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(/7CL1CITYOF ��NSTRUCTION - � <br /> everett PERMIT PERMIT N0. 11442 <br /> CITY HALL 259�8745 <br /> EVERETT,WA �ezoi ❑ COMBINATION ❑ BUILDING � MECHANICAL ❑ PLUM6ING <br /> OY/NER MAII AUORESS CIiY ZIP PHONE <br /> A. William France 4611 Fowler <br /> ARGNITEC7 OR DESIGNER IdAIL ADDRE55 CiTY 21P PMOHE <br /> GENERAL CONIFAGiOR MAR q�ORE55 C17Y ZIP PHONE uCENSE 1 <br /> MECIIFNICFL CONTRACiOR MAIL ADDRE55 f,i�Y <br /> Same Z�P �MONE UCENSE/ <br /> PLUMBINGCONiRACiOF MAIIAD�PESS qTY ZIP P/IONE • � <br /> LICENSE� <br /> ClA55OF WORK <br /> ❑NEW ❑ADDITION ❑ALTERATION ❑REPAIR ❑DEMOLITION ❑FENCE ❑SIGN ❑GARAGE <br /> VAWAiION OF WORN <br /> S <br /> �ESCRIBE WORK <br /> install free standing stove <br /> °ROPOSED USE OF BUILUII/G <br /> I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AP- <br /> LEG4�DESCRiFiIONOFPFOPERTY�SHOWpEl01Y0RAiTACMFOURGOPIE51 PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. <br /> ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS <br /> ��r �1OC�—OF TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED <br /> HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT <br /> PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PRO� <br /> VISIONS OF ANY OTHER STATE OF LOCAL LAW REGULATING <br /> CONSTRUCTION OR THE PE FONMANCE OF CONSTRUCTION. <br /> JOB ADORE55 SIG1�AiURE�'CONiRhC10 R RpiNO !ED FGENi DATE <br /> 4611 Fowler X 1/20/83 <br /> PLUMBING MECHANICAL <br /> NO. TYPE OF FIXTURE OR ITEM FEE NO. TYPE OF EQUIPMENT FEE <br /> YlATER CLOSET(TOILET� AIR COND UNITS—H.fl EA <br /> BATHTUB REFRIGERATIpN UFiTS—HP EA <br /> LAVATORY�WASH 84SIN) �OILERS—HP.EA. <br /> SHOWER GAS FlRED A C. UNITS—TONNAGE EA <br /> KITCHEN SINK 8 DISP. FORCED AIR SYSTEMS—B.T.U. !d EA. <br /> DI541YJASHER iVA��HEATERS—B.T.U. M <br /> LAUNDRY TRAV UNIT HEATERS—B.T.U. M <br /> CLOTHES WASHER EVAPpRATNE COOLERS <br /> tivnTER HEATER CLOTHES ORVERS <br /> URIHAL VENTILATION FAN <br /> URMKING FOUNTAIN RANGE HOOD <br /> ROOR DAAIN AIR HANDIING UNIT— CF M. <br /> VACUUM BFEAKERS 1 STOVE �QOOC� �Q <br /> FOOF DRAINS—RAINLCnUEPS METAI FIREPLACE 6 CHIMNEY <br /> SINK�SERViCc—BAR,ETC.) <br /> SUB TOTAL SU9 TOTAL S 7 S 0 <br /> PERMIT S PEHMIT f a <br /> TOTAL FEE S TOTAL FEE 5 ],7 S O <br /> SIDE VARD SETBACK STREET SETBACK REAR VARD$EiBACK PLAN CHECf(NUMBER PLAN CHECN FEE <br /> FEE RECEIPT N0. <br /> USE ZONE LOT AREA VACANT SITE <br /> ; iYES llNO FEES VALUATION FEE <br /> TYPE OF CONST. pCCUPANCV GROUP NO.UF DWEILING UNITS <br /> BUILDING 5 <br /> S12E OF BLDG. NO.OF STORIES 1dA%.OCC.LOAD <br /> PLUMBING <br /> FIRE ZONE BASEMENT FIRE SPRINKLERS <br /> REOUIRED MECHANICAL 17 50 � <br /> IIYES iINO <br /> APPRCVALS BY DATE OTHER <br /> 1. ENViRO�UdENtnL CHECK L��ST PENAL7V U.B.C. <br /> 2. Bl11LDiNG PLnNS SEC.3C!(a) <br /> 3. FIRE HYDRANT T�TA� ].7 S O <br /> 4 FIRE PqOTEC710N SVSTEM PERMIT VALIDATION <br /> 5. GRADING VJHEN PROPERLY VALIUAT[D�IIJ THIS SPACE)THIS IS YOUR PERh11T <br /> �_ 6. D.i/.INAGE z� a � ; t;0 I 7. 5� �'� -]! <br /> Q� <br /> 7 E'JVIRONMENTAL IMPACT STATEMENT . , , , � <br /> 8. F%ALTHDISTRICT •I l!U'R RE�E}p7 � <br /> APP!i.:AT10N ACf BV PLANS CHECKED BV APPR.FOR ISSUANCE DY 7HA N K YO�U <br /> ,abDRE55 FILE ' F 0 � 83 <br />