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f+- <br />21 <br />�1icei��T�e°' ; 10NSTRUCTIOP' <br />everett pERMiT PERMIT N0. 12005 <br />CITV HALL 259�B7d5 <br />EVERETT, WA 90201 (� COMBINATION L� BUILDING � MECHANICAL �] PLUMBING <br />OIYNER 1AAiL ApDRE55 CIiV IIP PMONE <br />Lawrence H. Nalbach 2132 Highland Everett 98201 252-7450 <br />ARCMITECT OR �ESIGNER MAIL A�ORESS CITY ZIP PHONE <br />GENERALCONTRAGTOR MAILAODPE55 CITY IIP PHONE LICENSEM <br />Same <br />MECHANICAL CONTqACTOR IdAIL FD�flE55 CITV ZIP PHONE LICENSE N <br />PLUMBING GONiRAGTOfl IAAIL AODRE55 GtTY Z�p PHON[ UCENSE � <br />E <br />O NEW ❑ ADDI710N ❑ ALTERA710N ❑ REPAIR O DEMOLI710N ❑ FENCE ❑ SIGN ❑ WOOD S70VFJr�� =PLACE INSER7 <br />20,000.00 <br />Interior rebuild of Duplex <br />USE OF BUILOING <br />Duplex <br />e�N� voacnirnun uh YHUNtFiv �SMUW 9ELOW OF ATTACM FOOR COPIES) <br />�aT 31-�2o�K 435oF EvereY.t Div. B_ <br />efeller <br />PLUMBING <br />N0. TYPE OF FIXTURE OF <br />WATcR CLOSET (TOILET) <br />1 BATHTUB <br />j LAVAI'ORY�WASHBASIN) <br />SHOWER <br />2 KITCHENSINKBDISP. <br />1 DISHWASHER <br />LAUNDRYTRAY <br />1 CLOTHES WASHE(i <br />1 WAiER MEA7ER <br />URINAL <br />DRINKWu FOUNTAIN <br />FLOOR DRAIN <br />VACUUM BREAKERS <br />ROOF DRAINS �- RAINLEA�ERS <br />SINK �SERVICE — BAR, EiC.� <br />SIDE <br />NO. <br />SUB TOTAL <br />PERMIT <br />TOTAL FEE <br />1. ENVIRONMEN.'AL CHcCK LIST <br />2. BUILDING PLANS � <br />3. FIRE HVDRANT <br />a. FIREPROTECT�N SYS7EIR� <br />S.GRADING-� ; ) <br />C�"7 <br />a. <br />S <br />S <br />S <br />F'EE <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED TIiIS <br />APPLICATION AND KNOVV THE SAME TO BE TRUE AND <br />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 O� A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE VROVISIONS OF ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. <br />SIGNqTURE OF CONTRACTOR OR AUTHOW E➢�AGEN/T OATE <br />%� ` li-�-��� `��,-,(�-! <br />MECHANICAL <br />N0. TYPE OF E�UIPMENT FEE <br />AIF COIJD. UNITS — H.P. EA. <br />REFRIGERATION UNI7S — H.P. EA. <br />BOILERS — H.P.EA. <br />GAS FIRED A.C. 11NITS — TONNAGE EA. <br />FOFCED AIR SYS7EMS — B.7.U. M EA. <br />WALL HEATERS — B.T.U. M <br />UNIT HEATERS — B.T.U. M <br />EVAPORATIVE COOLERS <br />1 CLOTHES ORVERS <br />j VENTILATION FNN <br />j RANGEHOOD <br />AIR HANDLING UNIT — C.F.M. <br />STOVE — WOOD <br />METAL FIREPLACE 8 CHIMNEY <br />FIREPLACEINSERT <br />HEAT PUMP <br />YAflD SETBACK IPLAN CHECK N <br />VES NO <br />YES NO <br />B� <br />BY IAPPR.FORISSUANCE <br />SUB TOTAL 5 ], z <br />PEHMIT 5 <br />TOTAL FEE 5 1 Z <br />rEE I RECEIPT NO. <br />FEES VALUATION FEE <br />BUILDING $ 105 00 <br />PLUMBING �.6 OO <br />MECHANICAL �.2 OO <br />OTHER <br />PENALTY U.B.C. <br />SEC. 307 (a) <br />TOTAL 133 00 <br />�QF�NIP�OI�D�'oYi'At1�f T�D (IN TF�ISIS�F�E) THI� IR'/bQA PEpM�� ((] <br />J� I � J V V 1= <br />lJ <br />Add to Permit #11341 O <br />,1 R R�CEIPT 1'OU R R�CEIPT � <br />i :',:'JK. YOU iHA�if; YOU <br />19�y83 <br />ADGRESS FILE <br />J 9 �hr 83 <br />