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1 � <br /> f <br /> r <br /> rheL'��rrxrrrn . ^O� w�����'O�' <br /> Ci1vcF � V <br /> everett PERMIT PERMIT NO. 13H11 <br /> . CIT1'HALL 259�8745 <br /> eve�aerr,wnsezoi ❑ COMBINATION ❑ BUILDING 7� MECHANICAL ❑ PLUMBING <br /> 01YNER MnILADDPE55 GITV ZiV PHONE <br /> (' Thomas D. Northrup 8111 East Glen Drive Everett 98203 355-0809 � <br /> ARCMITEGi OR OESIGNER MAIL ADORE55 CITY 21P PNONE <br /> GENERALCONTRACTOR MRILAODPESS CITY 21P PHONE LILENSE� <br /> MECMANICRL CONTPAGTOR Mml ADDRESS CITY 11P PNONE LILENSE M <br /> PLUMBING WNTRACTOR MAIL ADORE55 GITY ZIP PHONE LIGENSE I . <br /> �V SS OF WORN <br /> O NEW O ADDITION ❑ ALTERATION ❑REPAIR ❑ DEMOLITION O FENCE ❑SIGN }Ly WOOD STOVHFIREPLACE INSERT <br /> VALUATION OF WORK <br /> S <br /> DESCRIBE WORK <br /> install wood stove <br /> PROPOSEO USE OF BUIIDINu <br /> � I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLICATION AND KNOW THE SAME TO BE TRUE AND <br /> LEGALDESGRIPTIONOFPPOPERTY�SHOWBEIOWORATTPGMFOUHCOPIES� CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES <br /> GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH <br /> �or_uiocK_oF_ WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A <br /> PERMIT DOES NOT PRESUMETO GIVEAUTHOR�TYTO VIOLATE <br /> OR CANCEL THE PROV�SIONS OF ANY OTHER STATE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE <br /> PERFORMANCE OF CONSTRUCTION. <br /> JOB AODRE55 SIGNATU OF CONTPnGiOR R AUiHOR12ED AGENT OATE <br /> 8111 East Glen Drive � X ���� 7 � `!��y�-�,�� 8/z3/84 <br /> PLUMBING MECiiANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EOl11PMENT FEE <br /> 1YATERCLOSET�TOILET) AIR COND.UNITS— H.P. EA. <br /> BATHTUB REFRIGERATION UNITS— H.P. EA. <br /> LAVAi09Y�WASH BASIN) BOILERS — H.P. EA. <br /> SMOWEF GAS FIRED A.C. UNITS— TONNAGE EA. <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS— B.T.U. M EA. <br /> DISHWASHER WALL HEATERS — B.T.U. M <br /> LAUNDRY TRAV UNIT HEATERS— B.T.U. M __ <br /> CLO7NES WASHEfi EVAPORATIVE COOLERS <br /> WATER HEATER CLOTHES DRVERS , <br /> URINAL VENTILATION FAN _ <br /> ORINKING FOUNTAIN RANGE HOOD <br /> PLOOR DRAIN AIR HANDLING UNIT -- C.F.M. <br /> VACUUM BREAKERS 1 STOVE — N100� 7 50 <br /> ROOF DRAINS— RAINLEADERS 41ETAL FIREPLACE d CNIMNEV <br /> SINK ISERVICE— BAR,E7C.) PIREPLACE INSER7 <br /> HEA7 PUMP <br /> SUB iOTAL S SUB70TAL S 7 SO <br /> PERMI7 S PERMI7 f <br /> TOTAI FEE S TOTALFEE S 0 <br /> SIDE YARD SETBACK STREETSETBACK FEAfl YARD SETBACK PLAN CMECK NUMBER PLAN CMECK PEE <br /> FEE RECEIPT NO. <br /> USE ZONE LOT AREA VACAN7 SITE FEES VALUATION FEE <br /> YES NO <br /> TYPE OF CONST. OCGUPANGV GflOUP NO.OF DWELLING UNITS <br /> BUILDING S <br /> SIZE OP BLDG. NO.OF STORIES MAx.OCC. LOAD <br /> PIUMBING <br /> FIRE 20Nf �ASEMENT REOUSRED KLERS MECHANICAL 17 50 <br /> � . -YES ' �NO <br /> r APPROVAL'a 9Y DATE OTHER <br /> 7. ENVIRONMEN7AL CHECK LIST PENALTY U.B.C. <br /> SEC.J03(a1 <br /> 2.EiUILDING PLANS TOTAL 17 SG <br /> 3.FIRE NYDRANT <br /> 4.FIRE PROTECTION SYSTEM PEHMIT VALIDATION <br /> WHEN PROPERLY VALIDATED�1N TH�S SPA�'E)THI cISoYI �. � 0 �T � � <br /> 5.GRADING 1, <br /> ' 6.DRAINAGE Q� <br /> 7.ENVIRONMEN7ALIMPACTSTA7EMENT (�") <br /> B.HEALTHDISTRICT ' " n � ' '" � <br /> APPLICA?ION ACC. BY PLANS CHEGKEO BY APPR. FOR ISSUANCE BY �� " �� '� � <br /> . . U <br /> � � .'��J �� �1 <br /> ADDRESS FILE <br />