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' Ci ISTRUiCTI®N <br />PERMIT APPLICATION <br />COMWAATION • BUILDING • MECHANICAL . PLUMBING <br />David A. Brandvold <br />P.O. Box 3066, Everett, WA 98203 355-1135 <br />GENERAL CONTRACTOR MAIL ADDRESS PHONE LICENSE NO. <br />David A. Brandvold Same _ <br />Everareen State Sheet Metal <br />a <br />❑COMBINATION <br />UGUILDING ❑PLUMBING []MECHANICAL NEW <br />ry V. <br />[]ADDITION ❑ALTERATION_ ❑HLPAIII <br />JATION OF WORK G(j ^ ,AII� <br />S 1�„-�n-"�_T"�_ ,� � �C� v�✓'I}❑DEMOLISH ❑FENCE ❑SIGN ❑:WIMMINO PUOI. <br />Const• arehouse _ <br />T►0— ,OTHER PERMITS O}R� APPRCVAIS <br />-jSL rl REZONE +-i SPECIAL USE <br />LEGAL OESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH <br />FOUR COPIESI <br />LOT BLOCK —OF <br />Legal attached. <br />K 1 _ Zc -S <br />JOB NDDRESS <br />----2--)20 34= S7 <br />PLUMBING <br />NO. I <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NA1H TUBS <br />S <br />CLOTHES WASHER <br />1 <br />DISH WASHERS <br />DRINKING FOUNTAINS <br />� <br />FLOOR DRAINS <br />KITCHEN SINKS IN DISP. <br />I <br />HAR SINKS <br />_T <br />HOOF DRAINS RAIN LEADERS <br />I <br />SHOWER BATHS <br />SERVICE SINKS <br />SUMPS .. SEWAGE PUMP <br />URINALS <br />_WATER CLOSETS <br />WATER I/EATEHS - ELECTRIC <br />WASH BASINS <br />I <br />LAUNDRY TRAYS <br />SUB TOTAL <br />I <br />PERMIT S <br />_� <br />TOTAL FEE <br />WATER SERVICE SIZE_ BLDG. SUPPLY SIZIi <br />USL LONE <br />LJYES ONO <br />IZE OFPLOG. • NO. OF STORIES <br />1lI��41 = I <br />#VARIANCE 1� SF'ORLINE <br />SEPA CHECK LIST REQUIRED <br />YES Has been reviewed and received <br />NO negative declar}tion. <br />MECHANICAL <br />TYPE OF ENERGY <br />- <br />TYPE OF_EQUIPMENT.__--...-},,..,,.-F, <br />AIR CONO. UNITS-II-P. EA. ....__ <br />—�S I <br />_..-. <br />._..-.....---_.'NUN ...._.. <br />RET RIGERATION UNITS tiP_LA. -_.-.-.__----_y---,- <br />-BOILERS H.P. EA. <br />--r- <br />FORCED AIR SYSTEMS B.T.U. MEA. <br />---�— <br />--T--- <br />SPACE (L WALL HEATERS B.T.U. <br />_ <br />UNIT IIEATERS N.T.U. <br />EVAPORATIVE COOLERS <br />----_—_--��-`•—•�-_ <br />CLOTHES DRYERS <br />_I <br />VENTILATION FAN <br />I_y <br />AIR HANDLING UNIT CF. M. <br />WATER HEATER <br />FAC. BUILT FIREPLACE ACHIMNEY - 1 <br />OAS. SYSTEM: NO OP OUTL(.1S �_- <br />- <br />-- PERMIT 5 r <br />1— <br />TOTALFEE S I <br />111i5 PETIMIT (IECOMES NL111. AND VOID II W(IIIK OH COIJSTIIUC <br />TION AUTHORIZED IS NOT CD'AMLNC( D WITIIIN 40 DAYS. OR tF <br />CONSTRUCTION OR WORK IS SUSPENDED Oil AP.ANDONEO FOR A <br />PERIOD OF 120 DAYS AT ANY TIME AF TER WOHK IS Cn NIMFNC.EO, <br />I HEREBY CERTIFY TIIAT I IIAVL READ AND EXAMINED T1119 AP <br />PLICATION AND KNON THE SAME TO III, TRUE AND CGIUIECT. ALL <br />PROVISIONS OF LAWS ANO ORDINANCES GOVERNING TIHS TYPE <br />OF WORK WILL BE COMPVEO Willi WHETIIER'1PECIF-ILO HEREIN <br />OR NOT. TIIF GRANTInU OF A PERMIT DOES NOT PRESUME TO <br />GIVE AUTIIORITY TO VIOI.A(E OR CANCEL TIIE PROVISIONS OF <br />ANY OTHER STATE OR LOCAL LAW HEGULATINO CONnIHUCTION <br />,OR THE PERFORMANCE OF CONSTRUCTION. <br />, <br />x Rf <br />c irEun n7ii c'nF C(1NT RACT OORAUTICAG E,NT D TE <br />❑YE^. ONO <br />1'LHIV { 111 .1� 1Y <br />JFE. �j <br />FEES <br />FEE <br />-VALUATION <br />nE7CEII'T NO, <br />7 <br />- FEE <br />j <br />I <br />1 <br />1-I <br />SPECIAL CONDITIONS: <br />BUILDING <br />PL UTAIII NO <br />MECHANICAL <br />$ 5549 Z8 <br />SEC. 307INI <br />SEPA REVIEW COMPLETE: ❑YES J3 NO <br />contact plannlnq dept. <br />OTHER <br />PENALTY <br />TOTAL <br />A OI TION ACLIFILU 11T <br />PLANT CNILRLO NY. <br />ANFNOVID DNI6VANt%IY <br />C <br />