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��EVe��� ,- (' 7NSTRlJCTION ry , <br /> everett PERMIT PERMITNQ:- �O�`t� <br /> 259 -8745 <br /> ❑ DEMOLITION ❑ COMBINATION ❑ BUILDING � MECHANICAL ❑ PLUMBING ❑ SIG1i <br /> OWNEB �,1AtLADORESS CiTV ZIP PHONE <br /> Ade:e Barilleaux ll09 ]6th St. Bv x�Rst 252-471A <br /> ARGIIRECTOfl0E5!GNER MAiLApDRESS CiTY ZIP PMONE <br /> GENFRAL CONTRACiOR MAIL AD�RE55 Cltt ZIP PMONE LICEN`E• <br /> MECHANiGAL CONTRACTOR MFLL AODRi.SS f.iTY ZiP Pi�ONE �ICENSE� <br /> Natural Gas Equiu 1625 E. Marine Y&f% Viaw nr. F�,A,-Att qa�ni Z58-2441 <br /> PLUMHINGCONTRACTOR R1AiLA��fiESS CITY LP PHONE LICENS[e <br /> NATURGE320N6 <br /> ClAS50F WORK , <br /> O NEW � ADDITION � ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDIt�G RELOCATION <br /> VALUATION OF WORK <br /> $ <br /> �ESCRItle WORH <br /> Install gas furnace and water heatei. <br /> ���nT,ou�ce <br /> ❑ EIECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTFIER <br /> PROPOSED 115E OF BUILOING <br /> R�siclxs�e Reisdence I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICNT�ON AND KNOW TFiE SAME TO BE TRUE AND <br /> �ecn�c=_scaiarior+oFanorer+rv�sNowoe�owoanrracHFouncoaiesi CORRECT. ALL PROVISIONS OF �AWS AND ORDINANCES <br /> �or__s�ocK _ oF GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> WHETHER SPECI�IED HEF[IN OR NOT. THE GRANI'iNG OF A <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO <br /> VIOLATE OR CANCEL THE PROVISIONS OF F.NY OTHER <br /> STA�iE OR LOCAL LAW RECULATING CONSTRUCTIUN OR <br /> THE PERF RMANCE OF CONSTRUCTION. <br /> doo nooaess sicvmune c _or�rnncrnn_,wn�¢E�� ,Frir o�omr�Eq omE <br /> 1709 15th St. X (��'���^x��� v �'_�C <br /> PLUMBING MECHANICAI <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOUIPMENT FEE <br /> WATER CLOSET(TOILET� A/C—A;HNDLG UNITS—H P <br /> BATH7UB REPRIGERATION UNITS—HP.EA <br /> LAVATORY(WASH BASIN) pOI�EflS—B.T.U./H P. <br /> SHJWER GASFIREDAL UNITS—B.TL. <br /> KITCF!EN SINK L OISP. 1 FORCED AIR SVSTEMS—B T.U. A1 EA. <br /> �ISHWASHER WALL HEATERS—B.T.U. M11 <br /> LAUNDRV TRAY UNIT H[4TERS—B T.U. M <br /> CLOTHES WASHER EVAPORATIVECOOLEFS <br /> URINAL CLOTHEti DRYERS <br /> DRINKING FOUNTAIN VENTILATION FAN <br /> FLOOR DRAIN RANGE HOOD <br /> BACKFLOW PREVENTERS 1 WATER HEATER � <br /> ROOF ORAINS— F�INLEADERS WpOD STOVE <br /> SINK(SERVIi,h—dAR,ETC.� METAL FIREPLACE 8 CHIMNEY � <br /> FIREPLACEINSERT <br /> HEAT PUMP �' <br /> GAS PIPING � <br /> E%FIAUST FAN <br /> -- � <br /> i <br /> SUBTOTAL S cUBTOTAL 5 <br /> PERMIT S PEflM1T <br /> TOTAL FEE S TOTAL FEE S <br /> rnoNiserencrc nEanseToncK sio[;EinncK PLANCHECKNUMOER FEE RE:'EIPTNO. <br /> GSEZONE IOTAHEn <br /> vncnNTsrte FEES VALUATION FEE <br /> ❑YCS ❑NO _ <br /> TVPE OF CONST OC�UP�NCY GROl1P NO OF OWELLING UNITS BWLDING S <br /> saEOFe�oc No oFsronies n�nz occ �onc PLUMBING OB/�S/BB 4:4 �f OOOA#2193 4:k':!: <br /> MECHANICAL � �0 50 <br /> INVESTIGATIONFEE ��¢�304�c� wy3 '.50 <br /> FIRE SPHINNLERS REOUIRED O VES ❑NO <br /> STATE BUILDING SURCHARGE CHECY S3 .SO <br /> STATEENERGVSURCHARGE <br /> AP{'LICATIONACC �Y PLANSCHECYEDFIY nf'Pll fOHI55UANC[UY <br /> []RIVEWAY PERMIT <br /> TOTAL 30 50 <br /> PERMIT VAL�DATION <br /> WHEN PIiOPEiiIV VALIDATBO pN IIIIS�SPAC[I'�115IS YOi1R PER�d1T <br /> �� <br /> �� <br /> L� <br /> � <br /> �� <br />