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"n �he Evergreen ��p N ST R U CT I O N� ��} <br /> o, C�iv OF r�^� <br />� everett PERMIT PERMIT N0. 16221 <br />� CITY HALL 2548745 <br /> EVERETT,WA 98201 � COMBINATION C� BUILDINQ C� MECHANICAL ❑ PLUMBING <br /> OWNER MAIL `OURE55 CITY 21P PHONE <br /> iKenneth L. Patrick °C3 Loaan Dr Alderwood Man��$Q�6 672-7678 <br /> �RCHITECT OR OESIGNER MAIL ADDPE55 CITY ZIP PMONE <br /> GENEHA�CONTR0,�7pp MAILADORESS CITY ZIP PHONE LICENSEM <br /> MECHANICAL CONTFACTOR MAIL AD�RE55 CITV ZIP PMONE LICENSE I <br /> PWMBINGCONTRACTOR MRILAOORE55 CITY ZIP PHONE IICENS=t <br /> CU55 OF WOHK <br /> ❑ NEW ❑ ADDITION � ALTERATION ❑REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPIACE INSERT <br /> VAlUAT10N OF W09H <br /> f <br /> DESCRIBE WORN <br /> Install furnace and duct work <br /> PFOPOS[D USE OF BUI��ING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGAlOE CRIPrIONOPP FERTYISNOWBELOWORATTACHFOUPCOPIES) CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> �or_e�ocK_or__ WHETHEH SFECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUME TG GIVE AUTHORITY TU VIGLATE <br /> OR CANCEL THE PROVISIONS OF ANY UTHER STATE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION. <br /> JOB ADDRE55 SIGNATURE OF CONTRACTOP OR AUTMORIZED AGENT �ATE <br /> 2501�i Maple X 3/25/86 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYPE OF EOUIPMENT FEE <br /> WATERCLOSET�TOILET) AIR CONO.UNITS— H.P. EA. <br /> BATHTUB REFRIGERATION UNITS— H.P.EA. <br /> LAVATORY(WASH BASIN) BOILERS — �i.P.EA. <br /> SHOWER GAS FIRED A.C.UNI'S—TONNAGE EA. <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS— B.T.U. M EA. <br /> DISHWASHER WALL HEATERS— B.T.U. M <br /> LAUNDRV TRAV UNIT HEATEqS— B.T.U. A7 <br /> CLOTHES WASHER EVAPORATIVE COOLERS _ <br /> WATER HEATEF CLOTHES DRYERS <br /> URINAL VENTILATION FAN <br /> DRINKING FOUNTAIN RANGE HOOD <br /> FLOOR ORAIN AIR HANDLING UNIT— C.F.M. <br /> VACUUM BREAKERS STOVE—WOOD <br /> ROOF DRAINS— RAINLEADERS METAL FIPEPLACE d CHIMNEY <br /> SINK(SEtiVICE— BAR,ETC.1 FIREPLACE INSERT <br /> HEAT PUMP <br /> 1 <br /> SUB TOTAL S SUB TOTAL f G 0 <br /> PERMIT S PERMIT S 10 <br /> TOTAIFEE S TOTAI FEE S 16 O <br /> SIDE YARD SETBACK STREET SETBACK REAR VARD SETBACK PLAN CHECK NUMBER PLAN CHECK FEE I <br /> FEE RECEIPT NO. � <br /> USE ZONE LOT AREA VACANT SITE FEES VALUATION FEE <br /> S:VES "-;NO <br /> TYPE OF CONS7. OC.UPANCY GROUP NO.OF DWELLING UNITS <br /> BUILDING b <br /> SIZE OF BIDG. NO.OF S70RIES MAX.OCC. LOAD <br /> PLUMBING <br /> FIRE ZONE BASeMENT REal11RED KLERS MECHANIGAL 16 00 <br /> CYES :=:NO <br /> APPROVALS BY DATE <br /> OTHER <br /> 1. ENVIRONMENTAL CHECK LIST FENALTY '���B.C. <br /> SEC.303(a) <br /> 2.BUILDING PLANS — 70TAL 16 00 <br /> 3.FIRE HY�RANT <br /> 4.FIRE PROTECTION SYSTEM PERMIT VALIUATION <br /> WHEN PROPERLY VALICATED(IN THISIS4AC�THIS�jOYR1PEqM1T__•� <br /> 5.GRADING � 6 h U V <br /> 8.DRAINAGE '-`' <br /> 7.ENVIRONMENTALIMPACTSTATEMENT " ' <br /> r : <br /> 8.HEALTH DISTRIGT ' . , �� , .� �.�-I�� I� <br /> APPLICATION ACC. BY PLANS CHECKED BY APPR. FOR ISSUAWCE BY , , , -. �� <br /> M.M. <br /> — � <br /> ) i..,l� „ 'J <br /> ADDP.ESS FILE <br />