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rhr G�rr�;rcrn <br />��TY U�- <br />everett <br />CITY HALL 259�8745 <br />EVERETT. WA 98201 <br />�^ ~;ONSTRUCTIOI"^ <br />PERMIT <br />C� COMBINATION ❑ BUILDING ❑ MECHANICAL <br />� <br />PERMIT NO. � 5115 <br />❑ PLUMBING <br />OWNER MAILAODRESS CI7Y ZIP PHONE <br />F10WARD B. PURV&S 471G COLLEGE EVEREI'1' 1VA 98203 252-4871 <br />ARGHITECi OR OESIGNER MAIL AODRESS CITY ZIP PMONE <br />GENEPAL CONTPACTOR MAIL AODflE55 CITY ZIP PHONE LICENSE � <br />Same (Cascade Millwork) <br />MECHANICAL CONTRRGTOR MAIL AD�RE55 GITY ZIP PHONE LICENSE � <br />PLIIMBING CONTRACTOR MAIL A��RESS CITY ZIP PHONE LICENSE � <br />�I NEW ❑ ADDITION ❑ ALTERATION ❑ PEPAIR ❑ DEMOLITION � FENCE O SIGN ❑ WOOD STOVE/FIREPLACE INSERT <br />VALUATION OF WORK <br />f <br />New single family residence <br />FOUR COPIES� <br />LOT_BLOCN_OF <br />Por of Lot 4 Plat of Maple Hts <br />JOB A��RE55 <br />1316 MJKILTEO BLVD <br />PLUMBINd <br />� <br />DATNTUB <br />LAVATORV�WASHBASIN) <br />SHOWER <br />OR ITEM <br />KITGHEN SINK 8 DISP. <br />DISHWASHER <br />LAUNDRVTRAV <br />CLOTHES WASHER <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRA�N <br />VACIIUM BREAKERS <br />ROOF DRAINS — RAINLEADERS <br />SINK ISEiiVICE — AAR ETCI <br />SUB TOTAL <br />TOTAL FEE <br />APPROVALS <br />t. ENVIRONMENTAL CHECK LIS7 <br />2. BUILDING PLANS <br />3. FIRE HYDPANT <br />4. FIRE PROTECTION SYSTEM <br />5. GRADING <br />7. <br />HEALTH DISTRICT <br />STATEMENT <br />PLANS CHECKED BY <br />f <br />f <br />S <br />VACANT SITE <br />�..YES ��.:NO <br />OCC.LOAD <br />BY <br />IC <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALl PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL �AW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGNATUREOFCONTRACT09"b ORIZE�AGENT OATE <br />��. ��J� ����� 7/10/85 <br />TYPE OF EOUIPMENT <br />Alti COND. UNITS — H.P. EA. <br />REFRIGERA710N UNIiS — H.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />WAI.L HEATERS — B.T.U. M <br />UNI7 HEA7ER5 — B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRYEFS <br />VENTILATION FAN <br />RANGE HOOD <br />AIR HANDLING UNIT — C.F,M. <br />STOVE — WOOD <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />SUB TOTAL <br />PERMI7 <br />TOTAL FEE <br />FEE <br />f <br />S <br />S <br />ree <br />RECEIPT NO. <br />FEES � VALUA710N � FEE <br />BUILDING I b <br />PLUMBING <br />MECHANICAL <br />O7HER <br />PENALTY U.B.C. <br />SEC. 30J lal <br />TOTAL I I Z�� I �� <br />PEHMIT VALIDATION <br />WHEN PROPERLY VALI�ATED QN THIS SPACF�) THIS IS YOUF��PERMIT _L(� <br />Rene«�al of Permit A'o.' 9171 ` `� <br />.-i <br />� <br />i,"+ <br />ADDRESS FILE <br />