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IheEn'rcroen �0���, l��TIO�� <br />+ � <br />QV�I��I, P�RM�T PERMIT N0. ����40 <br />CITV HALL 259A7d5 <br />evEaetr wneezo, ❑ COMBINATION ❑ BUILDING .C�7t MECHANICAL ❑ PLUMBING <br />01YNER MAIL ADDRf55 CIiY 21P PHONE <br />Duane Hendry 5914 We�nore Everett 98201 <br />49CNrtECT OP DESIGNER MrIL ADORE55 GITY ZIP PMONE <br />GCNERAL CONiFAG�OR MRII ADDBE°a QTY ZIP PMON[ IICENSE � <br />MECMRNICAL CONTRACTOR MAI� ApDRC55 CITY ZIV PNONE LICENSE � <br />iJatural Gas Equipment 1625 East Marine View Drive Everett 98201 258-2441 <br />olUM9iNG GO'�JiRRCiOR MAIL ADD�E55 Gi• 2iP PHONE L�CENSE � <br />❑ I:EW ❑ ADD�TION O ALTERATION ❑ REPAIR ❑ �EMOLITION ❑ FENCE ❑ SIvN ❑ WOOD STOV6FIREPLACE INSERT <br />S <br />DESCNiBE WORN <br />PRO�'OSED USE Oi' 9JILDING <br />IEGAL DEICRIPTiON LF PRO'ENTY ISMOK <br />�oT___e�ocK_��F <br />J00 ADDRE55 <br />5914 Wetmore <br />PLUMBING <br />N0. TYFE OF FIXTURE <br />W A7[R GLOSET �TOI LEn <br />BATNiUB <br />LAVATORv IWASM BASIN� <br />SNOWER <br />KITCNEN $INK & DISP. <br />DISMWFSHER <br />LAUNDRY T(iFY <br />CLOTHESWASHER <br />WATER HEATER <br />URINAL <br />ORINKING FOUNTAIN <br />FLOOR ORAIN <br />VACUUM UREAKERS <br />ROOF DFAINS — RAINIEADERS <br />SINK �SEPVICE — BAR. ETCJ <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />APPPOVALS <br />L ENVIPONMENTAL GHECK LIST <br />2.dUILDINGPLANS __ <br />3. FIRE HYDRANT <br />d. FI;iE PROTECTION SYSTEM <br />5 GRADING <br />fi. DFAI4AGE <br />7. ENVIRONMENiAL IMPACT STATEMENi <br />B.HEALTH DISTRIGi <br />APPLICATION ACC. B� PLANS CHECKED BV <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE Sati!'e TO BE TRUE AND <br />Fouacovies COPRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORh 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 ChNCEL THE PROVISIONS OF ANY OTHER STPTE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR 7HE <br />PERFORMA E OF CONSTRUCTION. <br />S:GNnIU�E OF N OR AUT RI2EO ��iENT DATE <br />X ,L <br />MECHANIf:AL <br />� <br />s <br />f <br />REAR <br />YES NO <br />FOR <br />TYPE OF EOUIPMENT <br />AIR CONO. UNITS — H.P. EA. <br />REFRIGERATION UNITS — MP EA. <br />�OILEFS — h.P. EA. <br />GAS FIRED A.C. UNI15 — TONNAGE EA. <br />FORCED AIR SVSTEMS — B.T.U. M EA. <br />WFILHEATERS—BT.U. M <br />UNIT HEATERS — B.T.U. M <br />6VAPORATIVE COOLERS <br />CLOTMES DRVERS <br />VENTILATION FAN <br />RANGEHOOD <br />AIR HANDLING UNIT — GF.M. <br />STOVE — WOOD <br />METAL fIREPLACE 8 CHIMNEV <br />FIREPLACEINSERT <br />1 Water Heater . <br />SUBTOTAL <br />PERMIT <br />lOTAL FEE <br />AN GHECK NUMBER F <br />FEE <br />FEES VAIUATION <br />BUIIDING <br />PLUMBII�G <br />MECHANICAL <br />OTHER <br />PENAITY <br />S <br />30J <br />� <br />Q— <br />s % 0 <br />f 10 � <br />s 14 0 <br />�MECN FF.E <br />RECEIPT NO. <br />FEE <br />14 � 50 <br />TOTAL I I 14 I S� <br />PERMIT VAL�UATION <br />WHEN PROPERLY VALIDAT[D �IN THIS SPACE) TMIS IS YOUP PEflM1T Q <br />, � � � j i' � ... _ �' <br />N <br />� <br />t-'i <br />f_`l'CcS�� fflE <br />Z <br />O <br />--I <br />.. <br />n <br />m <br />�1 1--i <br />�� <br />r y <br />in x <br />m <br />co <br />mo <br />—1 c <br />O 3 <br />t*� <br />--� z <br />m� <br />.O z <br />a --i <br />rx <br />1 N <br />< <br />T <br />�� <br />1m <br />(�i �--' <br />N <br />j r <br />n m <br />C tn <br />3 N <br />m <br />zn <br />-�i r <br />m <br />D <br />A <br />� <br />_ <br />v <br />z <br />0 <br />� <br />r <br />f� <br />