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lhcfl�rrL'rCCn '-� CONSTRUCTIC� <br />everett PERMIT PERMIT N0. 13050 <br />CITY HALL 259�87<5 <br />EveRerT,v�n�ezoi � �OMBINATION ❑ BUILDING q{� MECHANICAL ❑ PLUMBING <br />01VNER NAIL ADDRE55 CITV ZIP PNONE <br />Harold t9ietKamp 2211 P1cDougall Everett 98201 <br />FRGMIiEGT OR OESiGNER F1AIL ADDPESS CITY 2tP PHONE <br />GENERAL CONTRACtOR MAIL RDDRESS GITY ZIP PMOYE LiCENSE r <br />MECNqryICRL CONTRACTOR MFIL ADORE55 CITY ZIP PMONE LIGENSE � <br />Natural Gas Equipment 1625 West Marine View Drive Everett 258-2941 <br />PLUMBING f,ONiRRCiOP MAIL ADDqE55 GITY Z P PNONE LICE.•ISE / <br />❑ NEW ❑ P.DDIiION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />S <br />�nr_o�ocK_oF <br />2211 D7cDougall <br />PLUMBING <br />TYPE OF FI%TUHE OR <br />WATER CLOSET (TOILEn <br />�ATHTUB <br />LAVATORY�WASHBASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />OISM\YASHER � � <br />LAUNOPYTRAY <br />GLOiHES WASHEP <br />WATER HEATEP <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS — RAINLEADERS <br />SINK (SERVICE — BAR, ETC.) <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />SIZE <br />APPPOVALS __ <br />1. EIJVIRONMENTAL CHECK LIST <br />2. Bl11LC11NG P.ANS <br />3. FIRE HYDRANT <br />4. FIqE PROTLCTION SYSTEM <br />S.GHAUING <br />G. DRAINAGE <br />.'.ENVIRONMENTAIIMPACTSTATEMENT <br />N. MEALTM DISTRICT <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />nnncNFouRcovies� CORRECT. ALL PFOVISIONS 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 STPTE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGNAi RE OF CCNTPACTOR P Api ORIZED AGENT OATE <br />X L 2/29/84 <br />MEC ANICAL <br />BV <br />FEE NO. TYPE OF EOUIPMENT <br />AIR COND. UNITS — H.P. EA. <br />FEFPIGERATION UNITS — M.P. EA. <br />BOILERS — HP. En. <br />GAS FIRED A.C. UNITS — TONN4GE EA. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />WFLL HEATERS — B.T.U. M <br />UNIT MEATERS — flT.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VENTIIATION FAN <br />RANGEHOOD <br />AIR HANDLING UNIT — C.F.M. <br />STOVE — WOOD <br />METAL RREPLACE A CHIMNEY <br />FIREPLACEINSEFT <br />HEAT PUMP <br />1 Water Heater <br />S <br />S <br />5 __ — _ <br />IEAP YARD SETBACK PLAN <br />�AJANT SITE <br />YES . NO _ <br />MA%. <br />PEOUIRED <br />YES NO <br />BY DATE <br />ISSUANCEBV <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTY <br />SUB TOTAL f <br />PERMIT S <br />TOTALFEE S <br />PLAN CI <br />FEE <br />VALUATION <br />5 � <br />U�A <br />SEC.3031a1 <br />FEE <br />RECEIPT NJ. <br />FEE <br />TOTAL I I 14 I S� <br />PERMIT VALIDATION <br />WHEN PROPEFLY VALIGATED IIN THIS SPACE� THI�$ I� YOUR PERMIT <br />��,�3 .,��►�:.5r,,._ <br />0 <br />m <br />: :: i i, r � <br />V I <br />.1 � �� <br />'3 <br />N <br />� <br />dG <br />t�] <br />O <br />� <br />� <br />C <br />� <br />tiH <br />K <br />O <br />� <br />CO <br />� <br />� <br />4 <br />r <br />