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r <br />r <br />L <br />L <br />k <br />L <br />r`" `�"rL„"' �ONS��UCTIC :J <br />everett PERMIT PERMIT NO. 1Z412 <br />CITY HALL 259-0745 <br />EVERETT,VIA98201 � COMBINATION ❑ BUILDING � MECHANICAL ❑ PLUMBING <br />OWNEP MAILADOFE55 GITY 21P PHONE <br />Steve Audette 913h 33rd Street Everett 98201 339-2564 <br />ARCNITE]iOP�ESiGNER ��ARAOORESS GiY ZIP PNONE <br />GENERALGONiRAGTOP MALLADDRE55 GITY 21P PHONE LIGENSE� <br />MECNANICAL GONiRACiOR MAIL ROORE55 CITV ZIP PNONE IiCENSE � <br />S A[IIE <br />PWMBIi.G CONTRAGiOR MAIL AOCPESS GITY ZIP PIIONE 4CENSE � <br />�IEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ �EMOLITION � F[NCE ❑ SIGN ❑ WOOD S70VEIFIREPLACE INSEFli <br />s <br />�or <br />-� 913h 33rd Street <br />PLUMBING <br />NO. TYPE OF FIXTURE OR <br />W ATEfl CLOSET �TOILEn <br />EiATHTIIB <br />LAVATORY(WPSH BFSIN� <br />SHOWER <br />K4CMEN SINK 8 OISP. <br />LAUNDflYTRAY <br />CLOTHES WASHEW. <br />WATER NEATER <br />URINAL <br />DRINHIflG FOUNTAII <br />FLOOR ORAIN <br />VACUUM BREAKERS <br />ROOF DRAINS — RAIi1LEADE <br />SINK �SERVICE — BAR, ETC.) <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />APPROVALS <br />1. ENVIP.ONMENTAL CHECK LIST <br />2. BUILDING PLANS <br />�. FIRF MYDf7ANT <br />d. FIRE PROTECTION SYSTEM <br />5. GRADING <br />6. DRAINAGE <br />7. ENVIRONMENTAL IMPACT STAT <br />B. HEALTH DISTFICT <br />APPLICATION ACC. BY PLAI <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AIJD <br />iOURCOPIE51 CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFO NCE OF CONSTRUCTION. <br />SiGNA EOF iPACT OR UTI '.NT 9/lz�d3 <br />X <br />MECHANICAL <br />N0. TYPE OF EOUIPMENT FEE <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — M.P. EA. I <br />BOILERS — N.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE FA. <br />FORCED AIfl SVSTEMS — B.T.U. M EA. <br />WALL HEATERS - B.T.U. M <br />UNIT HEATEflS - B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES ORYEPS <br />VENTILATION FAN <br />FANGEHOOD <br />AIR HANDLING UNIT - C.F.M. <br />STOVE - WOOD <br />METAL FIREPLACE 8 CHIMNEV <br />FIREPiACEINSERT <br />HEATPUMP <br />5 <br />f <br />S <br />IEAR YARD SETBACH PLAN <br />'ACANT SITE <br />YES NO <br />MA%. <br />APPR.FOR <br />DATE <br />5118 TOTAL f <br />PEpMIT f <br />TOTALFEE f <br />FEE I PECEIPT NO. <br />VALUATION FEE <br />8!11LDING $ <br />PLl1M9iNG <br />MECMANICAL � ].% SO <br />OTMER <br />PENALiV U.B.C. <br />SEC. 303 �a� <br />TOTAL 1� SO <br />PERMIT VALIDATION <br />WHEN PROPFRLV VALI�ATED pN THI� SPACE) TMISQS(�'CtJqP�ielT��-. .: � <br />7bJ •Du � <br />� <br />�Y <br />(•! <br />YOUR RFC[IPT,`; <br />;�-�r,���: vou <br />ADDRESS FILE <br />I 2 �� 83 <br />`� <br />� <br />[1 <br />J <br />J <br />