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nc� £verxreen . ^ O N ST R U CT I O�C <br />o;v oF <br />everett p�RMIT FcRMIT NO. ��529 <br />CIi1' MALL 259�8745 <br />EVERETT,WA90201 � COMBINATION ❑ BUILDING K�i. MECHANICAL ❑ PLUMBING <br />0\'JNEN MAiL �OD'E55 (:ITY ZiP PMONE <br />Dan VanSJinkle 4631 Marble Lane Everet� 98201 <br />ARCHITECT OR DESiGNER MAIL AODPE55 CITY LIP PMGNE <br />GENERAL CONTRAGTOR MRIL ADOPE55 LITY ZIP PHONE LIGENSE � <br />MECHANIGRI LOVTRACTOR MAIL AD�NE55 CITY 21P PMONE LIGENSE � <br />NTYIIYT� Gas Eauiament 1625 East Marine Vzew Drive Everett 98201 258-2441 <br />__.. ..., ounuc ucEl'SE � <br />❑ NEYJ ❑ ADDITION ❑ ALIENATION ❑ REPAIR O DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE II�SERf <br />s <br />DE T <br />L�i _ BLOGN __OF _ <br />JODAODRE55 <br />4631 Mar.ble Lane <br />PLUMBING <br />TYPE OF FIXTURE OR ITEM <br />BATHTUB <br />LAVATORY�WASNBASIN) <br />SHOWER <br />KITCHEN SINK R DISP. <br />DISHWASMER <br />LAUNDRYTRAY <br />CLOTNES WhSHER <br />WATER HFATEH <br />URINl�L <br />DRIW:ING FOUNTAIN <br />FLOOR OP.AIN <br />VACUUM BREAKERS <br />ROOF ORAINS — RFINLEADERS <br />SINK ISERVIJE — BAR, ETG! <br />SUBTOTAL <br />�L�] <br />FIRE <br />TOTAL FEE <br />APPROVALS _ <br />1.ENVIRONMENTALCHECK LIST <br />2. BUILDIKG PLANS <br />3. fIRE HYDFANT <br />4. FIRE PROTECTIO� 5Y3TEM <br />5.GRADING <br />6.ORAINAGE <br />7.ENVIRONMENTALIMPACTSTATEMENT <br />B.HEALTH DISTRICT <br />APPLICATION ACC. BY PLANS CHE <br />FOUR <br />FEE <br />f <br />S <br />1CPNT SITE <br />YES . NO <br />MAX. OCC. <br />YES <br />BY IAPPR.FORISSUANCE <br />I HEREBY CERTIFY THAT I HAVE READ ANG EXAMINED THIS <br />APPLICATION AND KNOW THE SAh1E TO BE TRUE AND <br />CORRECi. ALL PROVISIJNS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE O� WORK �VIL!. SE COMPLIED WITH <br />�VHETHER SPECIFIED HEREIN OR NOT. TH[ (iRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF C�NSTRUCTION. <br />SIGNQ�T PE OF CONTRAGTOR OR AUTHORIZfiD AGENT �ATE <br />X f�l��.v �, ��]� ���16.�.+Z 6/20/84 <br />NO. TYPE OF E�UIPMENT <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — H.P. EA. <br />FIOIL'eR5 — H.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />1 FORCED AIF SYSTEMS — B.T.U. M EA. <br />WALL MEATERS — B.T.U. M <br />UNIT HEA7ERS — B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VE�TILATION FAN <br />RANGEMOOD <br />AIR HANDLING UNIT — C.F.M. <br />STOVE — WOOD <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />CHECK <br />BUILUING <br />Pi.UMBING <br />�dECHANICAL <br />OTHEP <br />PENAL7Y <br />SUBiutAl <br />PERMIT <br />TO7ALFEE <br />F <br />FEE <br />VA1.UA710N <br />�_— <br />SEC. 3D3 Ia) <br />FEE <br />� <br />S <br />5 ZO SO <br />CNECK FEE <br />RECEIPT NO. <br />FEE <br />2� 50 <br />TOTAL I I iO I SO <br />PERMI7 VALIDATION J,� � � _ � <br />WHEN PROPER�V VALIDATED pN THIS SPACE) IHIS IS �'u`� P Rr� -(y� L� <br />I .' J !' � <br />�[� <br />' . .._ . . 'ir'1 <br />�� <br />H F <br />y �; <br />r� � <br />� � <br />O <br />� �. <br />OF <br />� :. <br />�� <br />� :_ <br />Hy � <br />K' <br />O• <br />�y r: <br />Ci7 c : <br />,'. <br />(C] � <br />CZ�] <br />H ; <br />