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�`�`���'�`�' `�- � �ONSTRUCTION� � <br />e���ti` � �=,,` � <br />PE� IMIT PERMIT N0. 16�7H <br />CITV HALL 259-87�5 � � <br />t-j eiER�'^'g�'$ ❑�6�A�INATION � BUILDING ❑ MECHANICAL ❑ PLUMBINQ <br />�N�— MAILADUflE55 CITY ZIP fHONE <br />"A" Wnstruction Co. 1003 Woodlawn EVerett 98203 252-4723 <br />ARCMITECi OR ESIGNER M�IL ADORESS CITY ZIP PMONE <br />Design Consultants <br />GENEFqL CONTflACTOR MAIL AUDRESS CITY ZIP PHONE LICENSE 1 <br />"A" Construction Co. ACONSC 179 DN <br />MECMANICFL CONTRACTOR MAIL ADDdESS QTY ZIP PHONE UCENSE I <br />PLUMBING CONTflACTOH MAIL ADDHE55 CITY 21P PHONE LICENSE I <br />CUSS OF WOqN <br />�GJEW ❑ ADDITION ❑ ALTERATION ❑ REFAIR O �EMOLITION ❑ FENCE O SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />f 78,000.00 <br />DESCRIBE WORK <br />New Construction - Single Family Residence <br />oT Z�- BLOCN_OF <br />3014 - 56th Street <br />PLUMBINfi <br />NO. I TYF� OF FIXTURE OR ITEM <br />Z BATHTUB <br />3 LAVATORY�WASHBASIN) <br />1 SHOWER <br />1 KITCHEN SINK 8 DISP. <br />1 DISMWASHER <br />LAUNDRYTRAY <br />1 CLOTHES WASHER <br />j, WATER HEATER <br />URINAI <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF ORAINS — RAINLEADEFiS <br />SINKISFRVICE — HAR_ETCI <br />R-S <br />�� <br />PERMIT <br />TOTAL FEE <br />�3 <br />Ir1906 S.F. � <br />F I E ' ' BASEMEN� <br />APPNOVALS <br />1. ENVIRONMENTAL CHECK LIS7 <br />2.BUILDINGPLANS ,� <br />3.FIREHYORANT w <br />4. FIRE PROTECTION SYSTEqI' <br />5. GFADING <br />' 6.-DRAINAGE ;,q <br />` . ENVIRONMEfJTAL IMPACF�'fATEMENT <br />� HEALTN DISTRIGT <br />APPLICATION ACC. BY ' PLANS CHEC <br />C: _ • i � O <br />O�• , - � i", � <br />ri.rt`: . -' ; s.c. <br />_.i <br />..l) <br />FEE <br />S <br />f <br />S <br />25' <br />1CANT SITE <br />YES ::.NO <br />1 <br />[: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 SPECIFIE� HEREIN OR NUT. THE GRANTING OF A <br />PERMIT OOES NOT PRESUMETO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STPTE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFO�ANCE OF CONST CTION. <br />SIGNATURE O�CONTR TOfl R AUT IZEO AGENT DATE <br />x �_ � _ . .� / � �-t3 Bl <br />MECHANICAL <br />NO. � TYPE OF EOUIPMENT <br />AIR COND. UNI75 — H.P. EA. <br />REFRIGERATION UNITS — H.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />FORCEO AIR SYSTEMS — B.T.U. M EA. <br />WALL HEATEFS — B.T.U. M <br />UNI7 HEATERS — B.T.U. M <br />EVAPORATIVE COOLERS <br />1 CLOTHES DRYERS <br />VENTILATION FAN <br />], flANGE HOOD <br />AIR HANDLING UNIT — C.F.M. <br />STOVE — WOOD <br />]_ METAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />E7BACK PL4N CHECK NUMBER <br />86/16378 <br />FEES <br />LING UNITS <br />BUILDING <br />IAD <br />PLUMBING <br />.ERS MECHANICAL <br />DATE OTHER <br />PENALTY <br />SUB TOT.1L <br />PERMIT <br />TOTAL FEE <br />FEEZ13.20 � <br />VALUATION <br />000.00 <br />U.B.C. <br />SEC. 303 <br />rtt <br />S �_ <br />f <br />S <br />CHECK FEE <br />RECcIPT NO. <br />7Q612 <br />FEE <br />367 00 <br />24 00 <br />TOTAL 419 50 <br />PERMIT VALIUATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />�, , !� _ ;_�i. <br />Additional Plan Check Fee Req�tired� �' $2�.35 ., <br />�'—� <br />FOR ISSUANCE BY � � � . , , �, , _ ��, � i ��� � <br />L. C. <br />ADDRESS FILE <br />. . " . . .. � �. i. � <br />,„�,� <br />,�� Cii <br />