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1 <br /> lllC !_Cfrl'r�•Cll <br /> everett � %ONSTRUCTIO � <br /> PERMIT PERMIT NO. 12�J45 <br /> CITY HALI 259�8745 <br /> EVERETT,WA9B201 � COMBINATION ❑ BUILDING IX.�j MECHANICAL ❑ PLUMBING <br /> OWNEq AIpIL AO�RE55 CIiV 21P PMONE <br /> ^ Dennis Kaupp 10617 62nd Place West Everett 98204 793-1786 <br /> � ARLMITEGT OR�ESIGNER MAIL ADDHESE CITY ZIP PHONE <br /> GENEFAL GONiPRGTOR MAIL ADDRESS CIiY ZIP PNONE LICENSE� <br /> MECNANICqL CONTRALTOH MFIL ApDRESS CITY ZIP PNONE LICENSE� <br /> Same <br /> FLUMpING CONTRACTOP MAIL qODRESS CITY ZIP PMONE IIGENSE� <br /> CLASS OF WORK � <br /> ❑NEW O ADDITION ❑ AL7ERATION ❑REPAIR ❑ DEM01 I'�G`7 ❑ FENCE ❑ SIGN � WOOD STOVEJFIREPLACE INSERT <br /> VALUATION OF WORK <br /> S <br /> DESCFIDE 1YOPK <br /> PROPOSEO USE OF BUILDING <br /> � 1 HEREBY CERTIFY THAT I H�\'� READ AND EXAMIIJED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEG/LOESCPIPTIONOFPFOPERTY�SHOWBELOWORATTACHFOURCOPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> LOT_BLOCK_OF GOVERNIN RIS TYPE OF WORK W�LL BE COMPLIED WITH <br /> WHETHE FECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT ESNOTPRESUMETOGIVEAUTHORITYTOVIOLATE <br /> OR CA CEV THE PROVI IONS OF ANY OTHER STATE OR <br /> LOCA LAW REGU ING CONSTRUCTION OR THE <br /> PERF R ANCE OF NSTRUCTION. <br /> JOB AODRESS SIGN R F CONTNACT OR UTHORIZE�AGENT �ATE <br /> 9 McGill Avenue X . ,,.Ltti-J / 10/11/83 <br /> PLUMBING MECH NICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EQUIPMENT FEE <br /> WATERCLOSETITOILEn AIR COND.UNITS — H.P.EA. <br /> BATHTUB REFRIGERATION 11N1T5— H.P.EA. <br /> LAVATORV(WASH BASIN) BOIlERS— H.P.EA. <br /> SMOWER GAS FIRED A.C. UNITS—TONNAGE EA. <br /> KITCMEN SINK 8 DISP. FORCED AIR SYSTEMS— B.T.U. M EA. <br /> DISMWASHER WALL HEATERS — B.T.U. M <br /> LAUNORY TRAV UNIT HEATERS— B.T.U. M <br /> CLO7HES WASHER EVAPORATIVE COOLERS <br /> WA7ER HEA7ER CLOTHES ORVERS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUN7AIN RANGE HOOD <br /> FLOOR DRAIN AIR HAN�LING UNIT— C.F.M. <br /> VACUUM BREAKERS STOVE—WOOD � <br /> ROOF DRAINS— RAINLEADERS METAL FIREPLACE 8 CNIMNEY <br /> SINK(SERVICE— BAR, ETC.) FIREPLACE INSERT <br /> HEAT PUMP <br /> SUB TOTAL S SUB TOTAL S <br /> PERMIT S PERMIT 5 <br /> TOTAL FEE 5 TOTAL FEE 5 <br /> SIDE YARD SETBACK STREEi SETBACK REAR VARD SETBACK PLAN CHECK NUMBER PLAN CMECK FEE <br /> FEE RECEIP7 NO. <br /> USE 20NE LOT AREA VACANT SITE <br /> VES NO FEES VALUATION FEE <br /> TVPE OF CONST. OCGUPANCY GROUP NO.OF D\YELLING UNI7S <br /> BUILDING S <br /> SVE OF BLCG. NO.OF STORIES MAX.OCG LOAD <br /> PLUMBING <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS MECMANICAL 1� SO � <br /> REOUIRED <br /> VES . NO <br /> `— APPHOVALS BY DA7E OTHER <br /> 1. ENVIRONMENTAL CHECK LIST PENALTV U.B.C. <br /> SEC.309�a� <br /> 2.BUILDING PLANS <br /> 3.FIRE HYDRANT TOTAL 17 SO <br /> 4.FIRE PROTECTION SYSTEM PENMIT VALIDATION <br /> 5.GflA01NG WHEN PROPERLV VALIDATED(IN TF4�S8SP,�E)THI�I�YIOt�R eE8M1T �� <br /> � � � � J <br /> i_. <br /> 6.DRAINAGE <br /> 7.ENVIRONMENTALIMPACTSTATEMENT <br /> B.MEALTM DISTRIC7 <br /> APPLICATION AGC.BY PLANS CHECKED BY APPR.FOR ISSUANCE BV '+'O U R REC E I PT ' � <br /> +H/1hK YOU <br /> I 2 oci 8 3 <br /> :'lDD!:E55 HI_t <br />