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01 <br />Me Evergreen <br />C11 V OF <br />C O N ST R U CT I O, <br />everett <br />PERMIT <br />CITY HALL 259-b745 <br />EVERETT, WA 98201 <br />❑ COMBINATION ❑ BUILDING kk MECHANICAL <br />MAIL ADDREGS CITY <br />OWNER <br />Tim Vardy <br />Everett <br />2931 Nassau <br />CITY <br />MAIL ADDRESS <br />ARCHITECT OR DESIGNER <br />MAIL ADDRESS CITY <br />GENERAL CONTRACTOR <br />MAIL ADDRESS CITY <br />PERMIT NO. 14383 <br />❑ PLUMBING <br />98201 <br />MECHANICAL CONTRACTOR98201 <br />Natural Gas Equipment 1625 East marine View Drive DITr Everett zIP <br />MAIL ADDRESS <br />S <br />N <br />❑ NEW ❑ ADDITION ❑ ALTER.:TION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />install circulating heater <br />THAT I HAVE READ AND EXAMINED THIS <br />ROPOSED USE OF SUILDINO <br />I HEREBY CERTIFY <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />EGAL DESCRIPTION OF PROPERTY (SHOW BELOW O R ATTACH FOUR COPIES) <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />TYPE OF WORK WILL BE COMPLIED WITH <br />Z <br />GOVERNING THIS <br />HEREIN OR NOT. THE GRANTING 07 A <br />O <br />LOT�—BLOCK_OF <br />WHETHER SPECIFIED <br />GIVE AUTHORITY TO VIOLATE <br />PERMIT DOES NOT PRESUMETO <br />PROVISIONS OF ANY OTHER STATE OR <br />n <br />m <br />OR CANCEL THE <br />LAW REGULATING CONSTRUCTION OR THE <br />LOCAL <br />PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT once <br />_ ,--, <br />JOB ADDRESS <br />X <br />m <br />2931 Nassau <br />MECHANICAL <br />�� m <br />PLUMBING <br />NO• TYPE OF EQUIPMENT FEE <br />c o <br />NO. TYPE OF FIXTURE OR ITEM <br />FEE <br />AIR COND. UNITS — H.P. EA. <br />m o <br />_ <br />WATER CLOSET(TOILET) <br />REFRIGERATION UNITS — H.P. EA. <br />O <br />BATHTUB <br />BOILERS — H.P. EA. <br />;n <br />-.- <br />LAVATORY (WASH BASIN) <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />m <br />SHOWER <br />FORCED AIR SYSTEMS — B.T.U. M EA. __ <br />_ <br />.O <br />KITCHEN SINKS DISP. <br />WALL HEATERS — B.T.U. M <br />D <br />DISHWASHER <br />UNIT HEATERS — B.T.U. M <br />LAUNDRY TRAY <br />EVAPORATIVE COOLERS <br />� <br />CLOTHES WASHER <br />CLOTHES DRYERS <br />T <br />O D <br />WATER HEATER <br />VENTILATION FAN <br />' <br />—I m <br />URINAL <br />RANGE HOOD <br />= <br />m <br />DRINKING FOUNTAIN <br />AIR HANDLING UNIT — C,F.M. <br />N <br />FLOOR DRAIN <br />STOVE — VIOCD <br />0 <br />O r <br />cT IT1 <br />VACUUM BREAKERS <br />METAL FIREPLACE &CHIMNEY <br />C N <br />ROOF DRAINS — RAINLEADERS <br />FIREPLACE INSERT <br />N <br />�^ <br />SINK (SERVICE —BAR, ETC.I <br />HEAT PUMP <br />r <br />1 Circulatin heate <br />• m <br />v <br />z <br />x <br />SUB TOTAL $ <br />Z <br />SUB TOTAL <br />$ <br />PERMIT $ <br />-i <br />PERMIT <br />S <br />TOTAL FEE 5 16 00 <br />=, <br />TOTAL FEE <br />$ <br />PLAN CHECK NUMBER PLAN CHECK FEE <br />N <br />SIDE YARD SETBACK STREET SETBACK <br />REAR YARD SETBACK <br />FEE RECEIPT NO. <br />z <br />O <br />-4 <br />USE ZONE LOT AREA <br />VACANT SITE <br />FEES VALUATION FEE <br />m <br />❑YES ;7NO <br />TYPE OF CONST. QCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />BUILDING = <br />SIZE OF BLDG. NO. OF STORIES <br />MAX. OCC. LOAD <br />PLUMBING <br />FIRE ZONE BASEMENT <br />FIRE SPRINKLERS <br />REQUIRED <br />MECHANICAL 16 <br />00 <br />YES CIN <br />OTHER <br />APPROVALS <br />BY DATE <br />U.B.C. <br />1. ENVIRONMENTAL CHECK LIST <br />PENALTY SEC. 303 (a) <br />16 <br />00 <br />2. BUILDING PLANS <br />TOTAL <br />3. FIRE HYDRANT <br />PERMIT VALIDATION <br />VALIDATED (IN THIS SPA) THIS 1S�YQUj1 Pf,FAIT <br />4. FIRE PROTECTION SYSTEM <br />WHEN PROPERLY <br />I b �f `� <br />5.GRADING <br />(l7 <br />o. DRAINAGE <br />"zr <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />.. <br />8. HEALTH DISTRICT <br />PLANS CHECKED BY <br />APPR. FOR ISSUANCE BY <br />APPLICATION ACC. BY <br />ADDRESS FILE <br />