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d,�• F,�o.en�rn <br />C�iv O� <br />everett <br />CONSTRUCTI4�� <br />PERMIT <br />PERMIT NO. �_ � �i'�.%'t <br />CITV HALI.'�'?��71d5 - <br />eveHerr. ri�� �szoi �] COMBINATION L.I BUILDING XXl MECHANICAL C� PLUMBING <br />01':NCH A1AIL AODRE55 <br />G11Y �IP PHON[ <br />Burch ^ambers 5110 South 3rd Avenue Everett 98204 259-4821 <br />P(iC111iEQ OR �E-i�411CR hlNl a0�BE55 <br />CITY ZIP PMONE <br />��T� Z�p PMO!!E IICENSE M <br />GLNFPALGCr;��FCiOH MAIL ApDP[SS <br />RI[CMnNIGnL GONTRALiOR <br />MAIL AO�RE55 GTY 2iP PHONE LICENSE � <br />Valley Natural Gas 11323 Highway 99 Everett 98209 355-7730 <br />MAILAOOR[LS GTl' 21P PNON[ LiGEHSE+ <br />PLUMBING GONTfl/GTOR VALLENG153LI <br />❑ NE1N ❑ ADDITION ❑ ALTERATION ❑ FIEPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ W�OD STOVEIFIREPLACE INSERT <br />i <br />�pi__BLOCK_OF <br />�Ofl ADORE55 <br />5110 South 3rd Avenue <br />PLUMBING <br />NO. TYPE OF FIXTURE OR <br />WATER CLOSET �TOILET) <br />BATHiUS <br />LAVATORVhVASH6A51N� <br />SH0INER <br />� KITCNENSINKBDISP. <br />DISHVJASNER <br />LAUNDPYTFAY <br />CLOTHESIVASMER <br />wnTFA HEATER <br />URINAL _ <br />DRINKING FOUNTAIN <br />FLOOR DHHIN <br />VACUUM BREAKERS <br />ROOF DRAINS — RAINLEADERS <br />SINK ISERVICE — BAF, ETC.) <br />FEE <br />SUO TOTAL s _ <br />PERMIT S __ <br />TOTAL FEE f <br />iTHEET SFTBAGK REAR YAR� 5' <br />�.OT AFE t VACANT SITE <br />V[S NO <br />OCCI+PANCYGRWP NO.OFDWEL <br />NO. OF STOFIES MA%. OCC. LC <br />�- APPROVALS <br />1. ENVIRONM1IENTAL CHECK LIST <br />2 DUIL�IKG PLANS <br />9. FlRE Hl'OFANT <br />d. FIRE PROiECTION SYSTEM <br />5. GRADING _ <br />ti. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STATEMENT <br />B. M[ALTH DISTRICi <br />BY IAPPR.FOR <br />APPRCATIONTANDTKNOW THERSAME TOEBEMIRUE AND <br />CORRECT. 1LL PROVISIONS OF LAVJS AND ORDINANCES <br />GOVERNING THIS TYPE OF N'ORK WILL BE COPAPLIED WITH <br />ERM T D ES NOT1PRESUMErfQ GIV�AUTHORTYTO V OL�ATE <br />OR CANCEL THE PROVISIC�JS OF ANY OTHER STPT[ OR <br />LOCAL LAW REGULATIhG CONSTRU('�TION OR THE <br />PERFORMANCE OF CONSTRUCTION. ��.JA7�G <br />S.GNA]U�1E OF CONTRnC10R OF n11T1 CRIZ[p nGENi � <br />ll n- l. n .. 1_ <br />MECI�ANICIIL ' <br />N0. TYPE OF E�UIPMENT <br />AIF GOND. UNITS - H.P EA. � <br />REFRI3ERATION UNITS - HP. EA <br />DOILERS - M.P. EA. <br />GAS FlRE� A.C. UNITS - TONNAGE EA. <br />FORCcD AIR SYSTEMi - BT.U. M EA. <br />WALL HEATEFS - e.T.U. M <br />11N1T MEATERS - B T.U. M <br />EVAPORATIVE COCLERS <br />CLOTMES �RVER� <br />VENTILATION FA'1 <br />RANGEHOO� <br />AIR HANDIING UNIT - C.F.M. <br />STOVE - WOC-0 <br />METAL FIREP'_ACE 8 CNIMNEY <br />FIREPLACE I'ISERT <br />NEAT PUMf' <br />BACK P�AN GMhGwI <br />F <br />NG UNITS __ <br />BUIIDihl�i <br />D — <br />PWMB'NG <br />RS MECH+NICAL <br />__ OTHFR <br />SIIB TOTAL <br />PERMIT <br />TOTAL FEE <br />T F <br />FEE <br />VALUATION <br />S <br />5 <br />5 10 9Q—. <br />5 <br />�HECK FE[ <br />PECEIPT NO. <br />FEE <br />22 SO <br />PLI:4LTV SEC. 3D7 (e) <br />TO�iAL—�—' i2 ��SU <br />PERMIT VALIDATION q [ (� � � <br />l',MENPROPERLYVALIDATEDpNTHIS�RA�y�TMISI�Q��RPERMIY �,-; <br />`;, <br />� • "' <br />. . � i.. �''i-i' � <br />BYI . .. ... � 1�� 1 <br />., i`RE�> � II � <br />Z <br />O <br />� <br />n <br />m <br />�. .. <br />--I '*1 <br />•-� ---I <br />N 2 <br />m <br />0 <br />co <br />mc <br />('� <br />�� <br />o� <br />m <br />-� z <br />m~ <br />oz <br />D —{ <br />rr.. <br />--I � <br />-G <br />T <br />O ' <br />—i i�i <br />2 <br />m.. <br />�: <br />O <br />or <br />C) fT <br />C t/� <br />3 �+ <br />m <br />z c' <br />-a r <br />m <br />� <br />x <br />2� <br />z <br />v <br />C <br />c'. <br />r. <br />