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0 <br />„ <br />`h`�E,��r11r�F r CONSTRUCTIO►'' <br />everett PERMIT PERMIT NO. 1:3055 <br />CITY HALL 259�8745 <br />EVERE7T,WA9B201 ❑ COMBINATION ❑ BUILDING � MECHANICAL ❑ PLUMBING <br />OWNER MAILADL'RESS CITY ZIP PHONE <br />Kirk S. Hautt 3304 Rockefeller Everett 259-1689 <br />ARCHRECT OF DESIGNER MAIL pODPE55 CITV ZIP PHONE <br />GENERAL CONTflACTOR MAIL AD�RE55 CITV ZIP PHONE LICENSE M <br />Custom Gas Service 22329 57th Avenue S.E. Bothell 98011 481-5515 <br />MELHANICAL CJNTRRCTOR MAIL AODRE55 GITY ZIP PMONE LICENSE M <br />CUSTOG5231P6 <br />PLUMBING CONiRACiOR MAIL ADORESS CITY 21P PMONE LICENSE � <br />❑ NEW ❑ ADDITION O ALTEHATION O REPAIR ❑ DEMOLI710N O FENCE � SIGN ❑ WOOD STOVEIFIREPLACE INS[RT <br />f <br />�ESGRIBE WORN <br />PROPOSEO USE OF BUIL�ING <br />LEGAL DESCRIPTION OF PPOPFRTY �SH01Y BELO <br />LOT _ BLOCN __OF <br />JOB ROORESS <br />3304 Rockefeller Avenue <br />PLUMBIN6 <br />TYPE OF FIXTU <br />W ATER CLOSET ITOILE� <br />BATHTUB <br />LAVATORV'WASH BASIN) <br />SHOWER <br />LAUNDRVTRAV <br />CLOTHES WnSHER <br />WATER HEAtER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS — flAINLEADERS <br />SINK �SERVICE — BAR, ETQ) <br />SUB TOTAL <br />PEHMIT <br />TOTAL FEE <br />SIZE <br />APPROVALS <br />1. ENVIRONMENTAL CHECK LIST <br />2. BUILOING PLANS <br />3. FIRE HYDRANT <br />a. FIRE PROTECTION SYSTEM <br />5. GRAOING <br />6. DRAINAGE <br />7.ENVIRONMENTALIMPACTSTA7EMENT <br />B. HEALTH DISTRICT <br />I HEREBY CERTIFI' THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS 1'YPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIl:D 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 STATE OR <br />LOCAL yqW REGULATING CONSTRUCTION OR THE <br />PERFoffMlA'NCE OF CONSTRUCTION. � <br />MEC NICAL <br />ITEM FEE NO TYPE OF EOUIPMENT FEE <br />AIR COND. UNITS — M.P. EA. <br />REFRIGERATION UNITS — H.P. :A. <br />BOILERS — H.P. EA. <br />GAS FIFED A.C. UNITS — TONNAGE EA. <br />FURCED AIR SYSTEMS — B.T.U. M EA. <br />WALL HEATERS — B.T.U. M <br />UNIT HEATERS — B.T.U. M <br />EVAPORATIVE COOLEFS <br />CLOTHES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />AIR HANDLING UNIT — C.F.M. <br />S70VE — WOOD <br />METAL FIREPLACE 6 CHINNEY <br />FIREPLACEINSERT <br />� HEAT PUMP <br />� <br />t <br />t <br />REAR VARD SETBACK <br />VAGPNT SITE <br />YES .:NO <br />NO. OF DWELLING UNITS <br />MAX. OCQ LOAD <br />FIRE SPRINKLERS <br />REOUIRED <br />—YE�S i NO � <br />BY I DATE <br />BY IPPPR.FOR <br />SUB 70TAL f <br />PERMIT S <br />TOTAL FEE S <br />CHECKNUMBER � PLAN <br />FEE I RECEIPT NO. <br />FEES I �ALUATION � FEE <br />BUILDING S <br />PLUM6ING <br />MECHANICAL 21 OO <br />OTHER <br />PENALiV U.D C. <br />SEC. 307 (a) <br />TOTAL I ( zl I OO <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED QN TM.I6 4P�.C�� THI�4NCiU�1 P�F�IIL � <br />6 Z1 Z <br />� <br />��' ^ � 1'i r: C� � P 1 r..+ <br />�<.; �•c�u <br />aDDRESS HL[ <br />- i ,t;,R s y <br />� <br />