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the EYerXreen n O N ST R U CT I C 1I' <br />CITY OF <br />everett PERMIT PERMIT NO. 14.'_ 4 <br />CITY HALL 259 8745 <br />r, <br />❑ MECHANICAL <br />❑ PLUMBING <br />EVERETT, WA98201 ❑ <br />COMBINAI ION l.7SP� BUILDING <br />OWNER <br />MAIL ADDRESS <br />CITY <br />Everett <br />g82D1 <br />259 ONE4593 <br />John Naples Sr. <br />�l5 33rd Street <br />PHONE <br />MAIL ADDRESS <br />CITY <br />ZIP <br />ARCHITECT OR DESIGNER <br />CITY <br />ZIP <br />PHONE LICENSE <br />GENERAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PHONE LICENSE M <br />MECHANICAL CONTRACTOR <br />MAIL ADDRESS <br />CITY <br />ZIP <br />PNONE LICENSE <br />PLUMBING CONTRACTOR <br />MAIL ADDRESS <br />❑ NEW ❑ ADDITION ❑ ALTERATION XXREPAIR ❑ DEMOLITION O FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSIST <br />$ 1,000.00 <br />Re -roof Composition <br />Single Family Residence <br />LEGAL DESCRIPTION OF 11 11 ISHOW BELOW OR ATTACH FOUR COPIES) <br />LkBLOCK _Lb 2 eP Everett Division P <br />1801 McDougall <br />PLUMBING <br />NO. T TYPE OF FIXTURE OR <br />BATHTUB <br />SHOWER <br />KHtCHENSINKB DISP. _ <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS - RAINLEADERS <br />muv reCoweF - RAP FTC1 <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />APPROVALS <br />1. ENVIRONMENTAL CHECK LIST <br />2, BUILDING PLANS <br />3. FIRE HYDRANT <br />4. FIRE PROTECTION SYSTEM <br />S. GRADING <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STAI <br />B. HEALTH DISTRICT <br />APPI ICATION ACC. BY PEA <br />FEE <br />:'.YES "-NO <br />NO <br />DATE <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AN <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF NORK WILL BE COMPLIED WITH <br />WHETHER PERMIT DOES NOTIED PR SURE TO GIVES AUTHORITY TO V OEIN OR NOT. THE GRANTINGOATE <br />OR THELLOCALNCEL LAW REGULLAITINNGSCONSTR CONSTRUCTION OF ANY OTHEROR <br />LTHE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGNATURE OS'�7Rx/OR O��THSORIZEG AGENT/ /DATE <br />v 12 14 84 <br />NO.7 TYPE OF EQUIPMENT FEE <br />AIR CON D. UNITS - H.P. EA. <br />REFRIGERATION UNITS - 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 />WALL HEATERS - B.T.U. M <br />UNIT HEATERS - B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGE HOOD <br />AIR HANDLING UNIT <br />STO'.E - WOOD <br />METAL FIREPLACE & CHIMNEY <br />FIREPLAr` INSERT <br />HEAT PUMP <br />SUBTOTAL $ <br />PERMIT S <br />TOTAL FEE S <br />FEE RECEIPT NO. <br />VALUATION FEE <br />BUILDING $ 11000. 17 SO <br />PLUMBING <br />MECHANICAL <br />OTHEk <br />PENALTY I SEC. 3031e) <br />TOTAL 17 SO <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED QN THIS SPACE) THIS IS Y UR (HERMIT LTf'J <br />P�. <br />nl <br />BY J <br />U <br />ADDRESS FILE <br />i„II ii 't <br />