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� <br />/hr £rrr�rcrn <br />��TY�� <br />everett <br />CITY HALL 259�8745 <br />'f �ONSTRUCTIOF' <br />PERMIT <br />PERMIT N0. 1�.942 <br />r EVERETT, WA 98201 � COMBINATION K� BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OIYNER MAII AOORESS CITY i.ip PHONE <br />LLOYD BUCKNER 2202 DlcDougal Everett 95201 2�2-G390 <br />ARCMRECT OF OES:GNEfl MAIL AD�RESS CITY ZIP PMONE <br />GENERALCONTRAGIOR MAILAOORE55 CITY IIP PMONE LICENSE• <br />Same <br />A�ECHANICAL CONTRAGTOR MAIL p�ORESS CITY 21P PMONE �ICENSE r <br />PL11M81NG CONTRafTOR MAI� AOORE55 GITY ZIP PHONE LICENSE ♦ <br />_- _ _ __ _—__-__-- _ <br />C1A55 OF WORN <br />❑ NEW ❑ ADOITION XJCAL7ERA710N ❑ REPAIR ❑ DEMOLITiO4 O FENCE ❑ SIGN ❑ WOOD STOVE/FIREPLACE INSEfi7 <br />�/LUAiION OF WORK <br />SS��.�� <br />ement stairs - front and Uack <br />Res <br />LOT _ BLOCk _OF <br />2202 ', <br />PLUMBING <br />512E OF <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINeD THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />DELOWORATTACHFOURGOPIE51 CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERN�NG 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 STPT[ OR <br />LOCAL LAW REGULAiING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGNATUPE OP CONiFACTOR OR Ay ,TNOR12ED AGENT OAiE <br />�-;i: i,,,, nn �%/nv,l. -�n,'' S/2/83 <br />TYPE OF FIXTURE OF <br />WAT[R CLOSET (TOILET) <br />BATHTUB <br />LAVATORY�WASHBASIN� <br />SHOWER <br />KITCMEN SINK 8 DISP. <br />DISHWASHEfl <br />LAUNDRVTRAY <br />CLOTHESV:ASHER <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />flOOF DRAINS — RAINLEADERS <br />S�NK �SERVICL — BAR, ETQI <br />SUBTOTAL <br />PEHM�T <br />TOTAL FEE <br />APPROVALS <br />1. ENVIRONMENTAL CHECK LIS7 <br />2. BUILDING PLANS <br />I 3. FIRE HVDRAN7 <br />a. FIRE PROTEC710N SYSTEM <br />5. GRADING <br />G. DRAINAGE <br />7.ENVIRONMENTALIMPACTSTA7EMENT <br />B. HEALTH DISTRICT <br />s��c <br />CHECKED BY <br />�S <br />REAR VARD <br />YES NO <br />BY <br />Ln�c <br />FEE <br />N0. TYPE OF"��UIPMENT <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — H.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIR[D A.C. UNITS — TONNAGE EA. <br />FORCED AIR SYSTEMS — B.T.U. A1 EA. <br />WALL HEATERS — B.T.U. M <br />UNIT HEATERS — B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOiHES DRVERS <br />VENTILATION FAN <br />RANGEHOOD <br />AIR HANDLING UNIT — QF.M. <br />S70VE — WO00 <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />SUB TOTAL 5 <br />_ PERMI7 5 <br />TOTAL FEE S <br />IETBACK PLAN CHECK NUh18ER pLAN Ci <br />FEE <br />FEES VALUATION <br />LING UNITS <br />BUILDING SSOO.00 <br />IAD <br />PLUM1IBING <br />.ERS ��ECHANICAL <br />OATE OTMER <br />PENAL7Y <br />�al <br />FEE <br />RECEIPT NO. <br />FEE <br />TOTAL 1 � lo � <br />PEqM1T VALIDATION <br />WMEN PROPERLY VALIDATED �IN THI; ZP'C=) THIS�SOYGIIaPF�i�1T— � <br />ti�[ J � U U <br />� <br />� <br />a� YOUR REC[IPT�� <br />Tf 1A�K YOU <br />,. , <br />- � lAY �, 3 <br />J <br />