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rhrErrrereen — '—;ONSTRUCTIO�' - <br />���,. �: � � <br />everet� P�RMIT PERM�r �o. 166�6 <br />CITV HALL 259-87<5 <br />EVERETT,WA98201 � COMBINATION ❑ BUILDING L, MECHANICAL ❑ PLUMBING <br />OWNER MAILADDFE55 QTY ZIP PMONE <br />Jeff Koehler 2221 Virginia Everett, WA 98201 252-8569 <br />ARCMITECi OR OESIGNEH M41L AD�RE55 QTY ZIP PHONE <br />GENERALCONTHRCTOR MiI�ADDRE55 CITY ZIP PMONE LICENSE� <br />Same <br />MECNRNILAL CONTRACTOR MFIL AD�HES$ CITY ZIP PMONE LICENSE / <br />PLU:ABING CONTRACtOR MAIL ADORE55 LIiY ZIP PHONE LIGENSE • <br />❑ NE1N ❑ ADDITION ❑ ALTERATION O REPAIR ❑ OEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVE/FIREPLACE INSEFT <br />Install free-standing fireplace <br />.�rvoeu use or nuauin� <br />Single family resic�:nce <br />BELOW OR ATTACN FOOF COPIES� <br />�oT_o�ocK_oF <br />Ave <br />PLUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET �TOILET) <br />BATHTUB <br />LAVATORV�WASM BASIN� <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />LAUNORVTRAY <br />CLOTMES WASMER <br />WATER MEATER <br />URINAL <br />�RINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS — flAINLEADERS <br />SINK ISEAVICF — BAR. ETC.1 <br />SUB <br />TOTAL FEE <br />S12E OF BLOG. I N0. OF STOflIES <br />1. ENVIRONMENTAL CHECK LIST <br />2. BUILPING PLANS <br />3. FIRE HYDRANT <br />a. FIRE PROTECTION SYSTEM <br />5. GRAOING <br />6. DRAINFGE <br />7. ENVIRONMENiAL IMPACT STATEMENT <br />FEE <br />i <br />5 <br />f <br />VES NO <br />MA%. OCQ LOAD <br />8. HEALTH DISTRICT <br />APPLICATION ACC. BV PLANS CMECKED BV APPR. FOR ISSUANCE BY <br />M.M. <br />I HEREBY CEFTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LA\NS 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 AIJY OTHER STPTE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGNRTURE OF GONIRAGTOR OR AUTMONiZED RGENT 6Q/,TE�86 <br />i� � � 1/i�./.Zw/ /ts <br />AIR COND. UNITS — Y.P. Eq. <br />REFAIGERATION U�11TS — M.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIREO A.C. UNITS — TONNAGE EA. <br />FORCED AIR SYST[MS — B.T.U. M EA. <br />WALL MEATERS — 6.T.U. M <br />UNIT NEATERS — B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRYEriS <br />VENTILA710N FAN <br />PANGEHO00 <br />AI7 HANOLING UNIT — C.F.M. <br />STOVE — WOOD <br />METAL FIREPLACE 8 CHIMNEV <br />FIPEPLACEINSERT <br />MEAT PUMP <br />PLAN CHECK NUA <br />FEES <br />BUIL�ING <br />PI UMBING <br />MECNANICAL <br />OTHEfl <br />PENALTV <br />30 <br />SUBTOTAL S ,3Q <br />PERMIT S <br />TOTAL FEE 5 <br />PLAN GMECK FEE <br />FEE FECEIPT NO. <br />VALUATION FEE <br />5 <br />95 <br />U.B.C. <br />� SEC. 303 �a� <br />TOTAL I I QS IOO <br />WH NITPROPIERLYOALICATEDIIN'T����CE�"Tti1�Yl7UAPE7iMli �# <br />110001667b ~ <br />� <br />i1ECH 545.00 �� <br />GiECF: 445.00 a—I <br />ADDRESS FILE <br />