FIFE PROTECTION SYSTEM <br />5. CRADING <br />6. DRAINAGE <br />7. ENVIflONMENTAL IMPACT STATEMENT <br />B. MEALTH DISTHICT <br />APPLICATION ACC. BY PLAN$ CME <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAM�NED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVER!JING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUMETO 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 />cicueTUPGl1Ff.(1NiRAfiONORGIITNOBIZ�AGENT DALE <br />MECHANICAL <br />FEE N0. TYPE OF EOUIPMENI <br />AIR COND. UNITS - H.P. EA. <br />REFflIGERAT10N UNITS — H.P.EA. <br />BOILERS — N.P. EA. <br />GAS FIREO A.C. UNITS — TONNAG <br />FOPCED AIR SVSTEMS — B.T.U. <br />WALL HEATERS — B.T.U. <br />UNIT HEATEPS — B.T.U. <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGE HOOD <br />AIR HANOLING UNIT — <br />S70VE — WOOD <br />METAL FIREPIACE 8 CMIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />� <br />f <br />f <br />REAR VARU S <br />VPCANT SITE <br />YES 'NO <br />NO.OF OWEL <br />MA%. OCG L( <br />FIRE SPRINNI <br />REOUIREO <br />YES NO <br />FOR <br />DAB <br />AN CHECK NUN <br />83/12289 <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTMER <br />PENALTY <br />TOTAL <br />PEPM�T <br />TOTALI <br />EA. <br />M <br />M <br />GF.M. <br />FEE �43 <br />VALUATION <br />5 750.00 <br />� <br />f <br />f <br />�HECK FEE <br />RECEIPT NO. <br />r,atian <br />FEE <br />14 50 <br />14 I 50 <br />PERMIT VALIOATION <br />WHEN PROPERLV VALIDATED (IN TH� 6F)40E) THlyly�Y�Ufl.fERMIT �, <br />7bb dU 4 JU <br />N <br />N <br />1'OUR REC[IPT� <br />�; �;,,nK You <br />AD�RES; f�LE <br />-2rucS� <br />