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� I <br /> ,�:� ��,��,r,.�.�,: �',Q N��� �� C�f l� �� <br /> �verett P E R I� �T �� � � � <br /> PERNIIT NO. <br /> r ii r HALL 259E7d5 <br /> !:e;�err.���n<�ezo� ❑ COMBINATION ❑ BUILDING �Ml MECHANICAL PLUMBING <br /> IAAIL ApPRE55 CRY Z�P ' � � � <br /> G:.'.i•i <br /> 1621 - 41st St Everett 98201 258- <br /> LPCHIi t I N[R <br /> MAIL ADDRE55 CITY ZiP FMONE � <br /> Gcy[HAL GONTRAGTOR MAIL AODPESS <br /> CITY 21P PMONE !ICENSE '� � <br /> I <br /> IAAI�A�pRESS CITY 21P PMONE LICENSE� � <br /> �t6CHANiCAL CONTRACTOR � <br /> SAFETY & SUPPLY CO 5510 E Marginal Way S Seattle 76Z-8500 Z SAFET5245NJ ONE ��cENs�� � <br /> i'w1dBING CONTPAGTOR 1AAll AODRE55 i <br /> CLA55 OF V.OPK — � <br /> ❑NEW ❑ ADDITION ❑ ALTERATION ❑REPAIR ❑ DEMOUTION ❑ FENCE ❑ SIGN ❑ WOOD STOVJFIREPLACE IRSERT <br /> VPWATION OF WORK <br /> OE CRI�E YlOFN <br /> Install Ansual fire suppression system in hoods _ _ <br /> r�r,ovoseo use oF eui�onie I HEREBY CERTIFY THAT I H�\VE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> I.LGBL�ESCRIPiIONOFPROPERNISNOW�ELOWORATTACHFOURGOP�ES� CORRECT. ALL PROVISIONE� OF LAWS AND ORDINANCES <br /> GOVERNING THIS TYPE OF VVORK WILL BE COMPLIED WITH <br /> LOT,__BIOCK_�F WHETHER SPEGFIED'1EREItV OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TO C!VE/.UTHOFITY TO VIOLATE <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br /> LOCAL LAW REGULATIN�3 CONSTRUCTION OR Ti-i[ <br /> PERFORMANCE OF CONSTRUCTION. pqrE <br /> SIGNATU EOFLONTFACTI.qORO i ONIZEOPGENT 9�4�84 , <br /> ,ou^16215 - 41 st k � � �^` <br /> I <br /> PLUMBING� MECHANICAI�� I <br /> I FEE NO. TYPE OF E�UIPNENT FEE -- <br /> NO. TYPE OF FI%TURE OR ITEM qIR COND. UNI7S — H.P. EA <br /> W A1"ER CLOSET 1T01 LET) <br /> REFRiGERAT�ON UNITS — N.P EA. <br /> BATHTUB <br /> BOILERS— H.P. EA. <br /> LAVATORY(WASH BASIN) <br /> GAS FIRED A.C. UNITS — TONNAGE EA. _ <br /> SHC W ER <br /> FORCED AIR SYSTEMS — B.T.U. IA EA. <br /> KIT(�HEN SINK 8 DISP. <br /> WALL HEATERS— B.T.U. �+� <br /> �ISNWASHER <br /> UNI7 HEATERS— B.T.U. M <br /> LhUNORVTRAY <br /> EVAPORATIVE COOLERS <br /> CLCTHES WASHER CLO7HE5 ORYEPS -- <br /> WA"ER HEATER <br /> VENTILATION FAN — <br /> UflIIJAL <br /> RANGEHO�D — <br /> DRIWKING FOUNTAIN Gf.M. - <br /> AIR HANDLING UNiT — _ <br /> FLOOF DRAIN � <br /> — STOVE — WOOD �— �. <br /> VACUUM BREAKERS C'1 <br /> ROC�F ORAINS— RAINLEADEflS <br /> METAL FIREPLACE 8 CMIMNE'! <br /> SINS�SERVICE — BAR,ETG) �FIREPLACE INSERT — <br /> HEAT PUMP <br /> — � � � <br /> � — QZ <br /> H r <br /> -� '_ <br /> SUBT07AL 5 � :-_ <br /> SUB TOTAL S — PERMIT s <br /> PERMIT S — � ' � <br /> � TOTAL FEE S TO7AL I�EE S �O O <br /> i7 r <br /> PLAN CHECK FE[ � <br /> SIDE YARD SETBAGN STREET SETBACK REAR YAFD SE70ACH PL�N CHECK NUMElER FF.EI RECEIPT NQ �` '� <br /> USE ZONE LOT AREA VACANT S1fE FEES VII�UATION FEE <br /> � .YES -.NO — <br /> fJ : <br /> TVPE OF CONST. OCCUPANCY GFiOUP NO.OF DWELLING UNITS - <br /> BUIL�ING 5 � <br /> tti :. <br /> SIZF.OF BI�G. NO.OF STORIES MAX.OCC. LOPD p�UMBING �' � <br /> FIRE SPRIPIKLERS �O OD '� � <br /> FIREZONE BASEMENT REOUIRED MECHANICAL _ '' <br /> YES NO = ' <br /> OTHER _ <br /> APPROVALS BY DATE U.B.C. <br /> 1. ENVIRONMFNTAL CHECN LIS1 PeNALTY SEC.9031a1 �"' <br /> ��, '. <br /> 2.9UILDING PLANS 707AL �O OO <br /> 3.FIRE HYDRANi ' <br /> FERMIT VALIOATION `; <br /> 4.FIREPROTECTIONSYSTEM yyHEN PROFEiiL'f VPLIDATED(IN TNIS.SPACE)TNIS�5 YOUF�PERMIT.--(rj, _ <br /> 5.GRADI NG � <br /> M <br /> 6.DRAINAGE <br /> 7.ENVIRONA1eNTALIMPACTSTATEMENT - � y - <br /> B.HEALTH DISTRICT . <br /> APPLICATION ACC.BY PLANS CHECKED BY APPR. FOR ISSUANCE 9� <br /> l _ — __ . <br />