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theEucCITY�OF I� C"'iNSTRUC T iON ' <br />everett PERMIT PERMIT NO. 20872 <br />259-8745 <br />❑ DEMOLITION ❑ COMBINATION ❑ BUILDING Q MECHANICAL IN PLUMBING ❑ SIGN <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Ramona Boylan 6917 Evergreen Way Everett, WA 98203 353-7770 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL <br />MAIL ADDRESS <br />CITY ZIP <br />Larsen Const. <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSER <br />PLUMBING CONTRACI OR MAIL ADDRESS CITY ZIP PHONE LICENSED <br />Water Works Plumbing 9006 172nd St SE Snohomish 98290 668-6228 WATERWP210CA <br />CLASS OF WORK <br />❑ NEW n ADDITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ BUILDING RELOCATION <br />VALUATION OF WORK <br />S <br />RRxk Plumbing addition <br />HEATSOURCE <br />❑ ELECTRICITY Cl GAS ❑ WOODSTOVE ❑ OTHER <br />PROPOSED USE OF BUILDING <br />Office <br />I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br />APPLICATION 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 WITH <br />WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A <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 />SIGNATU E OF CONTRACTOR, A AGENT. OR OWNER DATE <br />X 9/21/88 <br />LEGAL DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES( <br />LOT _ BLOCK _ OF <br />JOB ADDRESS <br />6917 Evergreen Way <br />PLUMBING <br />HANICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />O. <br />TYPE OF EQUIPMENT <br />FEE <br />2 <br />WATER CLOSET (TOILET) <br />10 <br />00 <br />A/C —A/F/NDLG UNITS —H.P. <br />BATHTUB <br />REFRIGERATION UNITS — H.P. EA. <br />2 <br />LAVATORY (WASH BASIN) <br />10 <br />00 <br />BOILERS —D.T.U./H.R <br />SHOWER <br />GAS FIRED A.C. UNITS — B.T.U. <br />1 <br />KITCHEN SINK & DISP. <br />5 <br />DO <br />FORCED AIR SYSTEMS — BT.U. M EA. <br />1 <br />DISHWASHER <br />5 <br />00 <br />WALL HEATERS—B.T.U. M <br />LAUNDRY TRAY <br />UNIT HEATERS — B.T.0 M <br />CLOTHES WASHER <br />EVAPORATIVE COOLERS <br />URINAL <br />CLOTHES DRYERS <br />DRINKING FOUNTAIN <br />VENTILATION FAN <br />FLOOR DRAIN <br />RANGE HOOD <br />BACKFLOW PREVENTERS <br />1 <br />WATER HEATER <br />D <br />ROOF DRAINS — RAINLEADERS <br />WOOD STOVE <br />SINK (SERVICE — BAR. ETC.( <br />METAL FIREPLACE S CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SUBTOTAL <br />$ <br />30 <br />OO <br />SUBTOTAL <br />PERMIT <br />$ <br />— <br />— <br />PERMIT 5 <br />15.00 X <br />X <br />TOTAL FEE <br />$ <br />30. DOOR <br />13 <br />TOTAL FEE $ <br />21 <br />50 <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO. <br />USEZONE <br />LOT AREA <br />VACANT SITE <br />❑YES ONO <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />$ <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />PLUMBING <br />30 <br />00 <br />SIZE OF BLDG. <br />NO OF STORIES <br />MAX OCC. LOAD <br />MECHANICAL <br />21 <br />n <br />50 <br />FIRE SPRINKLERS REQUIRED DYES EINO <br />INVESTIGATION FEE <br />Sec.?04(e) <br />STATE BUILDING SURCHARGE <br />#000M72 <br />STATE ENERGY SURCHARGE <br />2 <br />MECH $50 <br />. <br />APPLICATION ACC. DY <br />M. M, <br />PLANS CHECKED BY <br />APPR FOR ISSUANCE BY <br />DRIVEWAY PERMIT <br />we ` $5 <br />•50 <br />TOTAL <br />oPGwT vnI InennH <br />WHEN PROPERLY VALIDATED ON THIS SPACE) THIS IS YOUR PERMIT <br />CV <br />N <br />00 <br />C=) <br />CV <br />ADDRESS I--ILE <br />