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__� <br /> `,". .`:,��T���F � CON�TRUCTIQ 'V <br /> everett PERMI� PERMIT N0. 15308 <br /> CI7Y HALL 259�87a5 <br /> � EVERET7,WA98207 ❑ COMBINATION ❑ BUILDING � MECHANICAL ❑ PLUMBING <br /> OWNER MAILADDFESS CITY 21P PHONE <br /> BURCH CAMBERS 4027 FRIDAY AVENUE EVERETT tJA 98203 259-6303 743-6376 <br /> ARCHITEGT OF OESIGNER MAIL AppRESS GITY ZIP PMONE <br /> GENERAL CONTRAC70R MAIL AOORE55 CITY ZIP PMONE LICENSE� <br /> MECHANICRL CONTPACTOR MAIL ADDRESS CI'Y 21P PHONE LICENSE� <br /> VALLEY NATURAL GAS 519 - SE Everett Mall Way Everett WA 98204 355-7730 <br /> PWM1IBING CONTRACTOR MAIL ADDRESS LITY ZIP PMONE LICENSE� <br /> VALLENG153LI <br /> CLF55OF WOFK <br /> I� NEW ❑ ADDI710N CI AL7ERATION ❑REPAIR ❑ DEMOLITION ❑ FENCE O SIGN ❑ WOOD S70VEIFIREPLACE INSERT <br /> VALUATION Of WORK <br /> S <br /> UES:.RIBE WOFlK <br /> Install gas piping for water heater and furnace <br /> PROPOSED USEOF BUILDING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS <br /> APPLIC�TION AND KNOW THE SAME TO BE TRUE AND o <br /> lE6AL0E5GRIPTIONOFPROPERTV�SMOWBELOWORATfACHFOUHCOPIES� CORRECi. ALL PROVISIONS OF LAWS AND ORDINANCES .--� <br /> GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH "" <br /> lOT_BLOGK_OF WHETHER SPECIFIED HEREIN OR NOT.THE GRANTING OF A m <br /> PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE <br /> OR CANCEL THE PROVISIONS OF ANY OTHER STPTE OR <br /> LOCAL LAW REGULATING CONSTRUCTION OR THE -i '� <br /> PERFORMANCE OF CONSTRUCTION. � -+ <br /> JOB A SIGN TURE OF CONTRACTO R Al1THORIZED AGE * g�14%85 O m <br /> �`��1� Friday Avenue X _ c o <br /> mo <br /> PLUMBING M HANICAL n <br /> om <br /> NO. TYPE OF FIXTURE OR ITEM FEE N0. TYVE OF E�UIPMENT FEE � 2 <br /> WATERCLOSET�TOILEn AIR COND.UNITS— H.P. EA. S --I <br /> BATH?_a REFRIGERATION UNITS — H.P.CA. .. <br /> LAVATORY�WASHBASIN) <br /> BOILERS— H.P. EA. Ca � <br /> SHOWER GAS FIRED A.C. UNI75 —70NNAGE EA. � M <br /> KITCHEN SINK 8 OISP. FORCED AIR SYSTEMS— B.T.U. �O� �JOO 6 OO K N <br /> DISHWASHER WALL HEATERS— B.T.U. M �i <br /> O � <br /> LAUNDPY TRAV UNIT HEATERS— B.T.U. M �'I 3 <br /> CLOTHES WASHER EVAPORATIVE COOLERS —1 m <br /> 2 <br /> W47ER HEATER CLOTHES ORYEfiS fn N <br /> URINAL VENTILA710N FAN � r <br /> DRINKING FOUNTAIN RANGE HOOD C N <br /> FLOOR DRAIN AIR HAN�LING UNIT — C.F.M. 3 v+ <br /> m <br /> VACUUM BREAKERS S70VE —WOOD � � <br /> ROUF DRAINS— RAINLEADE(iS METAL FIREPLACE 8 CHIMNEY • m <br /> ➢ <br /> SINK ISERVICE— BAR,EiC.) FIREPLACE INSEP7 A <br /> HEAT PUMP = <br /> water eater 4 50 Z <br /> gas piping 2 00 � <br /> _ <br /> SUB TOTAL i SUB TO7AL S �Z �JO ln <br /> PERMIT S PEHMIT S �O OO Zo <br /> TOTAL FEE 5 TO7AL FEE f ZZ 5O —I <br /> SIDE YARD SETBACK STREET SETBAGK REAR YA(iD SLTBACK PLAN CHECK NUMBER PLAN CMECK FEE n <br /> FEE RECEIPT NO. m <br /> USE ZONE LOT AREA VACANT SITE FEES VALUATION FEE <br /> �.�:YES �.�.NO <br /> TYPE OF CONST. OCCUPANGY GROUP NO.OF DWELLING UNI7S <br /> BUILDING 5 <br /> SIZE OF BLDG NO.OF STORIES MA%.OCC. LOAD <br /> PLUMBING <br /> FIFE ZONE BASEMENT REOUIRED KlERS MECHANICAL ZZ 5O <br /> � -.YES �. NO <br /> APPROVALS 0Y OATE OTHER <br /> 1.ENVIRONMENTAL CHECK LIST PENALTY U.B.G. <br /> SEC.903 Ial <br /> 2.BUILDING PLANS TO7AL ZZ 5O <br /> �.FIRE HVDRANT <br /> 4.FIRE PROTECTION SYSTEM PEHMIT VALIDATION <br /> S.GRADING WHEN PFOPERLY VALIDATED(IN 7HI5 SPACE)THIS IS YOUR.PERMIi ��� <br /> � <br /> 6.�RAINAGE M <br /> 7.ENVIRONMENTALIMPACTSTATEMENT � <br /> 8.HEALTH DISTRICT � � �� <br /> APP!ICATION ACC.BY PLANS CHECKED BY APPP.FOR ISSUANCE BY , <br /> ADDRESS FIi.[ <br />