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�����`�`�""�`��� ;ONSTRUCTIO�' <br />everett PERM�T PERMIT N0. 1373� <br />QTY HALL 759�87d5 <br />EVERETT.VJA98201 � COMBINATION Y� BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OYM[R MAIL AODRES$ LITY ZI> PMONE <br />LEDA VOAG 221 PECKS DP. EVERETT lJA 98203 347-2439 _ <br />ANCHIiECi OR OESIGNEN MAIL AO�RE55 GTY ZIP PNONE <br />GENERnI GONiRACiOR IdAIL AODPE55 QTY 21P PNONE IICENSE � <br />Same <br />M[GHPNICAL CONTRNGTOR MAIL ApOPE$S CIiY 21G PHONE LICENSE • <br />PLUMBING CONTRNGiOR MAIL ADOPE55 CITY ZiP PMUNE IIGEHSE 1 <br />O NEW ❑ ADDITION ❑ ALTERATiON i�O REPAIR O DEMOLITION ❑'EhLC G SIGN ❑ WOOD STOVBFIREPLACE INSEHT <br />t 40�0.�0 <br />Repair foundation <br />ng <br />LOT _ BIOCK,�y��OF <br />17&18 <br />PLUMBING <br />TYPE OF FIXTURE OR <br />WATER CLOSET �TOI LEn <br />BATHTUB <br />LAVATORY�WASM BASIN� <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISNWASMER <br />LAUNDRVTRAY <br />CLOTHES WASHER <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM OREAKERS <br />ROOF ORAINS — RAINLEADERS <br />SINK �SERVICE — BAR, ETC.) <br />SUB TOTAL <br />PERMIT <br />iOiALFEE <br />APPROVALS <br />1. ENVIRONMENTA. CYECK LIST <br />2. BUILOING PLANS <br />J, FIRE NYDflANT <br />4. FIRE PROTECTION SVSTEM <br />5. GRADING <br />f. ORAINAGE <br />7.ENVIRONMENTALIMPACTSTAT <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERN�IT DOES NOT PRESUME TO GIVE AUTHOR!TY TO V�OLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHFR STPT[ OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERF09.MANCE OF CONSTRUCTION. <br />SIGNATUB�.bF pp}ITRRCTOP QR AUIMOR�EED AGENT DAIE <br />FEE NO. TYPE OF EOUIPMENT <br />AIR COND. UNITS - H.P. EA. <br />REFHIGERATION UNITS - H.P. EA. <br />BOILERS - N.B EA. <br />GAS FIRED A.C. UNITS - TONNAGE EA. <br />FCRCED AIR SYSTEMS - B.T.U. M EA. <br />WALL HEATERS - B.T.U. M <br />UNIT HEATER$ — B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRYERS <br />VENTILA710N FAN _ <br />RANGEHOOU <br />AIR HANDLING UNIT — C.F.M. <br />STOVE — WOOD <br />METAI FIREPLACE fl CHIMNEV <br />FIREPLACE INSERT <br />HEAT PUMP <br />S <br />S <br />YES NO <br />MAX.00C.LOAD <br />RE� <br />NO <br />OATE <br />ISSUANCE BY <br />SUB TOTAL S <br />PERMIT S <br />TOTAL FEE 5 <br />PLAN GMECK NUh19ER PLAN ,^' <br />FEE <br />FEES VpLUA710N <br />BUILDING <br />PLUMBING <br />MECMANICAL <br />OTHER <br />b4,000. <br />FEE <br />K FEE <br />RECEIPT N0. <br />FEE <br />44 50 <br />PENnLTV SEC 30� (a� � <br />TOTAL 44 50 <br />PERMIT VALIDATION <br />WMEN PROPEPLV VAI.IDATED pN TM15�SPPGE'�THIS IS YOl1R PEfjM�1 _!f'� � <br />. . . . � . . �. ' � �7 <br />��' <br />M <br />.. .`�,. ��'� <br />,1 <br />J <br />11DDF.L,�, IILI. <br />