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0 <br />u <br />�� <br />thc t.':•ergreen <br />everett r CONSTRUCTIO� � <br />PERMIT PERMIT NO. 12910 <br />CITY HALL 259�8745 <br />EVERETT, WA98201 � COMBINATION ❑ BUILDING X� MECHANICAL ❑ PLUMBING <br />OWNEN MqIIADDRE55 CITY ZIP PNONE <br />SIMMS 5105 WILMINGTON EVERETT WA 96203 252-6356 <br />AqCMITFGTORDE5IGNER MRILADORESS QTY ZIP PHONE <br />GENER�L GONiR�CTOR MRIL NDDRE55 CITY 21P PMONE UCENSE I <br />Same <br />1.1ECM�NICAL CONTR�CTOR MRIL pDORE55 GTY iIP VHONE ULENSE II <br />PUIMBING fANTR�CTOR M�IL ADDRESS CITY ZIP PHONE LILENSE � <br />O NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLIiION O FENCE G SIGN A�M WOOD STOVFJFIREPLACE INSERT <br />s <br />install free standing wood stove <br />Res <br />LOT <br />mington <br />PLUMBINO <br />N0. TYPE OF FI%TURE UR ITEM <br />WATER CLOSET �TOILEn <br />BATMTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCMEN SINK 8 DISP. <br />LAUNDRYTRAY <br />CLOTHESWASMER <br />WATER HtATER <br />URINAL <br />DRINKING fOUNTAIN <br />FLOOR �RAIN <br />VACUUM BREAKERS <br />ROOF DRAINS — RAINLEADERS <br />SINK (SEFVICE — BAR. ETC.) <br />SUBTO7Al <br />PERMIT <br />TOTAL FEE <br />YARD <br />1. ENVIRONMENTAL CHECK LIST <br />2. BUILDING PLANS <br /><. FIRE PROTECTION SVSTEM <br />5. GRADING <br />6. ORAINAGE <br />7.ENVIRONMENTAIIMPACTI <br />B.MEALTH DISTRICT <br />FEE <br />3 <br />f <br />S <br />�. �9E5 ; !NO <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS 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 ANY OTHEP STPTE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGNyc �R ,9� CONTpACTOR UiHOF12E0 AGENT �/�yJ�T'/Sa OATE <br />X L, Ir�� �%�.L/ �/�/i.� .( . .t / <br />���� <br />MECHANICAL <br />FEE <br />AIR CONO. UNITS — H.P. EA. <br />REFRIGERATION UNITS — H.P. EA. <br />BOIIERS — H.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />WALL HEATERS — B.T.U. M <br />UNIT MEATERS — B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHESDRYERS <br />VENTILATION FAN <br />FANGEHO00 <br />AIR HANDLING UNIT — C.F.M. <br />STOVE — WOOD <br />METAL FIREPLACE 8 CNIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />SUB TOTAL f <br />PERMIT S <br />TOTAL FEE f <br />FEE I RECEIPT NO. <br />FEES � VALUATION � FEE <br />BUILDINC S <br />PLUMBING <br />MECHANICAL U SO <br />OTHER <br />PENALTV U.B.C. <br />SEG. �03 (a1 <br />TOTAL <br />WHEN PROPERLY VALIDATED pN THIS65PqC�1 THIS �S �(Oy��1�T_ Q. <br />y4 au i � T <br />m <br />�1 <br />BY <br />`i�^JR RGCEIPT•-; <br />� � i,�r��: ��ou <br />ADDRESS fILE <br />2 2 J„u S 4 <br />