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`'"�''`�"""' ^ONSTRUCTION <br />,, �: <br />everett PERMIT PERMIT NO. 1��`�7 <br />QTY HALL 259�H745 <br />eveaerr.wneezo, ❑ COMBINATION ❑ BUILDING KJ MECHANICAL ❑ PLUMBING <br />O14NER fAAILA0�RE55 Gtt LP W�ON[ <br />ELMER R. HAGGLUND 5307 ROCKEFELLER EVERETT WA 98203 353-4715 <br />ARCMrtECT ON DESIGNER <br />MAII AD�RE55 CILY LP PMONE <br />GENEePLGOH1RNLi0P <br />MAIL PDDRE55 GIiY 21V PMONE UGENSE • <br />SAME <br />MEGMPNIGALGONTNRCTON <br />MAIL AOOflE55 GITY 21P PHONE UCENSE � <br />PLUMBING CONTPPLtOR <br />AUIL AOOHE55 GiY ZIP PHONE UCENSE • <br />� NEW ❑ ADDITION ❑ ALTERATION ❑ F7EPAIR C� DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLALE INSERT <br />S <br />DCSCRIBE WORN <br />1'ireplace insert <br />paovoseo �•se ov em�ort+c <br />Residence <br />IEGAL GESGPIPTION 4F PROPERiY� <br />LOT_BLOCN__OF_ <br />JOB POORE55 <br />5307 Rockefeller <br />PLUMBING <br />NO. TYPE OF FI%TURE <br />W ATER CLOSET �TOILEn <br />BATHTUD <br />LAVATORV�WASH BASIN� <br />SHOWER <br />KITCHEN SINK & DISP. <br />LAUNDRVTflAY <br />CLOTMES WASMEfl <br />WATER HEATER <br />URINAL _ <br />DHINKI,'�G FOUNTAIN <br />FLOOR ORAIN <br />VAWUM l7REAKERS <br />ROOF �RAIIJS — RAINLEADERS <br />SINK ISERo�CE — BAR, ETC.) <br />SUB TOTAL <br />PERMIT <br />i �1TAL FEE <br />OF <br />1, ENVIRONMENTAL CHECK LIST <br />2. BUILDING PLANS <br />3.FlREHVDRANT <br />d. FIR� PROTECTION SYSTEM <br />5. GRAOING <br />fi. OFAINAGE <br />7. ENVIRONMENTAL IMPACT STA' <br />B. HEALTH DISTRICT <br />APPI ICATION ACC. BY PLA <br />OV <br />I HEHi=BY CEflT�FY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW ThIE SAME TO 8E TRUE AND <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 PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCT�ON OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />51GNAluB[ OF �ONTR4C10P OF AUTHORIZEDPGENT � DATE <br />X ��-. <br />MECHANICAL <br />FEE N0. TYPE OF E�UIPMErv i <br />AIF CONO. UNITS — M.P. EA. <br />REPRIGERATION UNITS — H.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIRED A G UNITS — TONNAGE EA. <br />FORCED AIR SVSTEMS — B.T.U. M EA. <br />WALL MEATERS — B.T.U. M <br />UNITHEATEf�S—BT.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DflYERS <br />VENTILATION FAN <br />RANGEHOOD <br />AIF MANDLING UNIT — C.F.M. <br />SiOVE — WODD <br />METAL FIREPLACE S GN�MNEY <br />j FIFEPLACEINSERT <br />NEAT PUMP <br />� <br />S <br />S <br />REAR YARD 51 <br />VACANT SITE <br />YES NO <br />NO. OF OWEL <br />MAX.00C.LC <br />FIRE SPRINKL <br />REOUIPED <br />VES NO <br />FOR <br />SUBTOIAL <br />PERMIT <br />TOTALFEE <br />NUM9ER F <br />FEE <br />FEES VALUATION <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTNER <br />PENALTY <br />Y <br />J.O.C. <br />SEC. J09 WI <br />3/12/84 <br />5 ] <br />S j� <br />f �] <br />GNECK FEE <br />RECEIPT NO. <br />FEE <br />TOTAI <br />PERMIT VALIDAiION <br />WMEN PflOPERLY VALIDATcD �IN TMI�S 9P�6E) TMIS.IS�ViUR PEFM�t � <br />.J Q 1 5 `; <br />� <br />M <br />eY � � ��cr-iPT � <br />��i �...,U <br />. .;'z��n i . <br />,�!?D4'�SS flir- <br />�i ., C 1 <br />