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�verett PERMIT pERMIT NO.O9HO4 <br />CIT1' HALL 259�Bia5 <br />eveaerr, wn 9ezo� ❑ COMBINATION ❑ BUILDING IX�MECHANICAL ❑ pLUMBING <br />OYINkF 1,1AILADDHE55 CIIY ZIP FHONE <br />J. L. Perrigo 2421 Rockefeller Everett 98201 <br />ARCHitLCiOHU[SGqCR MAILAODRE55 CITY ZIP PHON[ <br />GENERAL CONiflAGTOR MAR qD�RE55 CITY ZiP PHOtIE �ICENSE 1 <br />IACCIIAMCAI CONiRAGTOP A1nIL FDDRE55 CiTV ZIP PNONE LIpENSE � <br />Natural Gas Equipment 1611 East Grand Everett 98201 256-2441 <br />PLUI.IpiryG(ANTRALTOR MAILnDORE55 CITV ZIP PHONE LIGENSE� <br />CLASS OF WOPK <br />❑NEW <br />VFWATION OF YfORK <br />S <br />UESCRIBE WORK <br />PROPOSED USE OF pUIIDING <br />LEGAL DESLRIPTION OF PROPERT' <br />LOT BLOCI(_OF <br />❑AD�ITION ❑ALTERAPON ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br />OEIOW OR <br />2421 Rockefeller <br />PLUMBING <br />NO. TYPE OF FIXTURE OR <br />WATER CLOSET fiOILFTI <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISHWASMER <br />LAUNDRVTRAV <br />Cl.OiHES WASHER <br />WATER fiEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM �REAKERS <br />ROOF DRAINS — RAINLEADERS <br />SINK �SERVICE — BAR, ETQ) <br />SUB TOTAL <br />SID� YARD SETBAGK <br />TYPE OF CONST. <br />SIZE OF OLDG. <br />f-IP.E ZONE <br />STREET SETBACK <br />l0T AREA <br />OCCUPANCY GROUP <br />NO. OF STORIES <br />BASEMENT <br />L ENVIRONMENTAL CHECK LIST <br />2. BUILDING PLANS <br />3. FIRE NVDRANT <br />4. FIRE PROTECTION SYSTEM <br />5. GRADING <br />fi. DRAINAGE <br />7. ENVIRONMENTAL IMPACT S7ATEMENT <br />8. HEALTH �ISiRICT <br />APPLICATION ACC. BY PIANS CHECKED BY <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br />PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br />ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br />TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFI�D <br />HEREIN OR NOT. THE GPANTING OF A PERMI? COES NOT <br />PRESUI✓�E TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PNO� <br />VISIONS OF ANY OTHER STATE OR LOCAL IAW REGULATING <br />CONSTRUCTION OR THE PERFORMANCE OF GONSTRUCTI N. <br />SIGNRi RF OI CONiRAC10R OR /UTMOR12ED AG[Ni D TE <br />x ��-Ji,�a�L�c�,S,�,, . ��isz �1 <br />FEE N0. TYPE OF EOUIPMENT <br />AIR WND. UNITS — H P. FA. <br />REFRIGERATION UNITS — H.P. U. <br />dCIlER6 — H.R EA. <br />GAS FIRED AL UNITS —?ONNAGE E. <br />FGRCED AIR SVSTEMS — B.T.U. <br />REAR VARD SETBACK <br />VACANT SITE <br />OYES CNO <br />N0. OF OWELLING uP <br />iINO <br />dY <br />APPR FOR ISSUANCE �V <br />1MALL MEAiF.RS — B T.l <br />UI71T HEATERS — � T.0 <br />EVAPpRAT!VE COOLERS <br />CIOTHES DRYERS <br />VENTILAiION FAN <br />RANGE <br />AIR HAi <br />STOVE <br />E 8 CHIMI <br />eater <br />� <br />i PEHMIT <br />TOTAL FEE <br />PLAN CHECKNUMBER PLAN <br />FEE <br />FEES VALUATION <br />BWLDING $ <br />PLUMBING <br />MECHANICAL <br />FEE <br />RECEIPT NO. <br />FEE <br />PENALTV U.B.C. <br />SEQ 3031a1 <br />TOTAL 12 00 <br />PENMIT VALIDATION <br />WHEN PROPERLY VALIOATED pN THIS SPACE) TNIS IS YOUR PEIiMIT <br />� ' 'I2.'"'—o�l <br />� <br />� <br />. . . ; t � � <br />ADDRESS FILE <br />