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the Eucrgrcrn <br />CITY pF <br />evere�tt <br />259-8745 <br />C'91�ST�RUCT�ON <br />PEFt11�IT <br />PERMIT NQ. � 7 9 J� <br />O DEMOLITION ❑ COMBIIdA710N C%3 BUILDING rJ MECHANICAL O PLUMBING ❑ SIGN <br />OWNER MAIL ��OPESS CITY ZIP PMONE <br />Snohemish Co. Physician� 7600 �vergreen Way Everett, S9A 98203 568-3i75 _ <br />APCYU�ECTOROGSIGNEfi MMLn00RE55 CITY 21P PIION[ <br />GENERAI LONi. ACTOB '��LL A�pCESS dTY ZiP PNONE LICENS� r <br />Kirtley �dt8M1f Cole Assoc. P.O. Box 605 Snohomish 98290 568-3175 KIRTLCA'170RD <br />MFCHR41LRlCONTfiBJTOf1 MAILADDPE55 CITY ZIP PIION[ UGENSE� <br />PWMpING CONTf1ACTOR <br />CLRSS OF WOfiK <br />❑ NEW ❑ ADDIY,ON <br />VAtUAT10NOF WOI1H <br />S I.rJ.��O.Q� <br />MAIL AODA[55 <br />L� ALTERATION ❑ REPAIR <br />CITY <br />❑ OEMOLITION <br />PHONE LICENSE• <br />❑ BUILDING RELOCATION <br />Tenant Improvement (Ciew offices and ceiling) _ <br />IIEAT SOUBCE <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />Office <br />LOT _ �LOCK _ <br />eoo <br />�LUMBING <br />NO. TYPE OF FIXTURE OR ITEM <br />WATER CLOSET (TOILET) <br />BATHTUB <br />LAVATORY�WASHBASIN) <br />SHOWER <br />KITCNEN SINK 8 DISP. <br />DISHWASHEFi <br />IAUN�RVTRAY <br />CLOTHES WASHER <br />URINAL <br />DPINKING FOUNTAIN <br />FIOOR ORAIN <br />OACKFLOW PREVENTERS <br />POOF �RAINS — PAINLEA�ERS <br />SINK �SERVIGE — BAR. ETC.) <br />SUBTO7AL <br />PERMIT <br />TOTALFEE <br />N/A I N/A <br />USE20NE LOTAREA <br />C-2 N/A <br />TYPE OF CONST <br />• V-N Fully Spri <br />SIZEOFpLDG. `1DOFSTORIES <br />part 1353 1 <br />FOUF GOPIES) <br />I HEREBY CERTIFY THAT I HAVE 7EAD AND EXAMINED THIS <br />APPLICAT�ON AND KNOW THE SAME TO BE TRUE AND <br />CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br />GOVERNING THIS TYPE OF WORK WILL BE COMPLIED VJITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF N <br />PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO <br />VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER <br />STATE OR LOCAL LAW REGULATING CONSTRUCTION OR <br />THE PERFORMANCE OF CONSTRUCTION. <br />SIGHATUfi° OF ONTRACTOR. AUTMORi] D AGENt. OR GWNER DFTE <br />X �%cz� �'. -,.�.�,.� y- .z �- 8 7 <br />h1ECHANICAL <br />TYPE OF EOUIPMENT FEE <br />A/C — A/HNDIG UNITS — HP. <br />REFqIGERAT10N I�NC S— HP. EA <br />BOILERS — B.T.0 /HP. <br />GAS FIRED AC. UNITS — B.T.0 <br />FORCED AIR SYSTEMS — 97L. M EA. <br />WALLHEATERS—BSL. M <br />UNITHEATERS—B.T.LL M1' <br />EVAPORATIVECOOLERS <br />CLOTI{ES DRYEF7S <br />VENTILATION FAN <br />RANGEHOOO <br />N'ATER HEATEF <br />WOOD STOVE <br />METAL F'REPLACE 8 CNIMNEV <br />FIREPLACEINSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />feaCK I pLAN CHECK <br />N/A <br />VACANT SITE <br />❑YES R]NO <br />UP NOOF�WELLINGUNiTS <br />B-2 0 <br />FIRE SPRINKLERS REOUIRE� C3C/ES ❑ NO <br />ACC <br />S.H. <br />FEES <br />BUILDING <br />PLUMBINCa <br />Il0 change I MECHANICAL <br />DY I/PP� FOB ISSUANCE DY <br />B.E. <br />INVES71GA710N FEE <br />STATE BUILDING <br />SUBTOTAL � <br />PEPMIT <br />TOTALFEE <br />FEE RECEIPT NO. <br />1 5. 0 89564 <br />VALUATION FEE <br />�15,000.00 162 00 <br />• ^+/R ?:^ H ,OOPft44?5 k:i <br />Sec.304(e) <br />STATE ENEFiGY SURCHARGE I E� SF:Cii <br />DfiIVEWAY PERMIT <br />.�� <br />L.C. TOTAL I � <br />PENMIT VALIDATION <br />WHEN PROPERLV VALI�ATED (IN THIS SPACE) THIS IS YOU(7 PERMIT <br />SEPARATE PLUMSING AND MECHANICAL PERMITS <br />�Q�•ix�o. <br />� <br />Cn <br />O7 <br />L� <br />� <br />