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theEvergreen -� �ON�TRUCTION �- � �� � <br /> CITY OF <br /> e�erett PERMIT pERMIT NO. O97H1 <br /> CITY HALL 259�8745 <br /> EVERETT.WA 98201 ❑ COMBINATION � BUILDING ❑ MECHANICAL PLUMBING <br /> OWNER MFILADDRE55 CITV ZIF PHONE <br /> Peter poyle 12"l2 Walnut Everett <br /> ARCIIrtECTOPDE5IGNER MAILADDRESS CITY ZIP PMONE <br /> GENERAL WNTRACiOR MAIL AODRE55 CITY ZIP PHONE LICENSE/ <br /> MECIIANICALCAIQFFCTOR MAILPD�RESS CITY ZIP PMONE IICEN5E1 <br /> Natural Gas Equipment 1611 East Grand Everett 98203 258-2441 <br /> PLUA'91NG GONTflACTOR MAIL ADDRE55 GITY ZIP PHONE LICENS[I <br /> CLA55OF WOPK <br /> ❑NEW ❑ADDITION ❑ALTEPATION ❑REPAIR ODEMOLITION ❑FENCE ❑SIGN GARAGE <br /> VALUlTION OF WORN <br /> S <br /> DESWIBE WORK <br /> PROPOSED USE OF BUILDING <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP� <br /> LEGALOESGPIPTIONOFPROPENiY15HOWBELOWORATTACMFOURCOPIES) PLICATION AND KNOW THE SAME TO 6E TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> ior o�ocK_oF TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> PRESUME TO GIVE AUTHORITY TO V'OLATE OR CANCELTHE PRO� <br /> VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING <br /> CONSTRUCTION OR TIiE PERFORMANCE OF CONSTRUCTION. <br /> 51G Ri RE OF CONTRAGTOR OR AUtHOR12ED FGENT �ATE <br /> JOBADORESS X �A � �ti� 9/16/81 <br /> 1222 Walnut <br /> PLUMBINO MECHANICAL <br /> N0. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF E�UIPMENT FEE <br /> 1VATER CLOSET(TOILET) AIR COND.UNITS—H.P.EA. <br /> REFPIGERATION UNITS—H.P.EA <br /> BATHTUB <br /> LAVATORV(WASH BASIN) 001LERS—H.P.EA. <br /> $HOWER GAS FIRE�AC.UNITS—TONNAGE EA. <br /> KI7CHEN SINK 8 DISP. FORCED AIR SYSTCMS—B T.U. M EA. <br /> WALL HEATERS—B.T.U. M <br /> DISHWASNER <br /> LAUNDRY TRAY UNIT NEATERS—B T.U. M <br /> CLOTHES Wl+SHER EVAPORATNE COOLERS — <br /> WATER HEATER CLOTHES DRVERS <br /> VENTILATION FAN <br /> UPINAL <br /> DFINKING�OUNTAIN RANGt HOOD <br /> AIR HANDLING UNIT— C.F.M. — <br /> PLOOR DRAIN <br /> VACUUM BREAKERS STOVE <br /> ROOF�RAWS—RAINLEAC EFS METAL FIREPIACE S CHIMNEY <br /> — 1 Water Heater 4 50 <br /> SINK(SERVICE—BAR,ETC.i <br /> SUB TOTAL SUB TOTAL S 4 5 0 <br /> PERMIT S PERMIT s <br /> TOTALFEE S <br /> TOTAL FEE S 7 5 O <br /> SIDE YARD SETBACK STREEi SEiBACK REAR YARD SETBACK PLAN CHECK NUMBER PLAN CHECK FE ECEIPT NO. <br /> FEE <br /> USE ZONE LOT�RFA VACANT SIT[ FEES VALUATION FEE <br /> ❑YES ❑NO <br /> TYPE OF CCNSI'. OCCUPANCY GROUP NO.OF DWELLING UNITS <br /> BU'LDING $ <br /> SIZE OF BLOG. NO.OF S70RIE5 MA%.OCC.LOAD <br /> PLUMBING <br /> FIREZONE BASEMENT REOU.iEDKLERS MECHANICAL 7 50 <br /> flYES ❑NO <br /> APPROVALS BY OATE OTHER <br /> 1. E�lVIRONMENTALCHECKLIST PENALT' U.B.C. <br /> SEC.303(e) <br /> 2. BUILDINGPLANS '] 50 <br /> TOTAL <br /> 3. FIRE NYDRANT — <br /> 4. FIRE PROTECTION SYS7EM PEHMIT VALIDATION <br /> WHEN FROPERLY VALIDATED(IN THIS SPACE)TNIS IS YOUR PERMI7 <br /> : I� /. � - .�I <br /> 5. GRADING ` ' ' ' � <br /> � <br /> 6. DRAINAGE �, <br /> 7. ENVIRONMENTAL IMPACT STATEMENT - � <br /> B. HEAITH DISTRICT 1 ' � <br /> . � <br /> APPUCATION ACC.BY PLANS CHECKED BY APPR.FOR ISSUANCE BY . . .. <br /> � I <br /> ADDRESS FILE <br />