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CITY OF <br />eveY'ett rkONSTRUCTION = _ 17669 <br />259-8745 PERMIT PERMITNQ _ <br />❑ DEMOLITION ❑ COMBINATION JO BUILDING ❑ MECHANICAL ❑ PLUMBING ❑ SIGN <br />OWNER MAIL ADDRESS CITY ZIP PHONE <br />Charles C. Allen 3501 Federal Ave #2 Everett, WA 98201 258-1884 <br />ARCHITECT OR DESIGNER MAIL ADDRESS CITY ZIP PHONE <br />GENERAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSED <br />Owner <br />MECHANICAL CONTRACTOR MAIL ADDRESS CITY ZIP PHONE LICENSE II <br />ADDRESS CITY ZIP PHONE LICENSE• <br />❑ NEW ❑ ADDITION ❑ ALTERATION Ln REPAIR CI DEMOLITION ❑ BUILDING RELOCATION <br />VALUATION OF WORK <br />f 4211119 500.00 <br />DESCRIBE WORK <br />Replacing sheetrock r.nd windows <br />❑ ELECTRICITY ❑ GAS ❑ WOODSTOVE ❑ OTHER <br />'POSED USE OF BUILDING <br />idential, tri-plex <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 PERFC41VIAIVCE OF CONSTRUCTION. <br />SIGNA URE OF CONTRACTOR, AUTHORIZED AGENT, OR OWNER DATE <br />1/15/87 <br />L DESCRIPTION OF PROPERTY (SHOW BELOW OR ATTACH FOUR COPIES) <br />LOT — BLOCK _ OF <br />See attached <br />JOB ADDRESS <br />3501 Federal Ave #2 <br />PLUMBING <br />ME <br />ICAL <br />NO. <br />TYPE OF FIXTURE OR ITEM <br />FEE <br />NO. <br />TYPE OF EQUIPMENT <br />FEE <br />WATER CLOSET (TOILET) <br />A/C — A/HNDLG UNITS — H.P. <br />BATHTUB <br />REFRIGERATION UNITS — H.P. F.A. <br />LAVATORY (WASH BASIN) <br />u_ <br />BOILERS —BT.U./H.P. <br />SHOWER <br />y <br />GAS FIRED AAC. UNITS — B.T.U. <br />KITCHEN SINK S DISP, <br />FORCED AIR SYSTEMS — B T.U. M EA. <br />DISHWASHER <br />j <br />WALL HEATERS — B T.U. M <br />LAUNDRY TRAY <br />j <br />UNIT HEATERS - B.T.U. M <br />CLOTHES WASHER <br />z <br />EVAPORATIVE COOLERS <br />URINAL <br />CLOTHES DRYERS <br />DRINKING FOUNTAIN <br />VENTILATION FAN <br />FLOOR DRAIN <br />RANGE HOOD <br />_ <br />BACKFLOW PREVENTERS <br />WATER HEATER <br />ROOF DRAINS - RAINLEADERS <br />WOOD STOVE <br />SINK (SERVICE - BAR. ETC.) <br />METAL FIREPLACE & CHIMNEY <br />FIREPLACE INSERT <br />HEAT PUMP <br />GAS PIPING <br />EXHAUSTFAN <br />SUBTOTAL <br />f <br />SUBTOTAL <br />PERMIT <br />f <br />PERMIT <br />TOTAL FEE <br />f <br />I TOTAL FEE S <br />FRONT SETBACK <br />REAR SETBACK <br />SIDE SETBACK <br />PLAN CHECK NUMBER <br />FEE <br />RECEIPT NO. <br />USEZONE <br />LOT AREA <br />CA <br />DYES SITE <br />FEES <br />VALUATION <br />FEE <br />BUILDING <br />5500,00 <br />15 <br />OO <br />TYPE OF CONST. <br />OCCUPANCY GROUP <br />NO. OF DWELLING UNITS <br />PLUMBING <br />n�Tn�Yp( <br />BT),1R00 <br />SITE OF BLDG <br />NO. OF STORIES <br />MAX. OCC. LOAD <br />MECHANICAL <br />FIRE SPRINKLERS REQUIRED ❑ YES ❑ NO <br />INVESTIGATION FEE <br />STATE BUILDING SURCHARGE <br />ELEE <br />Mp II,Ue: <br />' <br />9Ap 1. <br />50 <br />STATE ENERGY SURCHARGE <br />000017669 <br />APPLICATION ACC. BY <br />M.M. <br />PLANS CHECKED BY <br />APPR FOR ISSUANCE BY <br />DRIVEWAY PERMIT <br />_ <br />F SRCH <br />1.50 <br />TOTAL <br />CHECK 8(O.5D <br />16 <br />50 <br />PERMIT VALIDATION <br />WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT <br />C" <br />co <br />C.n <br />E` <br />r— <br />ADDRESS FILE <br />