Laserfiche WebLink
r <br />`r <br />� <br />L <br />fpr!'n'r¢rCr�i ' �O��,TRUCTIC V <br />���a��� PERMIT PERMIT N0. 1��2t� <br />CITV HALL 2ii9-ri7:5 <br />tvEFlETi.�'+A""z°, ❑ COMBINATION ��J BUILDING X+k MECHANICAL ❑ PLUMBING <br />���.,H��� MAIL(�UORE55 CIiY ZIV VHONE <br />Gary L. Bogue 7201 7tb Drive West �verett 98203 347-4058 <br />...�. ...,.�.« CiiY ZIP PHONE <br />GEN[flALCONTRACiOR <br />MAIL ADORESS CITY ZIP PHONE LIGENSE X <br />Same <br />1.1[CNFNICAI CONTRAGTOR MAIL POOFE55 CITV ZIP PNONE UCENEE X <br />IdA�L Ap�RE55 CIiY ZIP PHONE UCENSE � <br />PWIA9ING GONiRACTOR <br />oF <br />S <br />O NEW ❑ ADDITION O ALTEFATION ❑ PEPAIR ❑ DEMOLITION ❑ FENCE O SIGN Q W�OOD STOVEIFIFEPLACE INSEFT <br />install wood burni <br />oPO5E0 USE OF E3UILOING <br />L[GAL UESCRiPTION OF PFOPERTY ISMOW BELOYJ <br />LOi _ BLOCN _OF <br />th Drive I9est <br />s <br />PLUMBING <br />NO. TYPE OF FIXTURE OP ITEM <br />W ATER CLOSET ITOILEn <br />SIZE <br />LAVPTORV (WASM BASIN� <br />SHOYJEF <br />KITCHEN SINK 8 OISP. <br />DISMWASHER <br />LAUNORYTRAV <br />CLOTHESWASHER <br />INATER MEATEft <br />URINAL <br />DRINI:ING FOUNiAIN <br />FLOOR DRAIN <br />VACUUM BFEAKEPS <br />ROOF ORAINS — RA�NLEAOERS <br />SINK �SERV�CE — BAR, ETC.) <br />SUB TOTAL <br />PERMIT <br />TOTALFEE <br />1. ENVIRONtdENTAL CHECK LIST <br />2. 7U'L[]INC "-A�JS <br />L 1 F'_RE 1VORANT <br />1 fIRS.'ROTECTION SYSTEM <br />5. GRADING <br />6. DHAINAGE <br />7.ENVIRONMENTALIMPACiSTATEMENT <br />B. HEALTH OISTflICT <br />L <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED T41S <br />APPLICATION AND KNCW 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 OF A <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br />OR CANCEL THE PROVISIONS OF ANY OTHER STPTE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFO MANCE OF CONSTRUCTION. <br />SIGNJA EOFGONTyRAGjOR/pl�IfPl11MOR11EUAGE!!I �ht� <br />.V �l /1 iu / / 1✓./� % B�L�J�a3 <br />FEE NO. TYPE OF EOUIPMENT FEE <br />AIR COND. UNITS — H.P. EA. <br />REFRIGERATION UNITS — H.P. EA. <br />901LEFS — H.P. EA. <br />GAS FIRED A.C. UNITS — TGNNAGE EA. <br />FORCED AIR SYSTEGIS — 8'.U. M EA. <br />WALL HEATERS — B.T.U. �A <br />UNIT HEATERS — B.T.U. M <br />EVAPORATIVE COOLERS <br />CLOTHES DRVERS <br />VENTILATION FAN <br />RANGEHOOD <br />AIR HnNDLING UNIT — GF.M. <br />STOVE — 1N00� % <br />METAL FIREPLAGE 8 CMIMNEV <br />FIREPLACE INSERT <br />HEAT PUMP <br />SUB TOTAL 5 <br />s PERMIT 5 <br />�—� TOTAL FEE S <br />> <br />_. _... _� �_�T � n.� ruoru uiiuwFR PLAN (,I <br />YES NO <br />APPR. <br />LOAD <br />NO <br />FEE � RECEIPT NO. <br />VALIIATION FEE <br />BUILOING $ <br />PW �d81NG <br />MFCHANICAL S% SO <br />OTHER <br />U.B.C. <br />PENALTY SEC. 303 �al <br />TOTAL 1 � O <br />PEfiMIT VALIDATION <br />WHEN PROPERLY VALIDATED pN TMIOSS 1A;E) THI�1$YQI�„R.P_Efj�+71T � <br />O UI+ jU <br />M <br />N <br />B� ';:;1;� RECEIPT `� <br />i � .,.f i't: YOU <br />;1DDRE5� RLE <br />I 5 it�u � J <br />'� <br />� <br />J <br />J <br />� <br />