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the Ever�reeri <br />�.,��: <br />everett <br />CITV HALL 259-97d5 <br />�ONSTRUCTI�" <br />PERMIT <br />PERMIT NO. -L3446 <br />EVEr�ETT. YJA 98201 � COMBINATION ❑ BUILDING � MECHANICAL C PLUMBING <br />OYINEP lAAil F��RE55 <br />CITY ZiP PMONE <br />Albert Dantie:,o 1413 21st Street Everett 98201 <br />ARCMITECT OR OESiGNER IAl.IL AOpFE55 CITV ZIP PMCNE <br />GENERAI LONiqAGiOR MFIL ADOFE55 CITY ZIP FHONE LiCENSE • <br />MECNANii.AL CONiPACTOR MAIL 4�DFE55 CITY 21P PnONE LICENSE � <br />Natural Gas Eguipment 1H75 East Mnrine �.ew Drive 9820� @=2941 <br />PWMBING CONiRAGTOR MAIL RODRE55 QTV ZIP PMONE LiCENSE • <br />❑ NEW G ADDITION ❑ ALTEFATION ❑ REPAIR ❑ DEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />l0� _BIOCK_OF <br />1413 21st Street <br />PLUMBiNG <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET �TOI L ET1 <br />BATHTUO <br />LAVATOFiY (WASH BASIN� <br />SHOWER <br />NITCHEN SINK 8 OISP. <br />DI�HNJASHER <br />LAUNDRYTRAV <br />CLO7HES WASMER <br />WATER HEATEF <br />URINAL <br />ORINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS — RAINLEqDERS <br />SINK (SEFVICE — BAR, ETC.) <br />SUB TOTAL <br />PEqM1T <br />TOTAL FEE <br />OF <br />FIRE ZONE <br />1. ENVIRONMENTAL CMECK LIST <br />2. BUILDING PLANS <br />3. FIRE HVDHANT <br />4. FIRE PRO7ECTION SYS7EM <br />5. GRA�ING <br />6.ORAINAGE <br />7.ENVIAONMENTALIMPACTSTATEMLNT <br />B.MEALTH DISTRICT <br />APPLICATION ACG. BY PLANS CHECKEO BY <br />� <br />5 <br />S <br />REAR <br />YES NO <br />IdA%.00C.LOAD <br />YES NO <br />I IIEFEBY CERTIFY THAT I HAVE RE.4D AND EXAMINED THIS <br />APPLICATION AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND OFOINANCES <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 AUTHORII � TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHEF; STPTE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCI'ION. <br />SIGNA UREOFCONTRAC�ORORAUiMOP12E�AGENT OAiE <br />'� 618 <br />X r�-��e.v 1'lo�-�t�,,.�,�. / / 4 <br />N0. TYPE OF EOUIPMENT <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERATIOIJ UNIiS — H.P. EA. <br />BOILEflS — H.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA. <br />FORCED AIR SYSTEh1S — B.T,U. M EA. <br />VJALL HEATERS — B.T.U. M <br />UNIT HEA7ERS — B.T.I�. M <br />EVAPORATIVE COOLEFS <br />CLO7HES DRYERS <br />VENTILATION FAN <br />RANGEHOOD <br />AIR HANOLING UNII — C.F.M. <br />S70VE — WOOD <br />IdETAL FIREPLACE 8 CHIMNEV <br />FIREPLACEINSERT <br />HtAT PUMP <br />SUB 70TpL f <br />PEFMIT 5 <br />TO7AL FEE 5 <br />( NUMBER PLAN C <br />FEE I <br />FEES VALUATIO� <br />BUILDING <br />PLUMBING <br />�dECHANICAL <br />OTHER <br />PENALTY <br />TOTAL <br />3 <br />SEC. 903 <br />FEE <br />RF.CEIPi Y0. <br />FEE <br />14 � 50 <br />14 I SG <br />PERMIT VA�IDATION <br />—\7HEN PFOPERLY VAUDATED pN THIS SPACE) THIS.,IS VpUR PERFLI! � <br />. , . 7 I 1! . ; .. -- s; <br />'.) <br />l'! <br />VCEBY . ., �•.���r'` Y; <br />i <br />ADDRc55 i=1L'e � ' � <br />