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r,,�E,���x,°�„ ('7NSTRUCTION '" <br /> CITv OF <br /> everet�t PERMIT pERM1T NO. 0�657 <br /> qTY HhLL 259�8745 <br /> EVERETf.I'lA `J8207 ❑ COMBINATION ❑ BUILDING �1ch1ECHANICAL PLUMBING — <br /> MPIL PD��E55 CIiY ZIP FMONF <br /> OWNfR <br /> Nancy Romerdahl 1014 Rucker Avenue Everett 9820 _ <br /> ARCHiTCCi OR OESIGN[R <br /> MAILPODPE55 CIiY ZIF FHONE <br /> GF.NERPL CONiFAQG� <br /> MAIL ADDRE55 CI1Y ZIP FHONE LICENSE I <br /> MCGNANIC>LCUNiRACiOP <br /> MAILPD�RE55 CITY ZIP PNOKE LIC[NSE� <br /> Natural Gas Equipment 1611 Ea t Grand Everett 98201 259-29 <br /> F�UMBING GONiPACtOR <br /> MPIL A�DRESS CIiY 21P VHDHE L�CENSE 1 <br /> C1A55 Of\WBK <br /> ❑NEW ❑ADDITION ❑ALTEPATION ❑REPAIR ❑DEMOLITIJN ❑FENCE ❑SIGN GARAGE <br /> vnwnrior+oF wOr+rc <br /> 4 <br /> OESCRIBE WORK <br /> PROPOSED WE OF BUR�VJG <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS A • <br /> �[(SAl�[SCRiPT�ON OF PROOERTY�SNOW OELOW OR PTTPCN FOUR CAP�ESI PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOV[RNING THIS <br /> �oT e�ocK_oF TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO� <br /> CON�STHUOCTION OR THERPERFORMANCOE OF CO STRUCT ON�NG <br /> SiGNATU OF CANTRACTOR OR nUiMORIZE�AGENi �Ar� <br /> JOB ADDRE55 X 8I17I81 <br /> 1014 Rucker <br /> MECH NICAL <br /> PLUMBIN6 FEE <br /> NO. TYPE OF FIXTUPE OR ITEM FEE N�� Ai�cONo u Y sE OH.PQAIPMENT <br /> WATEfl CLOSET ROILET) <br /> REFPIGERATION UNITS-HP.EA <br /> 1TNTUB — <br /> BOILEPS-HP.LA. - <br /> �.AVATORY p4A5H BASIN) <br /> GAS FlR[D A C.UNITS-TONt�AGE EA. <br /> SHOWEP <br /> _ FORCED AIR SYSTEMS-0 T.U. M EF. <br />� KITCHEfI SINK 4 DISP. M <br />.�� - WALL HEATERS-0 iU. <br /> DISHWASfI[R ti� <br /> UNIT HEATERS-BS.U. <br /> LAUNDRYTRAY <br /> EVA{'OFATNE COOLERS <br />�1 CLOTI�ES W ASHER CLOTHES DRY ERS <br /> WATER NEATER yENTILATION FAN <br /> I� URINAL <br /> RAN(iE HOOD <br />�t� DRINKINCa POUNThIN C.P.M. <br /> Alft H�NDLING I�NIT- <br /> i� FLOOR DRPW - — <br /> VACUUM BHEAKERS ETOVE <br /> METAL FIREPLACE&CHIIANEV 4 S O <br /> 1� ROOfOPAINS-NAINLEADER$ 1 wate <br />(, SiNK(SERVICE-BAR[TC.) <br />� SUB TOTAL SUB TOTAL S 4 S O <br /> PERMIT f 3 00 <br /> PEHMIT s TOTAL FEE s <br /> TOTRL FEE S P�.AN CHEGK FEE <br /> SIDE VARD SETBACK STREET SEidACN REAR YARU SETBACK PLAN Cl/ECK NUMBER FEE RECEIPT NO, <br /> � USE 20NE l0�AREA vA ES T�]NO FEES VALUATION FEE <br /> 6 <br /> TVPE OF CONST. OCGUPANCY GROUP IIO.OF DWELLING UNITS <br /> BUILDING $ <br /> SIZf OF BLDG. N0.OF S70RIE5 MA%.6:C.LOhD - <br /> PLUMBING <br /> FIRE ZONL PASEMENT pEU IHEO t��CR--- ���CHANICAI � S O <br /> I-iYES ❑NO ^� � <br /> pPPpOVALS <br /> OY DAT[ OiHER <br /> PcNALT� U 0 C <br /> L ENVIRONMENTAL CHECK I.IST SEC.303�a) <br /> ^. BUILDIN3PlANS �TaTA� � SO <br /> �--- <br /> 3 �-1RE HVORANT <br /> PENMIT!'ALIDATION <br /> 4. FlRE PROTECTION SVSTEM WMEN PRUPERLV VALIGATED(IN THIS tiPACE)THIS IS YOUR PEFMIT <br /> 5. GRADING � _ _ I . � I. � � � <br /> G. DRAINAGE CD <br /> 7. ENVIRONMENTAL IMPACT STATEMENT U) <br /> 8. HEALTHO'�^:TRICT � ' � � <br /> APPLICATIOu ACC.BY PIANS CHECKED EY APPfl.FOR ISSUANCE OY � � ' <br />