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die Ecercrren - ^ p N ST R U CT I O N <br />everett PERMIT PERMIT N0. 135�2 <br />CITY MALL 259 B7d5 <br />EVERETT.VJA96201 � COMBINATION � BUILDING ❑ MECHANICAL PLUMBING <br />GTY ZIP PHONE <br />OWNER MAiLADDRF55 ��n ....�n — <br />G1TY Zip f�NONE IiCENSE i <br />GENERF� GONiHPGTOR <br />MR�I ADORE55 <br />M[GMnNIGAL GONtPRGTOR MRiL ADORE55 <br />CITY 2iP PNONE L�CENSE � <br />❑ NEW ❑ ADDITION ❑ ALTERATION XR� REPAIR ❑ DEMOLITION ❑ FENCE O SIGN ❑ Vl00� STOVEIFIREPLACE INSERT <br />s ........,.. <br />iGPIAE WORN <br />Reside <br />�roseo usE or <br />Garage <br />2 sides of garage, repair work <br />shop <br />�0�_aIOCK_Ur <br />Lots 26, 27, ptn 28 Blk 577 Hatch Heirs <br />LaMoures <br />te St <br />PLUMBING <br />NO. TYPE OF <br />WATER CLOSET (T <br />BATIiTUO <br />SHOWER <br />KITCHEN <br />LAUNDRYTRAV <br />CLOTHESIVASHER <br />WaTCR HEATEP <br />URINAL <br />f`^INKING POUNTAIN <br />FLOOR DRAIN <br />VALUUM BREAKEPS <br />ROOF DRAINS — qA�NLEA�ERS <br />SINK �SEPVICE — BAR, ETC.) <br />TOTAL <br />TOTAL <br />NO. <br />L ENVIRONMENTAL CHECK LIST <br />2.BWlDINGPLANS _ <br />7. FIRE HYDRANT <br />a. FIRE PROTECTION SYSTEM <br />5. GRADING <br />6. DRAINAGE <br />7. EN V I RONMENTAL I MPACT STA' <br />8. HEALTH DISiRICT <br />APPLICATION ACG BY PLp <br />BV <br />� <br />f <br />f <br />iEAR YARD 5 <br />JACANT SITE <br />YES NO <br />VO. O� DWEI <br />h1AX. OCG L( <br />FOR <br />I HEREBY CEATIFY THAT I HAVE READ AND EXAMINED THIS <br />APPUCATION 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 />p RM T DOES NOTIPR SUME TO GIVE AUTHORITY TO V OL� TE <br />OLOCALN LAW HREGU�LATI�GSCONSTRU�CTTION SOF T�E <br />PERFORMANCE OF CONSTRUCTION. o4TE <br />SIGNATUR CONT—R'7ALIOR p/R Al1�T 'OR12E0 AGENT 6/ 21 /84 <br />i( ��.a-C.:_ /��-C� " 'L - <br />MECHANICAL <br />___ rvnv ne ohI11PMFNT FEE <br />AIF GOND. UNITS — H.P. EA. <br />R[FHIGEHATION UNITS — H.P. EA. <br />BOILEiiS — H.P. EA. <br />GAS FIRED A.C. UNITS — T�NNAGE EA. <br />FOi±CED AIR SYSTEMS — O.T.U. M EA. <br />WALL MEATEFS — B.T.U. M <br />UNIT NEATEPS — B.T.U. M <br />EyqpORATIVE COOLERS <br />CLOTHESDFYERS <br />VENTILATION FAN <br />RANGEMOOD <br />AIR HANDLING UNIT — QF.M. <br />S10VE — WOOD <br />METAL FNEPLACE 8 CMIMf:'Y <br />FIREPLACEINSERT <br />HEAT PUMP _ <br />BI�IIDING <br />PLUMBING <br />IdECHANICPL <br />OTMER <br />PENALTY <br />SUB TOTAL S <br />PERMIT f <br />TOTAL FEE _ <br />PLAN C <br />FEE <br />VALUATION <br />�8��.0� <br />U e.C. <br />SEC.3031a� <br />RECEIPi NO. <br />FEE <br />TOTAL I I 16 I��— <br />PERMIT VALIDATON � � <br />\NHEN PROPERL� VALIDATED pN TH15 SFACE� TMIS I$ Y UP PERMIT <br />: ; P i . C 0 - -1>. <br />J7 <br />C `i <br />.. .-,' � ri i a_ i <br />BV <br />l� <br />, .';:�_5< f ILE <br />H� <br />y "; <br />ry � <br />N � <br />� €: <br />[ <br />m �' <br />Cb :. <br />r � <br />Kr <br />[ <br />O� <br />� �_. <br />r <br />� � <br />f <br />9 <br />