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, � .�� , �ONSTRUCTIOn <br />o,�or i� � <br />eve�ett PERMIT PERMIT N0. �4 i14 <br />pTY HALL 259�8745 <br />EVERET7, WA 98201 ❑ COMBINATION �I BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OYfNER MAILADDRE55 �ITY 21P PMONE <br />�namic Sign Company Box 1460 Hellingham 671-40�0 <br />AflCHITEGT OR OESIGNER MAIL AODFES: CITV ZIP PMONE <br />GEN[RAL CONTRACTOR MAII apDRE55 GTY ZIP PMONE UCENSE M <br />Same <br />MECMANICAL CONTflACTOR MAIL AU�RESS CITY ZIP PHONE LICENSE M <br />PLUMBING CONTflACTOR MAIL P��RE55 QTY ZIP PMOKE LICENSE N <br />s <br />❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVE/FIREPLACE INSERT <br />OF WOpK <br />892.00 <br />erect nonilluminated sign <br />L0T_BLOCK_OF <br />4-29-5 <br />3812 28th Place N.E. <br />PLUMBING <br />TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOI LEn <br />BATHTUB <br />LAVATORY�WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISP. <br />DISHWASHER <br />LAUNDRYTRAY <br />CLOTHES WASHER <br />WATER HEATER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS — RAINLEADERS <br />SINK (SERVICE — BAR, ETQ) <br />PERMIT <br />TOTAL FEE <br />OF BL�G. I NO. <br />1. ENVIRONMENTAL CHECK LIST <br />2. BUILDING PLANS <br />3. FIRE HYDRANT <br />4. FIRE PFOTECTION SYSTEM <br />5. GRADING <br />7.ENVIRONMENTALIMPACTSTATEMENT <br />8. HEALTH DISTRICT <br />APPLICATIUN ACC. BY PLANS CHE <br />JEF <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED TH�S <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />coaies� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE GF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AU7HORITY TO' 'OLATE <br />OR CANCEL THE PROVISIONS OF AN'f OTHER STPTE OR <br />LOCAL LAW RE LATING CON:iTRUCTION OR THE <br />PERFORMANCE 0 ONSTRUCTION. <br />SIGNATUREOFWNTR AUT�HORi2EDALENT DATE <br />X L f� �7 � �./� <br />MECHANICAL �!71 ���yy"'1'jt� <br />FEE NO. TYPE OF EOUIPMENT <br />AIR GOND. UNITS — H.P. EA. <br />REFRIGEFATION UNI7S — H.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIRE� A.C. UNI7S — TONNAGE EA. <br />FORCED AIR SYSTEMS — B.T.U. M EA. <br />WALL HEATERS — B.T.U. M <br />UNIT HEATERS — B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRYEflS <br />VENTILATION FAN <br />RANGEHOOD <br />AIR HANDLING UNIT — C.F.M. <br />STOVE — WOOD <br />METAL FIREPLACE & CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />� <br />S <br />S <br />REAC YARD SETE <br />VACANT SITE <br />YES ::NO <br />NO. OF DWELLIN <br />MAX.00G LOAD <br />FIRE SPRINK�ERI <br />REOUIFED <br />;_YES CNO <br />BY DA1 <br />FOR ISS�JANCE BY <br />LC <br />SUB TOTAL 5 <br />PERMIT S <br />TOTAL FEE S <br />C NUMBER PLAN C <br />FEE <br />FEES VALUATION <br />BUILDING <br />PLUMBING <br />MECHANICAL <br />OTHER <br />PENALTY <br />S 892.00 <br />U.B.C. <br />SEC.303 <br />RECEIPT NO. <br />FEE <br />F�? <br />TOTAL I I 16 I00 <br />PEHMIT VALIDATION <br />WHEN PROPERLY VALIDATED QN THIS SPACE) THf.s IS YO�fi�PERMIT_ _� <br />, � <br />� <br />� <br />i � <br />ADDP,ESS FILE <br />