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_ � <br /> die E�•rrtreen <br /> ��T�°� �� � CONSTRUCTIO' ' - <br /> everett PERMIT PeAMir No. 14516 <br /> �ITY MALL 259�8745 <br /> EYERETT,WA 98201 ❑ COMBINATION ❑ BUILDING ❑ MECHANICAL �I PLUMBING <br /> OWNER MRIL AODRE55 CITY ZIP PHONE <br /> Norton Medical Building H7[X%f01SX1IYpX Partnership 3216 Norton Everett 98201 <br /> RRCHITECT OR UESIGNER MqIL A�ORE55 CITY ZIP PNONE <br /> GENERAL CONTRACTOR MFIL ADDRE55 CITY 21P PMONE LICENSE Y <br /> MECHANICAL CONTq�CTOR MAIL AD�RE55 CITY ZIP PMONE LICENSE II <br /> PLUMBING CONTRACTOR MAIL ADDRESS GITY ZIP PHONE LILENSE II <br /> Berqs Nursery 19403 133rd Court N.E. Woodinville 98072 d 483-0717 <br /> ' cuss oF wonK BERGSN*214J6 � <br /> ❑NEW ❑ ADDITION ❑ ALTERATION ❑REPAIR ❑ DEMOLITION O FENCE � SIGN O WOOD S70VE/FIREPLACE INSERT <br /> VALUATION OF WORN <br /> S <br /> DESCRIBE WORK <br /> Install check valve <br /> PROPOSED USE OF BUI�UING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND = <br /> LEGAL DESCRIPTION OF PROPERTY�SNOW BELOW OR ATTPCH FOUR GOPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES � <br /> GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH � <br /> LCT__B�OGK_OF <br /> ... <br /> WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A m <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE " <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STPTE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE ..,.., <br /> PEHFORMANCE OF CONSTRUCTION. -i � <br /> JOB AD�RE55 SIG OF GONTRAGTOR OR AUTMORIZEO AGENT OFTE r� —/ <br /> 3216 Norton Avenue X 2/28/85 �^m <br /> 0 <br /> PLUMBINO MECHANICAL m o <br /> NO. TYpE OF FIXTURE OR ITEM FEE NO. TYPE OF E�UIPMENT FEE �3 <br /> WATER CLOSEf(TOILEn AI9 COND.UNITS - H.P. EA. �n <br /> BATHTUB RF.FRIGEFATION UNITS- H.P. EA. _-i <br /> m <br /> LAVATORY(WASH BASIN� BOILERS- H.P. EA. p= <br /> SHOWER GAS FIRED A.C.UNITS-70NNAGE EA. C <br /> KITCHEN SINK 8 DISP. FORCED AIR SVSTEMS - B.T.U. M EA. r= <br /> DISHWASHER WALL HEATFRS- B.T.U. M � N <br /> � <br /> LAUNDRY TRAY UNIT HEA7EHS- B.7,U. M � A <br /> CLOTHES WASHER EVAPORATIVE COOLERS 'T1� <br /> WATER HEATER CLOTHES ORYERS � �1 <br /> 2 <br /> URINAL VENTILATION FAN m �+ <br /> N <br /> DRINKING FOUNTAIN RANGE HOOD 0 r <br /> FLOOR DRAIN qIR HANDLING UNIT- C.F.M. � N <br /> VACUUM BREAKERS STOVE-WOOD � N <br /> ROOF DRAINS- RAINLEADERS METAL FIREPLACE 8 CHIMNEY Z C� <br /> SINK(SERVICE- BAR,ETC.) FIREPLACE INSERT �D <br /> HEAT PUMP � <br /> 2 <br /> D <br /> _ <br /> - .� <br /> SUB TOTAL f Z QQ SUB TOTAL f = <br /> � <br /> PEHMIT S PEPMIT S � <br /> TOTAIFEE f S 00 TOTALFEE f � <br /> SIDE YARD SETBAGK S7REETSETBACK HEAR VARD SE7BACK PLAN CHECK NUMBER PLAN CHECK FEE -i <br /> � <br /> � FEE RECEIPT NO. m <br /> USE ZONE LOT AREA VACAN7 SI7E <br /> I;YES :�INO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> BUILDING S <br /> SIZE OF BLDG. NO.OF STORIES MA%.OCC. LOAD <br /> PLUMBING S 00 <br /> FIRE ZONE BASEMEN � FIRE SPRINKLERS �dECHANICAL <br /> REDUIRED <br /> ;�.�VES I:NO <br /> APPROVALS BY DATE OfHEF `� <br /> 1. ENVIRONMENTAL CHECK LIST U B.C. <br /> FENAL7Y SEC.3031a) <br /> 2.BUILDING PLANS <br /> 3.FIRE HYDRANT TOTAL S 00 <br /> 4.FIRE PROTECTION SYSTEM PERMIT VALIDATION <br /> 5.GRADING WHEN PROPERLY VALIDATE�QN THISSPAC�E)THIS�IS.YOUp PERtAIT �� <br /> 1 <br /> 6.DRAINAGE �"� <br /> I <br /> 7.ENVIRONMENTALIMPACTSTATEMENT � � <br /> B.HEALTHDISTHICT � ' <br /> I�"" <br /> APPUCATION ACC.BY PLANS CHECKED 9V APPR.FOR ISSUANCE BY �� � � �� � T ' <br /> i ' <br /> I� <br /> i <br /> � � . ) <br /> ADpR[SS FILE <br /> L „� <br />