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theErerg�e�er� �� �STRUCI'10� � <br /> arv o� �� I <br /> ev�re�t PERMIT PERMIT NO. ��E6o <br /> CITY HALL 259�8�45 <br /> EVS:icTi,WA98201 � COMBINATION ❑ BU!LD!NG �] MECHANICAL ❑ PLUMBING <br /> OWNEF lAAILADDRESS CIIY ZIP P�iOF.[ <br /> ld. D. Howell <br /> ARCHITEC'iOROESIG:JER MAILADDRE55 GTV ZIP PNONE <br /> GENEFAL GONTRACTOR MAIL CDORESS . CITY 21P PMONE LIGENSE R <br /> MEGHANICAI CONiRACiOR IdAIL ADDRESS CITY 2IP PHONE LICENSE M <br /> Evergreen State Sheet Metal PO Box 1508 Everett WA 98206 252-3114 EVERGSS302DB <br /> PLUMBING CONTflFCTOR MAIL AOORESS CITV ZIP PHONE LICENSE X <br /> ClASS OF WORK <br /> � NEW ❑ AO�ITION ❑ ALTERA710N ❑REPAIR ❑ DEMOLI710N ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPI.ACE INSERT <br /> VAIUATION OF WORK <br /> S <br /> DESCRIBE WORK <br /> Heating and Air Conditioning <br /> PROPOSE'J USE OF BUILO!NG <br /> C11111C I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGALOESCRIPTIONOFPROP:RTY�SMOWBELOWORARACHFOURCOPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> LOT_BLOCK__OF GOVERNING iHIS TYPE OF WORK WILL BE COMPLIED WITH <br /> WHETHER SPECIF�ED HEREIN OP NOT.THE GRANTING OF A <br /> PERMI f DOES NOT PRESUME TO GIVE AUTHORITY TO VIOL.,TE <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STPTE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OF THE <br /> PERFOR NCE OF CONSTRUCTION. <br /> JOBA'1➢�EaS� _ ���� Sa. SIGNATpPE F ONTA rIORAUTIiG EDAGENT 6/12/86 <br /> � � � x <br /> PLUMEING MECHAN AL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIP�AENT FEE <br /> WATERCLOSETITOILEn AIR COND. UNITS- H.P. EA. <br /> i3A7HTUB REFRIGERATION UNI75— H.P.EA. <br /> LAVATORV(WASH BASIN) BOILERS— H.P. EA. <br /> .�,HOWE9 Z GAS FIRED A.C. UNITS —TONNAGE EA. I 3 OO <br /> KITCHEN SINK 8 DISP. FORCED AIR SYS7EM5— B.T.U. M EA. <br /> DISHWASHER WALL HEATERS— B.T.U. M <br /> LAUNDFV TRAY UNIT HEATERS — B.T.U. M <br /> CLOTHES WASHER EVAPORATIVE COOLEFS <br /> WATER HEATER CLOTHES�PYERS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN qANGE HOOD <br /> FL."`OR OFAIN AIR HANDLING UNIT— C.F.M. <br /> VACUUM BREAKERS STO\E— WOOD <br /> ROOF DRAIMS— RAINLEhDERS METF,L FIREPLACE 8 CHIMNEY <br /> SINK(SERVICE— BAR, ETG.) FIFEPLACE INSERT <br /> HEAT PUMP <br /> gas pipin 3 0 <br /> SUB TOTAL 5 SU9 TOTNL 5 �F) Q <br /> P[FMIT S PERMIT S � 5 O <br /> TOTAL FEE S 70TAL FEE 5 3� O <br /> SIDE YARD SETBACK STHEET SETBACK REAR YARD SETOACK PLAN CHEf:K NWABER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA V�ICANT SITE <br /> :YES . .NO FEES VALUATION FEE <br /> TYPE OF CONST. OCCUPANCY GROUP NO. OF DWELLING UNI7S <br /> BUILDINC 4 <br /> SIZE OF BL�G. NO.OF SiORIES MAX. OCG LOAD �— <br /> PLUMBING <br /> FIREZONE BASEMEN7 FIRESPRINKLERS MECHANICAL <br /> flE0U1RED 3� Q <br /> YES � NO Q��lZ�l 9� + .� <br /> APPROVALS BY �ATE OTHER <br />, 1.ENVIRONMENTAL CHECK LIST PENALT` ��� <br />' 2.BUILDING PLANS � <br /> 3.FIREHVDRANT TOTAL 3� O <br /> 4.FIRE PROTECTION SYSTEM PEHMIT'JALIDATION <br /> F.GhADING WHEN P90PERLY VALIDATED�IN THIS SPACE�?HIS IS YOUR PERMI�' � <br /> G.DRAINAGE UJ <br /> 7.ENVIRONMEN7ALIMPACTSTATEMEN7 � <br /> 8.HEALTH DISTRICT `} <br /> APPLICATION AGC. BY :° ANS CHECKED BY APPR.FOR ISSUANCE 9Y � <br /> ADDRESS FILE <br />