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rAt£ver�mn �p N STRU�T101'� <br /> ��T�oF r- - — <br /> `���� PERMIr� PERMIT NO. 16011 <br /> CRY MALL YA87r5 <br /> �"ETT�WA°8�01 ❑ COMBINATION � BUILDINO ❑ MECHANICAL ❑ PLUMBINfi <br /> i <br /> M�IL�DORESS CITY ZIP FNONE � <br /> Dr. Joseph Welch 4005 Colby Avenue Everett 98201 <br /> M NIIILADDNE55 CITY 21P PMONE � � <br /> I1L M�IL�OORE55 CITY ZIP PMONE IICENSE 1 <br /> lfney General Contracting Inc. 9502 19th Avenue S.E. Everett 98204 <br /> MFCXANICAI CONiMCTOR MAIL RDDNE55 GTV 21P PMONE UCENSE� <br /> RIMIC�N6WNTMCTOR MAILAOURE55 GTY 21P PNON[ LIGENSEI <br /> CU80 OF K.'�RR <br /> ❑NEW ❑ ADDITION ❑ ALTEMTION ❑REPAIR }[}�DEMOLITION � FENCE ❑ SIGN ❑ WOOD STOVEJFIREPLACE INSERT <br /> VALUATON OF W4RK <br /> { <br /> DEi�11lE W011N <br /> Demolieh Single Family Residence <br /> rnorosso us¢oF eun.oiNa <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE ANO <br /> 1F011�DESGMPTION OF PfiOPERTY�SHOW BEIOW OR�TT�CH FOUR COPIES) CORRECT. ALL PROVISIONS OE IAWS AND ORDINANCES <br /> 5-6 10 �^limax Land Co's lst GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> wr_e�ocK_oF_ Wy�HER SPECIFIED HEREIN OR NOT.THE GRANTIN60F A <br /> PERMIT DOES NOT PRESUMETO GIVE AUTHORITY TO VIOLATE <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> P,EfiFORMANCE F ONSTRUCTION. <br /> JOB ADUflESS ICN TUHE OF CONT T A RED�GENT DATE <br /> 4009 Colby Avenue — Q — <br /> PLUMlINO E ANICAL <br /> N0. TYPE OF FIXTURE OR REM FEE N . TYPE OF EQUIPM T FEE <br /> WATER CLOSET(TOILE7) AIR COND.UNITS—M.P.EA. <br /> BATHTUB REFRIGERATION UNITS— H.P.EA. <br /> UVATORY(WASHBASIM1) BOILERS—H.P. EA. <br /> SHOWER GAS FIREO A.C.UNITS—TONNAGE EA. <br /> KITC:IEN SINK 6 DISP. FORCED AIR SYSTEMS— B.T.U. M EA. <br /> DISHWASMER WALL MEATERS— B.T.U. M <br /> LAUNURYTRAY UNITHEATERS— B.T.U. M <br /> CLOTHE3 WASHER EVAPORA7IVE COOLEFlS <br /> WATER HE�TEH CLOTHES�RYERS <br /> URIN�L VENTILATION FAN <br /> DRINKIN�FOUNTAIN RANGE HOOD <br /> FLO.R DRAIN AIR HANDLING UNIT— C.F.M. <br /> VACUUM BREAKERS STOVE—WOOD , <br /> ROOF DRAINS— HAINLEADERS METAL FIHEPLACE d CHIMNEY _ <br /> SINK(SERVICE—BAR,ETC.) FIREPLACE INSERT <br /> HEAT PUMP <br /> SUSTOTAL f SUBTOTAL f <br /> PEHMIT S PENMIT S <br /> TOTALFEE f TOTALFEE S <br /> SI�E YARDSETBACK STREETSETBACK PEAR YAND SETBAGK PLAN CHECK NUMBER PLAN CHECK FEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACANT SITE <br /> GVES CiNO FEES VALUIITION FEE <br /> TYPE OF I:ONST. OCCUPANCY GROUP NO.OF OWELLING UNITS <br /> BUILDING S 00 00 00 <br /> SIZE OF BLDG. NO.OF STOHIES MA%.OCC. LOAO <br /> PLUM6ING <br /> FIREZUNE BASENENT FIPESPRINKLERS MECHANI�pL <br /> flEOUIREO <br /> ❑YES ❑NO <br /> APPHOYAlS BY OATE OTHER <br /> 1.ENVIRONMENTAL CMECK LIST PENALTY U.B.C. <br /> SEC.30J(a) <br /> P.BUILDING PUNS <br /> 3.FIREHVORANT TOTAL 00 00 <br /> �.FIRE PROTECTION SYSTEM PERMIT VAl10ATI0N <br /> S.OMOING WHEk PROPERLV VALIDATED�1N TH185j Z�E1 THI�IO O O. O O I? �'n <br /> 6.DMINAGE � <br /> 7.ENVIRONMENTALIMPACTSTATEMENT `�, <br /> 8.MEAITH OISI'RICT r q ' <br /> APPLICATION.4CC. BY PLANS CMECKED BY Af•PR.FOR ISSUANCE BY ,�.`, '� �� '\L C��I � ` � <br /> - ' ^�:"`li: Y�) � <br /> � Q JhiJ o u <br /> ADDRESS FIIE <br />