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,n� t_����.�.��E�,� <br />everett <br />CITV HALL 259�87a5 <br />EVERETT, VJA 98201 [] COMBINATION <br />G4:NER <br />Anthonys Home Port <br />cRGnilEGi OR DESiGNFH <br />;ONSTRI�CTlO�' <br />PERMiT <br />❑ BUILDING hj{ MECHANIC,4L <br />PERM{T NO. 1 � � � 7 <br />❑ PLUMBING <br />MECHfNICAL GONTRACTOR MAIL ADDRE55 <br />CITY 21P PMONE LICENSl • <br />1133 N 100th Seattle 98133 523-2686 <br />Custom Mfg. Corp. Zip p„oNE ucENse • <br />Pll1M3iNG WNTRAGiOR <br />una aooqEss cirr <br />❑ NEW ❑ ADDITION ❑ ALiEflATION ❑ AEPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />S <br />�o r ._ n�ocK _or <br />�oo >ooaess <br />1720 47est Mar <br />PLUMBING <br />NO. TYPE OF FI% <br />CiATHTUB <br />LINATORY pN4SH BASIN) <br />Sr10WEF <br />KITCHEN SINK S DISP. <br />DISHWASHEP <br />LAUNDRYTRAV <br />CLOiMES WASMER <br />WATER HEATER <br />URINAL <br />DRINKING FOUNi AIN <br />, FLOOR DRAIN <br />OR <br />ROOF �RAINS — RAINLEADERS <br />SINK �SERVICE — BAR, ETC.) <br />SUBTOTAL <br />PERMIt <br />TOTALFEE <br />n VE OF CONST. OGGUPANG <br />SiZL OF BLOG. NO. OF STC <br />RHE ZONE �ASEIdENT <br />-- APPROVALS <br />t. ENVIRONMENTAL CHECK LIST <br />.^.. �UI�OING PLANS <br />7. FIRE HYDRANT <br />d. FIRE PROTECTION SVSTEM <br />5. GRADING <br />G. DRAINAGE <br />7. ENVIROYME�lTAL IMPAGT STATEMENT <br />B.MEALTH DISTRICT <br />nPPI ICATION /�.CC. B1' PLANS CME <br />BY <br />I HERC-BY CEhTIFY THAT I HAVE READ AND EXAMINED THIS <br />APP�ICATION AND KNCW THE SAME TO BE TRUE ANG <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESU� � GIVE AUTHORIT`,' TO VIOLATE <br />OR CANCEL THE,�PROV''I NS OF ANY OTHER STATE OR <br />LOCAJ� �AW� �UL NG CONSTRUGTION OR THE <br />pEodl.t�Gpn.���'E�C TRUCTION. oq,r <br />1�7��' f e��iHnnizeonGEr+T <br />,^' v y7 Ep OF E�UIPMENT FEE <br />AIR COND. UNITS — HP. EA. __ <br />FEFRIGERATION UNITS — H.P. EA. <br />�OILERS — H.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />FORCED AIR SYSTEMJ — B.T.U. M EA. <br />\YALL HEATER3 — B T.U. M <br />UNIT HEATERS — B.T.U. M <br />1 EVAPORATIVE COOLERS <br />JLOTHES DRYEPS <br />4 VENTILATION FAN <br />RANGEHOOD — <br />j, AIR HANDLING UNIT — C.F.M. % SO <br />SiOVE — WOO� <br />METAL FIREPLACE 8 CMIMNEY <br />FlREPLACEINSERT <br />HEAT PUMP <br />SUBTOTAL f `�� <br />S S l� <br />f - PERMIT __ <br />-- — TOTALFEE s <br />S PLAN CHECK FEE <br />',EAfi YARO SETLACK PLAN CHECK NUM�ER I qECEIPT NO. <br />I FEE <br />. 1_-- <br />�ACANT SITE FEES I �ALUATION FFE <br />YES . NO —� <br />I,tAX.00Q LOAD <br />FIPE SPRINKLERS <br />REOUIPED <br />YES NO <br />BY OATE <br />FOR <br />8Y <br />BUILDING S �I_ <br />PLUM8ING <br />MECHANICAL � <br />OTMER <br />U.B.C. <br />PENALiY SEC. 903 (a) <br />TOTAL $3 5� <br />PERMIT VALIOATION <br />VJHEN PPOPERLY VALIDAiED �IN THIS SPACEI 7H151S VOUji PEFMIT r— <br />'. ` ' j5.�%�—�S <br />� �1 <br />CY' <br />� — <br />` <br />r <br />r. <br />r: <br />