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d�e Ecrrereen <br />��,�� <br />everett <br />GTY HALL 259�B7d5 <br />� �ONSTRUCTIO�" <br />PERMIT PERMIT NO. �33g4 <br />EVERETi. WA 98201 ❑ COMBINATION CX BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OWNE� MP4 qppRE55 CrtY 2iP PHONE <br />Atartin Ii. Ostby 2229 Oklahoma Avenue Evererr 98201 252-1900 <br />AqCHrtEGT OR OESIGNER MnIL AODRESS CItY 21P PNONE <br />GENERnL GONiRnGTON MPR AOpRESS QTY 21P PMONE UCENSE • <br />Same <br />MECNANiCAL GONTRACTOR MAR ApDPESS CIiY ZiV PNONE LICENSE • <br />VLUMBiNG GONTRAGTOR MAiL ADDRE55 CiTY ZIP PMONE LIL[NSE � <br />O NEW ❑ ADDITION ❑ ALTEFATION f,J�,REPAIR ❑ DEMOLITION O FENCL ❑ SIGN ❑ WOOD STOVFJFIRFPLACE INSEHT <br />VALUAT104 OF WOR <br />S BOO.00 <br />fire <br />Single Family Residence <br />EGAL OESGRIPTION OF PROPERTY ISMOW BELOW OF ATTAGH i( <br />15 Temwalt Terrace <br />LOt _ BLOGN _OF <br />JOB ApORE55 <br />2229 Oklahoma Avenue <br />PLUMBING <br />N0. TYPE OF FIXTURE <br />WATER CLOSET (TOILET) <br />BATMTIiB <br />LAVATORY�WASH BASIN) <br />SHOWEF <br />KITCNEN SINK 8 OISP. <br />DISHWASHER <br />LAUNORYTRAV <br />CLOTHES WASHER <br />WATEfl HEATER <br />URINAL <br />ORINKING FOUNTAIN <br />FLOOP DRAIN <br />V4CUUM BREAKEF7S <br />ROOF DRAINS — RAINLEADERS <br />SINK (SERVICE — BAR, ETC.) <br />SUB TOTAL S <br />PEflMIT f _ <br />TOTAI FEE S <br />EET SETBACK REAR VARO <br />FIRE ZONE <br />APPROVALS <br />i. ENVIRONMENTAL CMECK LIST <br />2. BUILDING PLANS <br />3. FIRE MYDRANT <br />d. FIRE PROTECTION SYSTEM <br />5. GRADING <br />6. DRAINAGE <br />7. ENVIqONMENTPI IMPACT STAT <br />B. MLALTH DISTRICT <br />FEE <br />VACANT SITE <br />YES NO <br />NO. OF DWELLING UNITS <br />MA%.00C.LOAD <br />FIRE SPPINKLERS <br />RcOUIPED <br />YES NO <br />BY DATE <br />APPUCA710N ACC.BY PLANS CHECKED BV IAPPR FURISSUANCE BY <br />I HEREBY CEP.I�IFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRU� AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANC[S <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHFTHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PPESUME TO GIVE AUTHORITY TO VIOIATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGUL.ITING CONSTRUC1lON OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF WNTBRCTOR ON AUiMOR12E� AGCNi �4TE <br />X 5/21/84 <br />MECHANICAL <br />NO. TYPE OF EOUIPMENT FEE <br />AIR CONO. UMTS -- H.P. EA. <br />REFRIGEflATION UNITS — H.P. EA. <br />301LER5 — H.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />FORCEO AIP .�VSTEIdS — B.T.U. IA EA. <br />WALL MEATERS — �T.U. M <br />UNIT HEATERS — B.T.U. M <br />EVAPORATNE COOLEF.S <br />CLOLNES DRYERS <br />VENTILAiION FAN <br />RANGE h100D <br />AIR HANDLING UNIT — C.F.M. <br />STOVE — 1NOOD <br />METAL FIREPLACE A CHIMNEY <br />FIREPLACE INSERT <br />MEAT PUMP <br />SUB TOTAL f <br />PERMIi f <br />TOTAIFEE S <br />FEE � RECEIP7 NO. <br />PEES I VALUATIDN I FEE <br />BUILDING 58�0.�� ],¢ SQ <br />PLUMBING — <br />MECHANIC/.L <br />OTNER <br />PENALTY U.BC. <br />SEC. 303 �a) � <br />TOTAL I I I.4 I S� <br />PERMIT VALIDATION <br />V1HEtJ PROPERLV VALIDATED IIN TMI& SPACEI TH6 �SYdUA P�RI�iIT-- � <br />Q7 <br />M <br />i i � � <br />•i <br />,'�t;',._ ...,,. <br />G <br />� <br />rf <br />C�7 <br />H 1- <br />y �. <br />H � <br />N � <br />� � <br />O� <br />� k: <br />k <br />� <br />Cy % <br />C� <br />r-i r <br />�� <br />"7 r' <br />� � <br />�` <br />[ <br />� E. <br />�� <br />. � <br />tl <br />