Laserfiche WebLink
ihc fiYergrecn <br />CITY OF <br />evere�t <br />, <br />�- �OIVSTRUCTICIE� <br />PERl1AIT <br />P�RMir rao. 14363 <br />CITY MALL 2�9�87a5 <br />EVERETT,WA90:01 C CC6NBINATION �c BUILDING ❑ MECHANICAL ❑ PLUMBING <br />OwHER <br />MAIL AOORESS GITY ZIP PHONE <br />Snohomiah County Physicians Corp. Everett <br />ARCMITECT ON OESIGNER <br />MAILA�ORE55 GITY ZIP PHONE <br />��n, Z�p PHONE LIGENSE� <br />OENERAIGONTPACTOfl MAILAODPESS <br />Kirtley Cole P.O. Box GOS Snohomish 98290 568-3175 <br />MECMAN1CAl CONTRACTOFi <br />MAILADDPESS CITY ZIP PHONE LICENSEII <br />PLUMBING GONTP�CTOR <br />MAILA��RE55 CITY ZIP PMONE LICENSE� <br />❑ NEW O ADDITI01: <br />VILUATION OF WOPN <br />5 <br />demoiition <br />office <br />E�AL OESCRIPTION J� PflOPERTY (SI�OW BELf <br />LOT_BLOCK_OF <br />�Gh� <br />lOB AD RE55 <br />��vergreen Way <br />PLUMBIN6 <br />N0. TYP� OF FIXTURE OH <br />WATER CLOSETfT01LEf) <br />BATHTUB <br />LAVATORY�WASH BASIN) <br />SHU\YER <br />KITCHEN SINK d DISP. <br />DISHWASHER <br />LAUNDRYTRAY <br />WATER HEATEfl <br />URINAL <br />DRINKING FOUNTAIN <br />FLCOR CRAIN <br />VACUUtI BREAKERS <br />fi00F GRAINS — RAINLEhDE <br />SINK (SERVICE — BAR, ETCJ <br />APPROVALS <br />i. ENVIRONMENTAL CHECK LIST <br />2. BUILDING PLANS <br />3. FINE HYDRANT <br />e. FIRE PROTECTION SYSTEM <br />5. GRAD�NG <br />8. ORAINAGE <br />v cuviu!)NGFNTALIMPACTSTA� <br />HEALTH <br />❑ AL'fERATION ❑ REPAIR �iDEMOLITION ❑ FENCE ❑ SIGN ❑ WOOD STOVEIFIREPLACE INSERT <br />COPIES) <br />TOTAL = <br />MIT f <br />AL FEE s <br />SEfBAGK REAR YARD SI <br />5q VACANT SITE <br />❑YES ❑NO <br />fYl <br />RE�UI <br />�7YES <br />! ucaEaY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION AND KNO�Y THE SAME TO BE TRUE AND <br />GOVERN NG THIST�YP�E IOF WORK WILL ENCOMPLIED WITH <br />WHETHER SPECIFIED HEREIN Ofi NOT. THE GRANTING OF A <br />PERMIT DOES NOT PHcSUME TO GIVE qUTHORiTY TO VIOLATE <br />OR CANCEL THE PROVISIONS OIT ANY OTHER STATE OR <br />LOCAL LAW REGULATING CONSTRUCTION OR THE <br />PERFORMANCE OF CONSTRUCTION. onre <br />SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT <br />X 1/21/85 <br />MECHANICAL <br />TYPE OF E�UIPMENT <br />AIR COND. UNITS — H.P. EA. <br />REFRIGEFiA710N UNITS — H.P. EA. <br />BOILERS — H.P. EA. <br />GAS FIRED A.C. UNITS — TONNAGE EA <br />FORCED AIR SYSTEMS — B.T.U. M E4. <br />WALL HEATERS — B.T.U. �'1 <br />UNIT MEATERS — B.T.U. M1� <br />EVAPORATIVE COOLERS <br />CLOTHES ORYERS <br />VENTILATION FAN <br />RANGE HOOD <br />j AIR HANDLING UNIT — C.F.M. <br />STOVE — WOOD <br />METAL FIREPLACE 6 CHIMNEY <br />FIPEPLACEINSERT <br />HEAT PUCdP <br />SUB TOTAL <br />FEE <br />FLE <br />rcc <br />� <br />S <br />S <br />CHECK FEE <br />RECEIPT NO. <br />FEES I VdLUATION � FEE <br />BUII.DING S OO OO <br />PLUM8ING <br />MECHANICAL <br />OTHER <br />U.B.C. <br />PENALTY SEC.3031a) ___ <br />TOTAL I I 00 <br />PEflM1T VALIDATION <br />WHEN PROPERLY VALIDATED (IN TNIS SpI�CE) THIS IS Y�QyRPE4iMIT <br />U �I �� <br />ADDRESS FIIE <br />'� . Ir'I <br />'. U <br />� <br />, � <br />