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,,,`.`"."r",: CONSTRli�T10:: <br />.:�: <br />everett PERMaT PERMIT NO. -� >� � � <br />CIiY HALL 259�ft7E5 <br />ever�eTt vr� 9sso, � COM8INATION l� BUILDING _, MECHP.NICAL L� PLUh181NG <br />o�.mca Mai�<ooaess wrr nr allone <br />Harold Reinertsen 2023 Virginia Everett WA 9820i 252-2783 <br />AVCHILEGT OR OESIGNEN �APIL S�URE55 GtY Z�� vl UN( <br />GENERALLONiR�CTOi' MAILADORES$ CITY ZIP PNONE LICENSE• <br />�/EGMINICALGON'RACTOR MNILpOpRE55 QTY 21P PHON[ ULENSE� <br />Fi UM61NG GONiPPLiOR MRIL p00RE55 CIiY ZIP PHON[ LILENSC a <br />� NEW ❑ ADOITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION U FENCE ❑ SIGN ❑ WOOD ETOYEIFIFEPLACE INSERT <br />Cement block chimney, wood stove <br />ence <br />LOT�BLOGN�OF <br />rginia <br />PLUMBING <br />TVPE OF FI%TURE OR ITEM <br />WATER LLOSFT �TOILET) <br />BATHTJO <br />LAVATONY �WASH BASIN� <br />SMOVJER <br />KITGNEN SINK A DISP. <br />NShhNASHER <br />L4UNDRVTRAY <br />CLOiMES WASMER <br />URINFL <br />DfiI�KING FOUNTAIN <br />FLOOR DFAIN <br />VACl1UM BFEAKERS <br />ROOF DRAINS — RAI <br />SINK ISERVICE — BA <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLIG�TION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PRO`.'ISIONS OF LA1NS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREiN OR NOT. THE GFANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF AN'i OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SiGNAT�U+ F CONTFAGiOR OA 1 �OP12[D AGENI �AiE <br />X N,�. ,ti `c.� ��.�v-v�2,� � 5/15/84 <br />FEE NO. TYPE OF I:OUIPMENT <br />AIR COND. UNITS — H P. EA <br />REFRIGGRHTION UNITF — MP. EF <br />BOILERS — M.P.EA. <br />GAS FlRED A.G. UN175 — TONNAGE EA. <br />FORGED AIR SYSTEMS — B.T.U. M E <br />1YALL HEATERS — B.i U. M <br />UNIT MEATERS — BS U. M <br />EVAPORATNE WOLERS <br />VENTILATION FAN <br />AIR HFN�LING UNIT — <br />— srove — w000 <br />EADERS METAL FIREPLACE 8 CHIMNEV <br />ETC.� FIREPLACEINSERT <br />SUBTOTAL <br />PERMIT <br />t ENVIRONMENTAI CHECK LIST <br />2BUILDWGP�ANS — <br />3.FIRENYORANT "� <br />d. FIRE PROTEGTION SYSjE�A <br />6. DRAINAGE <br />�L ENVIFONMENTAL IMP/�G7: <br />-B.HEALTHDISTRICT �� <br />� <br />S <br />f <br />YES .NO <br />MA%.00G LOAD <br />DATE <br />APPR. FOR ISSUANCE BY <br />C.F.M. <br />SUBTOTAL S <br />PEflM1T S <br />TOTALFEE S <br />FEE I REGEIPT N0. <br />VALUATION FEE <br />BUILDING f aQ QQ � <br />PLUMBING <br />MECHAHICAL % SO <br />OTMER <br />PENALTY UBC. <br />SEC. JO7 �a� <br />TOTAL <br />P[RMIT VALIUATION <br />\NHEN PROPERLY VALIOATE� (�N THI i SPAC�) TM�S�S�O�f�PE�i�IT —� <br />� � <br />M <br />Ch <br />i• <br />i: i� : � I <br />� <br />'.L. .i`_ ,�, <br />